bluuebunny/crossref_metadata_2025 huggingface dataset:
Rationale and Design of the Cardiac Magnetic Resonance Imaging Substudy of the ONTARGET Trial Programme
Authors: Anderson C
Published: February 2013

Angiotensin-converting enzyme (ACE) inhibitors have been shown to improve cardiovascular disease outcomes in high-risk patients, but evidence for the cardioprotective effects of angiotensin II receptor blockers (ARBs) is less extensive. The ONgoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial (ONTARGET) and the parallel Telmisartan Randomized AssessmeNt Study in aCE iNtolerant subjects with cardiovascular Disease (TRANSCEND) - which together form The ONTARGET Trial Programme – are long-term, large-scale, double-blind, multinational outcome studies with the primary objectives of determining if the combination of the ARB telmisartan 80 mg and the ACE inhibitor ramipril 10 mg is more effective than ramipril 10 mg alone, and if telmisartan is at least as effective as ramipril (in the case of ONTARGET), and if telmisartan is superior to placebo (in the case of TRANSCEND), in providing cardiovascular protection for high-risk patients. A pre-defined substudy is being conducted within The ONTARGET

Trial Programme to compare the effects of these agents, alone and in combination, on cardiac structure and function. The substudy overcomes criticisms of many previous studies, which have been performed in small numbers of patients using suboptimal methodology, by evaluating changes in left ventricular structure and function using sophisticated technology provided by magnetic resonance imaging (MRI). Some 300 randomized patients within ONTARGET, recruited from selected centres in Australia, Canada, Germany, Hong Kong, New Zealand and Thailand, will have MRI undertaken at baseline and at 2-year follow-up. As this method of assessing left ventricular dysfunction is somewhat time-consuming, expensive and complex, and in the light of current interest in the role of B-type natriuretic peptide (BNP) as a simple, inexpensive diagnostic and prognostic tool, the substudy will also examine whether changes in BNP during follow-up correlated with changes in left ventricular dysfunction.
The 5-Hydroxytryptamine2A Receptor Antagonist Sarpogrelate Hydrochloride Inhibits Acute Platelet Aggregation in Injured Endothelium
Authors: Houkin K , Nakayama N , Nonaka T , Koyanagi I
Published: February 2013

In this study, the effect of sarpogrelate hydrochloride, a 5-hydroxytryptamine2A receptor antagonist, on platelet aggregation at the site of injured carotid artery endothelium was examined. The rat common carotid artery was clamped for 30 min to induce endothelial injury. Sarpogrelate hydrochloride was administered before and after the injury, and the effects were compared with those in rats receiving sham operation only and those receiving clipping injury but no sarpogrelate hydrochloride. The animals were killed 24 h after the procedure. The common carotid artery was examined by scanning electron microscopy and stained immunochemically for factor VIII. Sarpogrelate hydrochloride treatment was associated with reduced aggregation of platelets on electron microscopy and lower expression of factor VIII at the injured intima. Sarpogrelate hydrochloride has an inhibitory effect on platelet aggregation at the intima in the acute stage after injury, suggesting that this drug may be used to prevent early ischaemic complications after surgical or endovascular arterial intervention.
Comparison between High and Low Molecular Weight Hyaluronates in Knee Osteoarthritis Patients: Open-label, Randomized, Multicentre Clinical Trial
Authors: Lee PB , Kim YC , Lim YJ , Lee CJ , Sim WS , Ha CW , Bin SI , Lim KB , Choi SS , Lee SC
Published: February 2013

Efficacy and safety of high and low molecular weight hyaluronates in knee osteoarthritis patients were compared in a randomized, open-label trial. Patients in the high molecular weight hyaluronate group were treated once weekly for 3 weeks and in the low molecular weight group once weekly for 5 weeks. We evaluated weight-bearing pain, degree of flexion, swelling and knee tenderness; frequency and amount of rescue medication; patient and investigator global assessment of pain, and safety over 12 weeks after final injection of study medication. Significant improvements in pain and WOMAC-Likert scores were observed in both groups, but not between groups. Knee joint pain improvement was noted in both groups by patients and investigators during follow-up. Close correlation was observed between patient-and investigator-reported data. There was no significant difference in side-effects between the groups. In conclusion, the efficacy and safety of high and low molecular weight hyaluronate are similar.
Amiodarone Offsets the Cardioprotective Effects of Ischaemic Preconditioning against Ischaemia/Reperfusion Injury
Authors: Koo EH , Park YC , Lim SH , Kim HZ
Published: February 2013

Both ischaemic preconditioning (IPC) and amiodarone protect against myocardial ischaemia. We examined whether a combination of IPC and amiodarone demonstrated an additive protective effect in isolated rat hearts ( n = 40). The controls (group I) were subjected to ischaemia/reperfusion injury; group II was subjected to cycles of IPC prior to ischaemia/reperfusion injury; group III was subjected to ischaemia in the presence of amiodarone (10−10 mol/l); and group IV was subjected to IPC followed by ischaemia in the presence of amiodarone (10−10 mol/l). Amiodarone produced the best preserved left ventricular end-systolic pressure and dP/dtmax, less developed ventricular stiffness, the shortest arrhythmia duration, and the smallest infarct size among the groups. All of the myocardial protective effects against ischaemia/reperfusion injury were diminished or abolished when IPC and amiodarone were applied sequentially.
The Effects of Exercise in Forest and Urban Environments on Sympathetic Nervous Activity of Normal Young Adults
Authors: Yamaguchi M , Deguchi M , Miyazaki Y
Published: February 2013

