bluuebunny/crossref_metadata_2025 huggingface dataset:
Active‐Can Implantable Cardioverter Defibrillator Placement from a Femoral Approach
Authors: GIUDICI MICHAEL C. , PAUL DEBORAH L. , MEIERBACHTOL CYNTHIA J.
Published: May 2003

This report describes a case of an active‐can ICD placed in the thigh. A 74‐year‐old man on chronic renal dialysis had no venous access from cephalic, subclavian, or jugular approaches. Using long active‐fixation leads the device was placed from a femoral approach with good sensing, pacing, and defibrillation parameters. (PACE 2003; 26:1297–1298)
The influence of bladder filling on anorectal function
Authors: Crosbie J. J. , Eguare E. , McGovern B. , Keane F. B. V.
Published: May 2003

Objective  The aim of this study was to develop a technique to simultaneously evaluate bladder and anorectal function. In particular, this study was designed to determine if anal sphincter resting pressure, anal sphincter squeeze pressure and rectal sensation change with bladder filling.

Patient and methods  A pilot study of ten female patients who presented to the pelvic physiology unit for assessment of urinary symptoms was performed. All patients completed a symptom questionnaire and quality of life assessment form. Following informed consent a baseline urodynamic test was performed with the bladder empty and subsequently followed by an anorectal manometric test. Changes in anal sphincter resting pressure, squeeze pressure and rectal pressure were recorded over a ten‐minute period. With the patient lying in the left lateral position, the bladder was then filled with isotonic saline at room temperature at a constant rate of 30ml/min. A continuous assessment of changes in anal sphincter resting pressure during bladder filling was made. Anal sphincter squeeze pressure and rectal sensation were measured at fixed intervals during bladder filling (50, 100, 150 ml etc.) and at fixed intervals relative to bladder capacity (25, 50, 75 and 100% capacity) by stopping bladder filling at the appropriate level.

Results   There was no significant change in anal sphincter resting pressure (Mean difference(s.d.) between bladder full and empty = 2.7(5.6) P = 0.92*), squeeze pressure (Mean(s.d.) difference = 9.5(26.3) P = 0.86*) and rectal sensation (Mean difference(s.d.) first sensation 10(15.2) P = 0.958; Mean difference(s.d.) urgency = 10(17.8) P = 0.07*) on bladder filling.

Conclusion   Under normal physiological circumstances, bladder filling does not influence anorectal function.

*Stastistical analysis: Wilcoxon signed rank sum test. P < 0.05 considered significant. Units = mmHg
Efficacy and tolerance of a new gentamicin collagen fleece (Septocoll®) after surgical treatment of a pilonidal sinus
Authors: Holzer B. , Grüßner U. , Brückner B. , Houf M. , Kiffner E. , Schildberg F. W. , Vogel P. , Rosen H. R. ,   the EMD study group
Published: May 2003

Objective  Pilonidal sinus is common. It causes substantial loss of working hours. The major disadvantage of open wound treatment is the long time required for healing. Primary wound closure is on the other hand often followed by infection. A controlled, multicentre trial was carried out to evaluate the efficacy of a new gentamicin collagen fleece (Septocoll®) combined with primary closure.

Patients and methods  One hundred and three patients (88 men, 15 women, median age 30 years) were included. Fifty‐one were randomised to gentamicin fleece plus primary closure (Genta Group), and 52 patients to open treatment alone (Open Group).

Results  The median interval to wound healing was 17 days in the Genta group and 68 days in the Open group (P = 0.0001, log‐rank test). Two patients in Group 1 developed infection within the first two weeks, requiring reopening of the wound, with primary wound healing occurring in 73%. Failure of primary healing (27%) was usually due to seroma or spontaneous dehiscence which subsequently healed.

Conclusion  The combination of gentamicin collagen fleece (Septocoll®) with primary closure resulted in a shorter period to healing than the open technique without unwanted effects.
The use of transscleral cyclophotocoagulation with a diode laser for the treatment of glaucoma occurring post intracapsular extraction of displaced lenses: a retrospective study of 15 dogs (1995–2000)
Authors: O'Reilly A. , Hardman C. , Stanley R. G.
Published: May 2003

The objective of this retrospective study was to evaluate transscleral cyclophotocoagulation (TSCP) using a diode laser for treating aphakic glaucoma that developed after intracapsular lens extraction (ICLE) had been performed for displaced lenses. Records of 15 dogs (21 eyes) were reviewed. The intraocular pressure (IOP) and the presence of vision were recorded at the time of ICLE and TSCP and at 1, 3, 6–9, 12 and 24 months post TSCP. The glaucoma was considered controlled if the IOP was less than 25 mmHg. The results indicated that the effectiveness of TSCP using a diode laser for treating aphakic glaucoma was of a short‐term duration (1–3 months), with three patients needing repeat TSPC. In addition, adjunctive antiglaucoma medications were often required to maintain an adequately controlled IOP. Over the 24‐month period the number of dogs requiring intrascleral prosthesis, intraocular gentamicin or enucleation, or that were lost to follow‐up, increased.
Idiopathic ocular and nasal granulomatous inflammatory disease in a dog
Authors: Gionfriddo Juliet R. , Krohne Sheryl G. , Powell Cynthia C. , Powers Barbara E.
Published: May 2003

A young female Akita presented for ocular and nasal lesions. Examination showed bilateral 360 degree limbal masses that extended onto the peripheral cornea. In addition, intranasal granulomatous masses were observed by rhinoscopy. Histopathologic examination with immunohistochemical staining showed that these masses were almost identical and were classified as an idiopathic, T‐cell rich, granulomatous inflammation. The dog responded well to anti‐inflammatory medication and the disease remains in remission 2 years after the initial presentation.
Intraocular pressure development after cataract surgery: a prospective study in 50 dogs (1998–2000)
Authors: Chahory Sabine , Clerc Bernard , Guez Julie , Sanaa Moez
Published: May 2003

ObjectiveTo study the course of intraocular pressure (IOP) after cataract surgery in 50 dogs.

DesignProspective study.

AnimalsFifty dogs without preoperative ocular hypertension were selected for cataract surgery.

MethodsAll dogs underwent cataract surgery: 25 by manual extracapsular extraction and 25 by phacoemulsification. For each dog, intraocular pressure was measured before surgery, and 1, 3, 5, 18 h, 1 week and 1 month post surgery.

ResultsNo significant difference of mean intraocular pressure between the two surgical methods was observed for each time measurement. Nine dogs had postoperative hypertension (IOP > 25 mmHg) during the first 5 hours post surgery. Incidence of postoperative hypertension was not significantly different with manual extracapsular extraction (16%) vs. phacoemulsification (20%). A decrease of mean IOP was observed 1 h after surgery (8.49 mmHg vs. 10.91 mmHg), then an increase 3 and 5 h post surgery (12.3 and 13.32 mmHg, respectively). At 18 h, 1 week and 1 month post surgery, mean IOP decreased. Mean IOP was 10.38, 10.38 and 8.84 mmHg, respectively.

ConclusionIn this study incidence of POH is not high. However, a follow‐up of IOP in the first hours after cataract surgery is required to avoid complications of the retina and optic nerve and to administer hypotensive treatment if necessary.
Unilateral ocular subalbinism in a laboratory Beagle dog
Authors: Shibuya K. , Hirai T. , Nunoya T. , Sugimoto K.
Published: May 2003