In Japan, forest-air bathing and walking (shinrin-yoku) has been proposed as a health-facilitating activity in which people spend a short period of time in a forest environment. Initially, we examined the usefulness of salivary amylase activity as an indicator of an individual's stress levels in a forest environment. The circadian rhythm of salivary amylase activity was measured in healthy young male subjects under stress-free conditions. The salivary amylase activity remained relatively constant throughout the day. Salivary amylase activity was then measured before and after walking in both urban and forest environments using a hand-held monitor. Our results indicated that (i) the circadian rhythm fluctuations in salivary amylase activity were much smaller than the stressor-induced variations; (ii) salivary amylase activity was an excellent indicator of the changes in sympathetic nervous activity; and (iii) the forest was a good environment in which people could experience much less environment-derived stress.
The Maternal and Neonatal Effects of the Volatile Anaesthetic Agents Desflurane and Sevoflurane in Caesarean Section: A Prospective, Randomized Clinical Study
Authors: Karaman S , Akercan F , Aldemir O , Terek MC , Yalaz M , Firat V
Published: February 2013

This study compared maternal and neonatal outcomes in women undergoing elective caesarean section under general anaesthesia with desflurane or sevoflurane; the neonatal effects were also compared with those in women undergoing epidural anaesthesia. Fifty women requesting general anaesthesia were randomly assigned to receive either 3% desflurane or 1% sevoflurane. Twenty-five women requesting regional anaesthesia received epidural anaesthesia with ropivacaine. Comparing desflurane and sevoflurane with respect to their maternal haemodynamic effects, maternal blood pressure levels were higher and tachycardia was more frequent in the desflurane group. Comparing general and epidural anaesthesia, no significant differences were detected in terms of neonatal Apgar scores or neurological adaptive capacity scores. In conclusion, 3% desflurane or 1% sevoflurane for general anaesthesia and ropivacaine for epidural anaesthesia for elective caesarean section had similar effects on neonatal outcomes. In women who received desflurane, blood pressure and heart rate elevation were significantly higher than in the sevoflurane group, though this difference did not have any clinical importance.
Traditional Chinese Medicine and Kampo: A Review from the Distant past for the Future
Authors: Yu F , Takahashi T , Moriya J , Kawaura K , Yamakawa J , Kusaka K , Itoh T , Morimoto S , Yamaguchi N , Kanda T
Published: February 2013

Traditional Chinese medicine (TCM) is a complete system of healing that developed in China about 3000 years ago, and includes herbal medicine, acupuncture, moxibustion and massage, etc. In recent decades the use of TCM has become more popular in China and throughout the world. Traditional Japanese medicine has been used for 1500 years and includes Kampo-yaku (herbal medicine), acupuncture and acupressure. Kampo is now widely practised in Japan and is fully integrated into the modern health-care system. Kampo is based on TCM but has been adapted to Japanese culture. In this paper we review the history and characteristics of TCM and traditional Japanese medicine, i.e. the selection of traditional Chinese herbal medicine treatments based on differential diagnosis, and treatment formulations specific for the ‘Sho’ (the patient's symptoms at a given moment) of Japanese Kampo - and look at the prospects for these forms of medicine.
The Biological Properties of a Novel Ethyl Methacrylate Resin
Authors: Suzuki T , Jinno S , Hattori N , Okeya H , Ishikawa A , Deguchi M , Ohno Y , Kawai T , Noguchi T
Published: February 2013

A novel ethyl methacrylate (EMA) resin was developed to overcome the tissue, organ and systemic damage associated with the residual monomer of conventional methyl methacrylate (MMA) resin bone cement. EMA resin is a chemical/ photopolymerizable material and is easy to handle during clinical procedures. The biocompatibility of EMA was evaluated in accordance with ISO10993-6. No inflammatory response was observed 1 and 9 weeks after implantation in the dorsal subcutaneous tissue of ddY mice. EMA resin also demonstrated better biocompatibility when compared with conventional bone cements. Poly-l-lactic acid (PLLA) was used as a carrier for bone morphogenetic protein (BMP) and added to the EMA slurry. The EMA-PLLA composite membrane was sticky and BMP readily adhered to its surface. The EMA-PLLA-BMP composite membrane induced new bone formation, the new bone growing in the shape of the EMA in the thigh muscle pouch of ddY mice. This novel EMA resin has many potential clinical applications.
Methylenetetrahydrofolate Reductase C677T is Not Associated with Expression of Pyrimidine Metabolic Enzyme Genes in Colorectal Cancer
Authors: Takeda R , Kamano T , Sakamoto K , Sugano M , Hosoda S , Watanabe T , Maeda T , Kojima Y
Published: February 2013

Methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism may influence the chemosensitivity of colorectal cancers to fluorouracil (5-FU) by increasing intracellular 5, 10-methylenetetrahydrofolate. The effect of this polymorphism on the expression of thymidylate synthase (TS), dihydropyrimidine dehydrogenase (DPD), orotate phosphoribosyl transferase (OPRT) and thymidine phosphorylase (TP) in colorectal cancer was investigated. The MTHFR C677T polymorphism was analysed and TS, DPD, OPRT and TP mRNA expression was measured in tumour and adjacent normal mucosal tissue. In all patients, the genotypes of the tumour and normal tissues were identical. No differences were found in the expression of TS, DPD or TP mRNA by genotype in either tumour or normal tissue. Although the OPRT mRNA level in tumour tissue was not associated with the genotype, normal mucosa with the TT genotype showed a significantly higher OPRT mRNA level than mucosa with other genotypes. The MTHFR C667T polymorphism is not associated with intratumoural expression of TS, DPD, OPRT or TP.
Multicentric Cardiac Myxoma Treated with Extended Surgery
Authors: Yilmaz M , Gurbuz O , Cengiz M
Published: February 2013