Blue discoloration of the iris was found in the left eye of a male laboratory Beagle dog, which had a normal tricolor coat and clinically showed no visual impairment. Ophthalmoscopically, the affected eye revealed red‐colored tigroid fundus, in which no tapetum was present. The retinal vasculature and the optic disc showed no noticeable changes. Histopathologically, in the left eye melanocytes had extremely few melanin granules in the anterior segment, including the anterior border layer, in the stroma and sphincter muscle of the iris and in the stroma of the ciliary body and choroid. However, the posterior pigment epithelium of the iris, the pigment epithelium of the ciliary body and the retinal pigment epithelium showed normal pigmentation. The tapetal elements were completely absent. Number and distribution of the S‐100 protein‐positive melanocytes with or without melanin granules in the iris, ciliary body and choroid of the left eye were similar to those of the normal right eye. Ultrastructurally, melanocytes in the anterior segment of the affected iris possessed no or few melanosomes which were incompletely melanized. In the right eye, no abnormal features were observed. Based on these results, the present case was diagnosed as unilateral ocular subalbinism with tapetal aplasia in a Beagle dog.
Use of a caudal auricular axial pattern flap in three cats and one dog following orbital exenteration
Authors: Stiles Jean , Townsend Wendy , Willis Michelle , Moore Phillip A. , Smith Eric
Published: May 2003

Orbital exenteration accompanied by wide eyelid excision in the cat and dog may leave a defect that cannot be closed in a primary fashion. This report describes the use of a caudal auricular axial pattern flap to effect closure following orbital exenteration in three cats and one dog. The most common complication was distal flap necrosis, which necessitated a second surgery in two patients.
Myxoid leiomyoma of the iris in a dog
Authors: Billson F. Mark , Mould John R. B. , Lee William R.
Published: May 2003

A leiomyoma of the iris is described in an 11‐year‐old Yorkshire Terrier. This is a rare primary intraocular tumor in dogs and we describe the clinical presentation, gross findings and histopathologic characteristics of this tumor. The diagnosis was made on the basis of light microscopy and immunohistochemical staining using antidesmin antibodies, which is specific for myogenic tissues. An unusual feature of the tumor was the presence of myxoid change. To our knowledge myxoid change has not been previously described in a primary intraocular leiomyoma.
Intraocular extramedullary plasmacytoma in a cat
Authors: Michau Tammy Miller , Proulx David R. , Rushton Steven D. , Olivry Thierry , Dunston Stanley M. , Gilger Brian C. , Davidson Michael G.
Published: May 2003

An 8‐year‐old, castrated male Domestic Short‐haired cat was referred for evaluation of a possible intraocular neoplasm following previous ocular trauma. The eye was blind, and uveitis and an iridal mass were noted on examination. An enucleation was performed and the mandibular lymph node excised. Histopathologic examination revealed neoplastic proliferation of plasma cells in the iris and lymph node. No other evidence of disseminated disease was detected. This is the first case reported of an intraocular extramedullary plasmacytoma in the cat. The variation in clinical manifestations and potential association with multiple myeloma are not known at this time. Disseminated metastasis from a primary plasmacytoma of the uveal tract could also involve the bone marrow and be indistinguishable from multiple myeloma. Early enucleation, as in trauma‐associated sarcomas, may be indicated to prevent metastasis. Periodic systemic evaluation for evidence of multiple myeloma should be performed.
Day‐blindness in three dogs: clinical and electroretinographic findings
Authors: Hurn Simon D. , Hardman Chloë , Stanley Robin G.
Published: May 2003

A 6‐month‐old Rhodesian ridgeback‐cross, a 6‐year‐old Chihuahua and a 12‐month‐old Australian cattle dog were presented to the authors with a history of colliding with obstacles in daylight. Ophthalmic examination was normal and all three dogs successfully negotiated obstacle courses in dim light. In daylight the dogs became suddenly blind and repeatedly collided with obstacles. Elecroretinography (ERG) revealed no retinal activity to high frequency (30 Hz), bright intensity blue light retinal stimulation by any dog, confirming cone dysfunction. Achromatopsia has previously been recorded in Alaskan malamutes and miniature poodles. This clinical case series illustrates the characteristic behavioral presentation and the electroretinographic findings of severe day‐blindness and demonstrates that this condition may exist in other breeds of dogs.
Presence of opioid growth factor and its receptor in the normal dog, cat and horse cornea
Authors: Robertson Sheilah A. , Andrew Stacy E.
Published: May 2003

Objective To determine if opioid growth factor (OGF, [Met5]enkephalin) and its specific receptor (OGFr) are present in normal cat, dog and horse cornea.