We present the case of a 37-year-old male patient with a multicentric myxoma admitted to hospital with dyspnoea, syncope and chest pain. Physical examination revealed a grade 3/6 systolic murmur at the left lower sternal border and diffuse bilateral lung rales. Transthoracic echocardiography and thoraco-abdominal computed tomography revealed a right atrial mass and a right ventricular mass obstructing the outflow tract. The patient underwent urgent surgical treatment. At operation, a solitary right atrial myxoma and a right ventricular myxoma originating from the tricuspid valve and attached to the free wall of the right ventricle were seen. The tumours were successfully excised and the tricuspid valve was replaced with a No. 33 Omnicarbon® metallic valve. The right ventricular free wall was repaired with a glutaraldehyde-treated pericardial patch. Histopathological examination of the tumours confirmed the diagnosis of myxoma. Post-operative recovery was uneventful and there was no recurrence after 1 year's follow-up.
Comparative Study of Barnidipine and Felodipine in Chinese Patients with Essential Hypertension
Authors: Zhu W , Li T , Ni C , Liu H , Fang L , Shang M , Kikkawa T , Katoh H , Yamamoto M
Published: February 2013

This study evaluated the efficacy and safety of barnidipine for the treatment of mild-to-moderate essential hypertension in Chinese patients. A total of 131 patients were randomized to receive either barnidipine (10-15 mg) or felodipine (5-10 mg) once daily for 4 weeks. Both drugs reduced blood pressure significantly, with ≥ 87% of patients obtaining a marked or moderate effect. The mean ± SD reductions in systolic and diastolic blood pressure were 19.2 ± 13.6 and 14.4 ± 7.0 mmHg, respectively, for barnidipine treatment, and 20.3 ± 11.3 and 14.7 ± 7.7 mmHg, respectively, for felodipine treatment. There were no significant differences between the two drugs in terms of anti-hypertensive effect, heart rate, laboratory test results or incidence of adverse events. More patients taking felodipine experienced palpitations, but this difference was not statistically significant. Barnidipine is as efficacious and safe as felodipine in the treatment of essential hypertension in Chinese patients.
Prevention of Gynaecological Adhesions using Haemostatic Fleece in a Rabbit Model
Authors: Dickneite G , Rolle U , Rosenthal D
Published: February 2013

This pre-clinical study was performed to investigate the ability of the haemostatic fleece TachoComb® to prevent adhesion formation following uterine surgery. Thirty rabbits were randomized to receive TachoComb® or no intervention following incision to the right uterine horn. After 14 days, the animals were killed and examined for the presence of adhesion. The lengths of any adhesions were measured and the severity was recorded as a score (0, no adhesion; 1, adhesion easy to lyse; 2, adhesion lysed with traction; 3, adhesion separated by sharp dissection). The incidence of adhesions was 100% in the control group compared with 33% in the TachoComb®-treated animals. The mean adhesion score was significantly lower (0.7 versus 2.2) and the mean adhesion length category was significantly shorter (0.4 versus 2.0) with TachoComb® than in the control group. This study indicates that TachoComb® is a well-tolerated and effective means of preventing adhesion following gynaecological surgery.
Interleukin-4, Interleukin-8 and E-selectin Levels in Intranasal Polyposis Patients with and without Allergy: A Comparative Study
Authors: Ural A , Tezer MS , Yücel A , Atilla H , İleri F
Published: February 2013

Intranasal polyposis is a chronic inflammatory upper airway disease with unknown aetiology. Interleukin (IL)-4 and IL-8 play very significant roles in allergic events and infectious inflammation, respectively. In contrast, E-selectin is important in the initiation and organization of inflammation. In this study, levels of IL-4, IL-8 and E-selectin were measured in nasal mucosa specimens of intranasal polyposis patients with and without allergic rhinitis, and healthy controls. Healthy controls had significantly higher IL-4 levels than allergic patients and non-allergic patients; IL-4 levels were similar in allergic and non-allergic patients. Allergic and non-allergic patients had significantly higher IL-8 levels than healthy controls; IL-8 levels were comparable in allergic and non-allergic patients. E-selectin levels were similar in all groups. The infection-based theory, represented by IL-8, seems to be more likely than the allergy-based theory, represented by IL-4, for the pathogenesis of nasal polyposis.
Thoracic Epidural Clonidine Attenuates Haemodynamic Responses Induced by Endobronchial Intubation
Authors: Choi SU , Lim CH , Lee HW , Lee SH , Sun K , Lim HJ , Yoon SM , Chang SH
Published: February 2013

Laryngoscopy and endobronchial intubation usually cause transient hypertension and tachycardia. We investigated whether thoracic epidurally injected 3 μg/kg clonidine attenuates cardiovascular responses to intubation compared with 2 μg/kg fentanyl and 1 mg/kg lidocaine. Epidural catheterization was performed at the T6–T7 or T7–T8 intervertebral space, and saline or clonidine in saline was injected 20 min before anaesthetic induction. Anaesthesia was induced using 5 mg/kg thiopental sodium and 0.1 mg/kg vecuronium. Laryngoscopy and endobronchial intubation were performed 2 min later. Mean blood pressure and heart rate were measured throughout anaesthetic induction. In the control group and the fentanyl group, mean blood pressure and heart rate 3 min after endobronchial intubation were elevated significantly compared with baseline. In the clonidine group, however, mean blood pressure and heart rate did not increase compared with baseline. The control group had higher mean blood pressure and heart rate than the clonidine group 3 min after endobronchial intubation. Thoracic epidural clonidine may attenuate the haemodynamic response to endobronchial intubation.
Predicting Chronic Leukaemias from Assessment of Complete Peripheral Blood Counts
Authors: Hayran M , Koca E , Haznedaroglu IC , Unsal I , Durgun B , Guvenc F , Ozturk B , Ratip S , Ozcebe OI
Published: February 2013

The chronic leukaemias include two distinct chronic neoplastic disease states, namely chronic myelogenous leukaemia (CML) and chronic lymphocytic leukaemia (CLL). The aim of this study was to assess the utility of leucocyte count, neutrophil percentage and absolute lymphocyte count from differential complete blood count analyses as indicators of the possible presence of CML and CLL. Blood counts from 102 patients with histopathologically confirmed CML and CLL were compared with counts for 858 cancer-free control subjects. Optimal cut-off values were identified by selecting values with the highest sensitivity–specificity combination for each blood count parameter for the two diseases. The results indicated that any individual with mature-appearing lymphocytes at a level > 6.65 × 109/l in the peripheral blood should be examined further for CLL, and that any individual with a leucocyte count > 18.0 × 109/l or a neutrophil proportion > 72.6% should be investigated for CML.
Azelnidipine, a New Long-acting Calcium-channel Blocker, Inhibits Tumour Necrosis Factor-α-induced Monocyte Chemoattractant Protein-1 Expression in Endothelial Cells
Authors: Matsui T , Yamagishi S , Nakamura K , Inoue H
Published: February 2013

Dihydropyridine-based calcium antagonists are among the most widely used drugs for the treatment of hypertension. Since azelnidipine is a highly lipid-soluble dihydropyridine-based calcium antagonist with high vascular affinity, it is conceivable that azelnidipine could play a protective role against atherosclerosis. The aim of this study was to determine whether azelnidipine could suppress the expression of monocyte chemoattractant protein-1, a principal chemokine which mediates the recruitment of monocytes to the vasculature, in tumour necrosis factor (TNF)-α-exposed human umbilical vein endothelial cells. TNF-α, at a concentration of 10 ng/ml, upregulated monocyte chemoattractant protein-1 mRNA levels about seven-fold. Azelnidipine, 10 nmol/l, was found to inhibit the TNF-α-induced upregulation of monocyte chemoattractant protein-1 mRNA levels in human umbilical vein endothelial cells significantly. Furthermore, azelnidipine suppressed TNF-α-induced monocyte chemoattractant protein-1 production by human umbilical vein endothelial cells. This study demonstrates a novel beneficial aspect of azelnidipine, whereby azelnidipine could play a protective role against atherosclerosis by suppressing monocyte chemoattractant protein-1 overexpression in endothelial cells.
Calcium Sulphate Delivery System with Tobramycin for the Treatment of Chronic Calcaneal Osteomyelitis
Authors: Papagelopoulos PJ , Mavrogenis AF , Tsiodras S , Vlastou C , Giamarellou H , Soucacos PN
Published: February 2013

The case of a 24-year-old woman with Pseudomonas aeruginosa and Proteus mirabilis chronic calcaneal osteomyelitis is presented. Extensive debridement of the necrotic bone and application of tobramycin-loaded polymethylmethacrylate beads was performed and ciprofloxacin was given post-operatively. Three months later, laboratory tests, including complete blood cell count, erythrocyte sedimentation rate and C-reactive protein, were normal. At this time, extensive surgical debridement and filling of the osseous defect with autologous iliac cancellous bone graft and tobramycin-impregnated calcium sulphate pellets and paste were performed. Oral ciprofloxacin was administered for 3 months after surgery. At the latest follow-up, 2 years later, the patient had full weight-bearing function; there was no recurrence of the infection, and complete incorporation of the autologous bone and calcium sulphate graft with the host bone was observed. This case demonstrates that two-stage surgical treatment with extensive debridement and tobramycin-impregnated calcium sulphate was effective in treating chronic calcaneal osteomyelitis.
Alcohol and Acute Myocardial Infarction
Authors: Biyik I , Ergene O
Published: February 2013

A number of studies from different countries and several large-scale meta-analyses have reported reduced coronary heart disease rates among those regularly consuming mild to moderate amounts of alcohol compared with those abstaining from alcohol. In contrast, various studies have also reported that heavy alcohol consumption promotes the progression of atherosclerosis and that binge drinking might trigger embolic stroke and acute myocardial infarction. We discuss the association between alcohol consumption and acute myocardial infarction on the basis of evidence from literature published recently. Alcohol consumption has both favourable and unfavourable effects on metabolism, lipid profile, blood coagulation and fibrinolysis, blood pressure and vascular tone depending on the amount of alcohol consumed and the way that it is drunk (i.e. drinking habits). We conclude that it is extremely important to warn people of the risks associated with binge drinking and to encourage them to remain within the recommended safe limits for alcohol consumption.
Barrier Function of the Gut and Multiple Organ Dysfunction after Cardiac Surgery
Authors: Braun J-P , Buhner S , Kastrup M , Dietz E , Langer K , Dohmen PM , Lochs H , Spies C
Published: February 2013

We studied the influence of sequential involvement of the gastrointestinal (GI) tract on the development of multiple organ dysfunction (MOD) after cardiopulmonary bypass (CPB). One hundred and forty-six patients undergoing elective cardiac surgery were included in this prospective observational study. Standardized oral inert-sugar tests (sucrose, lactulose, mannitol, sucralose) were performed before and after CPB in different patients. Enzyme-linked immunosorbent assay of plasma levels of endotoxin core antibodies (EndoCAb) were performed peri-operatively. The functional mucosal surface was calculated from the amount of mannitol absorbed from the GI tract. Lower urine concentrations of absorbed mannitol were observed pre-operatively in patients developing MOD. In binary logistic regression this was an independent parameter. Decreased plasma concentrations of EndoCAb after surgery were seen in every patient, but were more significant in patients developing MOD. A reduced pre-operative functional mucosal surface may predict the early occurrence of MOD after surgery.
Evaluation of Driver Stress in a Motor-vehicle Driving Simulator Using a Biochemical Marker
Authors: Yamaguchi M , Sakakima J
Published: February 2013

The purpose of this study was to evaluate salivary amylase activity (sAMY) as an indicator of the acute psychological effects of driving. The influence of the operation of a device not directly associated with driving was also estimated using a car navigation system. The psychological effects of driving were examined using sAMY analysis, oculomotor angle and subjective evaluation with a questionnaire, and the methods were compared. The change in sAMY over time was analysed before and during driving. The results indicate that the psychological effect of driving-induced stress, a condition that cannot be easily detected or recognized by a subjective evaluation, is quickly quantified using sAMY. Moreover, the results suggest that the operation of a non-driving-related device may also reduce the driver's capacity to concentrate on driving.
Atrial Fibrillation after Off-pump Coronary Artery Surgery: A Prospective, Matched Study
Authors: Turk T , Vural H , Eris C , Ata Y , Yavuz S
Published: February 2013

The effect of cardiopulmonary bypass and myocardial ischaemia on the occurrence of atrial fibrillation (AF) after coronary artery bypass graft (CABG) was studied in 136 patients undergoing off-pump CABG who were matched for age and number of distal anastomoses with 136 patients undergoing on-pump CABG. Possible risk factors for postoperative new-onset AF were recorded. AF occurred in 64 (24%) of the 267 patients for whom data could be analysed. AF occurred in 29 patients (22%) in the off-pump group versus 35 (26%) in the on-pump group, but this difference was not statistically significant. On univariate analysis, age and length of hospital stay were significant risk factors for the occurrence of AF. In a multivariate analysis that included operative technique, age was found to be the only significant risk factor. In conclusion, the occurrence of AF after CABG does not depend on the type of operation.
Ocular Bleeding Related to Warfarin Anticoagulation in Patients with Mechanical Heart Valve and Atrial Fibrillation
Authors: Biyik I , Mercan I , Ergene O , Oto O
Published: February 2013

We investigated the incidence of ocular bleeding in patients taking anticoagulant therapy (warfarin) and its association with other related factors. We examined 210 patients taking warfarin and 210 gender-and age-matched controls for ocular bleeding. Patients and controls were examined by external ocular examination and fundoscopic examination. The incidence of ocular bleeding was 11.4% in patients and 3.8% in controls. It was five times higher in patients with hypertension than in other patients. The incidence of ocular bleeding was higher in older than in younger patients. No association was found between ocular bleeding and factors such as gender, international normalized ratio, duration of warfarin therapy, concomitant aspirin use and diabetes mellitus. Thus, warfarin therapy increases the frequency of ocular bleeding. The higher incidence of ocular bleeding in the patients with hypertension and advanced age should be kept in mind and this subgroup of patients taking warfarin should be monitored closely.
Use of a Geographic Information System in an Epidemiological Study of Measles in Istanbul
Authors: Ulugtekin N , Alkoy S , Seker DZ
Published: February 2013

A geographic information system was used in an epidemiological study of measles in Istanbul, Turkey. The aim was to obtain more reliable results and to increase the facilities for spatial monitoring in epidemiological studies. The Gaziosmanpasa district of Istanbul was selected as it experiences the highest level of migration, and currently has the highest population growth rate of the city's districts. The epidemic distribution of measles was investigated on the basis of examination of 320 children. The number, geographical distribution, complications and time of measles outbreaks were analysed and represented in thematic maps (a small selection is shown in this paper). The results were evaluated and, in view of these results, new vaccination plans were arranged.
Neutralizing Antibodies to Interferon β-1b are not Associated with Disease Worsening in Multiple Sclerosis
Authors: Goodin DS , Hurwitz B , Noronha A
Published: February 2013

The clinical impact of neutralizing antibodies (NAbs) on interferon beta (IFNβ) efficacy was studied in three large patient cohorts comprising 6698 multiple sclerosis (MS) patients receiving IFNβ-1b across North America, Europe, and Australia. In North America and Europe, NAb testing was generally undertaken because of a poor clinical response; in Australia, it was mandatory for every patient. Of the 6697 patients tested, 28.9% had at least one NAb titre ≥ 20 neutralizing units (NU)/ml, 14.4% had NAb titres ≥ 100 NU/ml and 7.7% had NAb titres ≥ 400 NU/ml. The NAb-positive rate of 37.0% in Australia was significantly greater than those in North America (21.3%) and Europe (27.6%), and this was observed at every NAb titre level. Our results suggest that NAbs are not responsible for poor clinical responses and that NAb status is of little clinical value. These findings will need to be confirmed in a large independent study.
Standardized Uptake Values of Normal Organs on 18F-Fluorodeoxyglucose Positron Emission Tomography and Computed Tomography Imaging
Authors: Zincirkeser S , Şahin E , Halac M , Sager S
Published: February 2013

Standardized uptake values (SUVs) of normal organs were evaluated by 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography and computed tomography (PET-CT) scanning. Seventy patients (38 men and 32 women) with no non-physiological 18F-FDG uptake participated in the study. All patients fasted for at least 4 h before PET-CT imaging and their fasting blood glucose levels were within the normal range. Image acquisition was performed after intravenous administration of 18F-FDG and images were obtained from the vertex to the upper thigh region. The SUVs of various organs were determined from the transverse views. The uptake of 18F-FDG was highest in the cerebrum, cerebellum, myocardium, tonsils, liver and spleen in both sexes. Having knowledge of the physiological uptake of 18F-FDG and normal organ SUVs is required for the correct interpretation of whole-body 18F-FDG-PET-CT studies.
Immunohistochemical Analysis of PCNA, Ki67 and p53 in Nasal Polyposis and Sinonasal Inverted Papillomas
Authors: Mumbuc S , Karakok M , Baglam T , Karatas E , Durucu C , Kibar Y
Published: February 2013

Immunoreactivity of proliferating cell nuclear antigen (PCNA), Ki67 and p53 in inflammatory nasal polyp and inverted papilloma tissues was investigated. Immunohistochemistry was performed using a standard avidin–biotin–peroxidase method, and the immuno-reactivity of PCNA, Ki67 and p53 was quantified by counting immunostained nuclei in at least 1000 epithelial cells. The mean labelling index (percentage of immunostained cells) for PCNA was 40.68 in the inverted papilloma group and 14.73 in the nasal polyp group, and for Ki67 was 15.43 in the inverted papilloma group and 2.64 in the nasal polyp group. Both of these differences between the inverted papilloma and nasal polyp groups were significant. Immunoreactivity for p53 was detected in five (35.7%) inverted papilloma patients and two (9.5%) nasal polyp patients. The increase in epithelial cell proliferation seemed to be greater in inverted papillomas than in inflammatory nasal polyps. Increased epithelial cell proliferation may be involved in the development of inverted papillomas.
Antimicrobial Resistance and Serotypes of Nasopharyngeal Strains of Streptococcus pneumoniae in Chinese Children with Acute Respiratory Infections
Authors: Yao K , Shen X , Yu S , Lu Q , Deng L , Ye Q , Zhang H , Deng Q , Hu Y , Yang Y
Published: February 2013

This prospective, multicentre, nasal carriage study in Chinese children with upper respiratory infection was carried out over the period from 2000 to 2002. Overall, the prevalence of pneumococcal carriage was 24.9%. Antimicrobial susceptibility tests were performed for 887 isolates of Streptococcus pneumoniae of which 33.5% were intermediately susceptible to penicillin and 6.4% were resistant. Multidrug resistance was very common. Pneumococcal strains ( n = 625) were serotyped, showing 72.2% were covered by the 23-valent pneumococcal polysaccharide vaccine and 57.6% by the seven-valent pneumococcal conjugate vaccine. Sero-groups 19 and 23 were significantly associated with penicillin resistance, which is increasing in China. Erythromycin, tetracycline and sulphamethoxazole/trimethoprim cannot be recommended as first-line treatments for respiratory tract infection as in some other developing countries. These features of serotype distribution are of importance for surveillance in the era of the new conjugate vaccine. In particular, these features will allow for documentation of serotype replacement after the introduction of widespread vaccination.
Post-operative Blood Salvage and Retransfusion in Total Hip and Knee Arthroplasty
Authors: Athanasoulias V , Mavrogenis AF , Sdrenias CV , Mitsiokapa EA , Lourikas V , Papagelopoulos PJ , Christodoulou NA
Published: February 2013

This retrospective study evaluated the safety and efficacy of post-operative blood salvage and retransfusion in 430 patients undergoing total hip arthroplasty and 530 patients undergoing total knee arthroplasty. Volumes of autologous blood retransfused (mean ± SD) were 525 ± 75 and 660 ± 95 ml in the hip and knee replacement groups, respectively. Overall, 230 patients (24%) also required allogeneic blood transfusion. In a subgroup of 150 randomly selected patients, the values of free haemoglobin in the allogeneic, autologous and patients' blood at the time of surgery were 0.568 ± 0.112, 0.272 ± 0.067 and 0.032 ± 0.011 g/l, respectively. On the first and third post-operative days, the levels in patients' blood were 0.092 ± 0.039 and 0.057 ± 0.028 g/l, respectively. There were no major complications; transient chills and fever were reported in 99 (10.3%) and 115 patients (12.0%), respectively. In conclusion, post-operative blood salvage and retransfusion is a safe way to reduce the need for allogeneic blood transfusion in patients undergoing elective orthopaedic surgery.
Reduced Glomerular Epithelial Protein 1 Expression and Podocyte Injury in Immunoglobulin a Nephropathy
Authors: Tian J , Wang H Ping , Mao Y Ying , Jin J , Chen J Hua
Published: February 2013

Expression of glomerular epithelial protein 1 (GLEPP1), a receptor tyrosine phosphatase present on the apical cell surface of the glomerular podocyte, and podocyte morphology were investigated in renal specimens from 51 patients with biopsy-diagnosed immunoglobulin A nephropathy (IgAN) and 11 controls. Clinical parameters, such as daily proteinuria were obtained from the patients' records and pathological manifestations of IgAN in the specimens were graded. GLEPP1 was strongly expressed and diffusely distributed in the glomeruli of control specimens. GLEPP1 expression was reduced in IgAN, especially in patients with nephrotic proteinuria and severe pathological manifestations. Podocyte injury was evident in IgAN and was associated with lower GLEPP1 expression and higher pathological grade. GLEPP1 expression was also significantly associated with clinical parameters. The results of this study suggest that GLEPP1 expression may be a useful marker of podocyte injury in IgAN, and may be predictive of clinical and pathological severity.
The Anti-proliferative Effects of Recombinant Human Lysozyme on Human Gastric Cancer Cells
Authors: Guo TK , Zhao XH , Xie XD , Chen ZH , Zhou CS , Wei LL , Zhang H
Published: February 2013

We investigated the anti-proliferative effects of recombinant human lysozyme (rHlys) on gastric cancer cell lines and normal human lung fibroblasts. Using conventional molecular cloning techniques we purified rHlys, which we incubated with cultured cells and measured the effects on cell proliferation and viability. At concentrations of 100 and 1000 μg/l, rHlys significantly inhibited the growth of human gastric cancer cell lines. In contrast, 10 and 50 μg/l of rHlys stimulated gastric cancer cell growth. None of the concentrations of rHlys affected cell viability. Only the highest concentration of rHlys (1000 μg/l) inhibited human lung fibroblast growth. Our results suggest that 100 μg/l is the optimum growth inhibiting concentration, which inhibited cancer cell growth but not normal cell growth. Our in vitro findings suggest that genetically engineered rHlys might inhibit human gastric cancer cell proliferation in vivo, so it might warrant further investigation as a potential novel anti-cancer agent.
Killing Effect of the Herpes Simplex Virus Thymidine Kinase/Ganciclovir Enzyme/Prodrug System on Human Nasopharyngeal Carcinoma Cells
Authors: Tang Y , Li J , Zhao S , Liu J
Published: February 2013

A promising new approach for the gene therapy of cancer is the introduction of the herpes simplex virus thymidine kinase (HSV tk) gene into tumour cells, where the HSV tk gene product converts the non-toxic prodrug ganciclovir (GCV) into its cytotoxic metabolite. We constructed a recombinant plasmid containing the HSV tk gene using standard molecular biology techniques in order to investigate whether the HSV tk/GCV enzyme/prodrug system could kill the human nasopharyngeal carcinoma cell line HNE-1. The recombinant plasmid pcDNA3.1(–) CMV.TK was transfected into the HNE-1 cells by electroporation. The expression of HSV tk by the transfected HNE-1/TK cells was confirmed by mRNA amplification and Western blotting. The growth of HNE-1/TK cells was inhibited by GCV in a dose-dependent manner. The HSV tk/GCV system also demonstrated a considerable bystander effect on co-cultured wild type HNE-1 cells. We conclude that the HSV tk/GCV system could be used as gene therapy for nasopharyngeal carcinoma.
Non-invasive Detection of Acute Renal Allograft Rejection by Measurement of Vascular Endothelial Growth Factor in Urine
Authors: Peng W , Chen J , Jiang Y , Shou Z , Chen Y , Wang H
Published: February 2013

Urinary vascular endothelial growth factor (VEGF) was determined by enzyme-linked immunosorbent assay in 199 renal allograft recipients and 80 healthy controls. Urinary VEGF level did not change significantly during the first 8 weeks after transplantation in 119 patients with stable renal function and there were no abnormal histological findings (No-AR). In 67 patients with acute rejection, urinary VEGF was significantly higher (28.57 ± 6.21 pg/μmol creatinine) than in the No-AR patients (3.05 ± 0.45 pg/μmol creatinine) and healthy controls (2.87 ± 0.35 pg/μmol creatinine). At a cut-off point of 3.26 pg/μmol creatinine, sensitivity and specificity for diagnosis of acute rejection were 86.6 and 71.4%, respectively. The 13 patients with subclinical rejection excreted urinary VEGF (16.14 ± 4.09 pg/μmol creatinine) at a significantly higher level than No-AR patients (3.05 ± 0.45 pg/μmol creatinine). At a cut-off point of 4.69 pg/μmol creatinine, sensitivity and specificity for diagnosis of subclinical rejection were 84.6 and 79.8%, respectively. In conclusion, monitoring VEGF in urine might offer a new non-invasive way to detect acute and subclinical rejection in renal transplant recipients.
Study of ATP-binding Cassette Transporter A1 (ABCA1)-mediated Cellular Cholesterol Efflux in Diabetic Golden Hamsters
Authors: Zhu Y , Wang H-J , Chen L-F , Fang Q , Yan X-W
Published: February 2013

The effects of cyclic adenosine monophosphate (cAMP) and atorvastatin on macrophage adenosine triphosphate (ATP)-binding cassette transporter A1 (ABCA1)-mediated cholesterol efflux were investigated in a diabetic animal model. Golden hamsters were fed a high-fat diet which resulted in insulin resistance. Diabetes was induced by a single intraperitoneal injection of streptozotocin (30 mg/kg). Normal golden hamsters were used as controls. Peritoneal macrophages were incubated with apolipoprotein A-1 (apoA-1), 8-bromoadenosine-3′,5′-cyclic monophosphate (8-br-cAMP), and atorvastatin in vitro Intracellular cholesterol accumulation was greater in the diabetic animals than in the insulin-resistant animals. Expression of ABCA1 mRNA in macrophages from diabetic animals was upregulated by 8-br-cAMP and atorvastatin. ApoA-1 caused a time-dependent cellular cholesterol efflux. Both atorvastatin and 8-br-cAMP significantly facilitated ABCA1-mediated cellular cholesterol efflux, with the maximal cholesterol efflux rate observed in the macrophages from diabetic animals. Accumulation of cholesterol in the macrophages of diabetic animals can be significantly alleviated by atorvastatin or 8-br-cAMP through improving ABCA1-mediated cellular cholesterol efflux.
Effects of Melatonin and Rilmazafone on Nocturia in the Elderly
Authors: Sugaya K , Nishijima S , Miyazato M , Kadekawa K , Ogawa Y
Published: February 2013

We compared the effects of melatonin, an antioxidant and sleep inducer in humans, and rilmazafone hydrochloride, a hypnotic, in elderly patients with nocturia. Patients received either melatonin (2 mg/day; n = 20) or rilmazafone (2 mg/day; n = 22) for 4 weeks. There were no significant differences in the mean age, the quality of life (QoL) score and the serum melatonin levels between the two groups at baseline. After 4 weeks' treatment, the number of nocturnal urinations was significantly decreased and the QoL score was significantly improved in both groups. There was no significant difference between the patient-reported effectiveness ratings between the two groups. The serum melatonin level was significantly increased in the melatonin-treated group, but it remained unchanged in the rilmazafone-treated group. Melatonin and rilmazafone were equally effective for nocturia in the elderly. We recommend that the problems of sleep disturbance should be considered when choosing a therapy for nocturia.
Activation of the Calcineurin/NFAT Signalling Cascade Starts Early in Human Hypertrophic Myocardium
Authors: Diedrichs H , Hagemeister J , Chi M , Boelck B , Mμller-Ehmsen J , Schneider CA
Published: February 2013

Cardiac hypertrophy is an independent risk factor for heart failure. Recent studies on gene regulation of proteins have involved intracellular Ca2+ homeostasis. The Ca2+-sensitive phosphatase, calcineurin, is one potential regulator of the hypertrophic response, so we aimed to investigate the calcineurin-dependent signal pathway at different stages of hypertrophy in human myocardium. We found the calcineurin pathway to be significantly activated in hypertrophic compared with non-hypertrophic myocardium as demonstrated by increased calcineurin activity and expression of calcineurin A-β and B, and GATA-4, and a shift of phosphorylated cytoplasmic NFAT-3 into the nucleus as dephosphorylated nuclear NFAT-3. There was a tendency for these changes to be more pronounced in the decompensated compared with the compensated hypertrophic myocardium. The present study provides evidence for significant activation of the Ca2+-triggered calcineurin pathway in hypertrophic humans. Already present in compensated hypertrophy it showed a tendency to a further increase following transition to decompensated hypertrophy.
Systemic Vanadate Ingestion Improves Early Medial Collateral Ligament Repair
Authors: Jiang DP , Li ZZ , Jiang ZT
Published: February 2013

The medial collateral ligament (MCL) of the knee is frequently injured in sport. Repair is slow and often complicated by scar formation which may result in impairment of function. Vanadate is a promising efficacious treatment for tissue injuries and this study aimed to examine its effect in rats on the histological and biomechanical features of MCL healing. Rats received either 0.025 g/kg per day vanadate or equivalent amounts of drinking water (control) by intragastric gavage for 1 week before and 2 weeks after wounding. Repaired sites were dissected out for histological and biomechanical tests 28 days after wounding. Fibre bundles in the vanadate-treated group were uniform and evenly spaced. Furthermore, vanadate significantly increased the diameter of collagen fibrils in the healing tissue. Stiffness and ultimate force of the femur–medial collateral ligament–tibia complex for the vanadate-treated group were significantly higher than for the controls. The results suggest that vanadate significantly improves the histological and biomechanical properties of healing MCL.
Effects of Astragalus Polysaccharides on Chymase, Angiotensin-converting Enzyme and Angiotensin II in Diabetic Cardiomyopathy in Hamsters
Authors: Chen Wei , Li Yi-Ming , Yu Mao-Hua
Published: February 2013

This study investigated the effects of Astragalus polysaccharides (APS), the main active extract from the traditional Chinese medicinal herb Astragalus membranaceus, on myocardial chymase, angiotensin-converting enzyme (ACE) and angiotensin II (Ang II) in diabetic cardiomyopathic hamsters. Plasma levels of insulin, C-peptide and glycosylated serum protein (GSP), plasma and myocardial levels of Ang II, and myocardial gene expression and activity of chymase and ACE were measured after treatment with APS at a dose of 1 g/kg per day or 1 ml of normal saline per day (controls) for 10 weeks. GSP levels, myocardial Ang II levels, and myocardial gene expression and activity of chymase were significantly decreased in diabetic hamsters after treatment with APS compared with controls. These results suggest that APS can inhibit the local chymase–Ang II system in diabetic cardiomyopathy.
Haemostatic Actions of the Folkloric Medicinal Plant Extract Ankaferd Blood Stopper®
Authors: Goker H , Haznedaroglu IC , Ercetin S , Kirazli S , Akman U , Ozturk Y , Firat HC
Published: February 2013

Ankaferd Blood Stopper® (ABS), a standardized mixture of five plants, has been used historically as a haemostatic agent but its mechanism of action remains unknown. This study investigated the in vitro effects of ABS on haemostatic parameters. When added to plasma or serum, ABS induced the very rapid formation of a protein network and erythrocyte aggregation. The levels of coagulation factors II, V, VII, VIII, IX, X, XI, and XIII were not affected by ABS. Plasma fibrinogen activity and antigen levels were decreased following the addition of ABS, in parallel with the prolonged thrombin time. Total protein, albumin, and globulin levels decreased after the addition of ABS. Our findings suggest that ABS stimulates the formation of an encapsulated protein network that provides focal points for erythrocyte aggregation. ABS has the therapeutic potential to be used for the management of haemorrhage and this agent should be investigated further in clinical trials.