Animals studied Normal dog, cat and horse.

Procedure Corneas were obtained from animals euthanized for reasons unrelated to this project. One cornea from each of three normal cats, dogs and horses was evaluated. The right or left cornea from each animal was chosen randomly. Corneas were harvested and placed in corneal storage media for transport to The M.S. Hershey Medical Center of The Pennsylvania State University where immunocytochemistry techniques were used to demonstrate the presence and location of OGF and OGFr. Tissues were rinsed in Sorenson's phosphate buffer, immersed in 20% sucrose in buffer and then snap frozen in isopentane. Corneas were then embedded in OCT medium and 15 µm cryostat sections were created. Presence of OGF was determined by using a polyclonal antibody to [Met5]enkephalin and assessing immunoreactivity. OGFr presence was determined by using a previously characterized rabbit polyclonal antibody to the receptor.

Results OGF and OGFr were identified in large quantities in the corneal epithelium of all three species.

Conclusion Opioid growth factor and its specific receptor are present in the corneal epithelium of normal cats, dogs and horses. OGF is present in the cornea of many species and its presence is theorized to inhibit healing of injured tissue.
Lens sparing pars plana vitrectomy and retinal transplantation in cats
Authors: Bragadóttir Ragnheður , Narfström Kristina
Published: May 2003

Neuroretinal transplantation techniques have been evolving during recent years. Experiments in rodent models with degenerative retinal disease have been encouraging. This paper describes a surgical technique developed for use in the Abyssinian cat mutant. After two‐port pars plana vitrectomy, retinotomy and bleb formation, whole sheets of neonatal neuroretinal allografts were placed into the subretinal space. The surgery was difficult but feasible, and the main complication was intraoperative hemorrhage.
The effect of anl‐type calcium channel blocker on the hemodynamics of orbital arteries in dogs
Authors: Källberg Maria E. , Brooks Dennis E. , Komaromy Andras M. , Miyabayashi Takayoshi , Bradshaw Patrick T.
Published: May 2003

Purpose(1) To determine the effect of thel‐type calcium channel blocker amlodipine on color Doppler ultrasound‐determined vascular resistance and blood flow velocities in the distal retrobulbar arteries of dogs; (2) to determine any effect of blood pressure and PCO2rate on such color Doppler‐determined circulatory measurements.

MethodsColor Doppler imaging measurements of the short posterior ciliary artery, long posterior ciliary artery, and ophthalmic artery of normal eyes of 10 dogs were obtained under isofluorane anesthesia before and 1 week after oral amlodipine administration. Mean systemic arterial blood pressure and PCO2were monitored.

ResultsThe mean resistive index decreased significantly in the short posterior ciliary artery (P = 0.0347), in the long posterior ciliary artery (P = 0.0092), and ophthalmic artery (P = 0.0004) following systemic amlodipine administration. The end diastolic velocity increased significantly in the long posterior ciliary artery (P = 0.0368) and ophthalmic artery (P < 0.0001). The peak systolic velocity increased significantly in the ophthalmic artery (P = 0.0256). Mean systemic arterial blood pressure was significantly negatively associated with resistive index (P < 0.0001) and significantly associated with the log of the end diastolic velocity (P < 0.0001).

ConclusionsSystemically administered amlodipine increases color Doppler imaging‐determined blood flow velocity and decreases vascular resistive index in the ophthalmic artery, short posterior ciliary artery and long posterior ciliary artery of normal dogs. Changes in systemic arterial blood pressure can significantly affect the measurement of color Doppler imaging parameters.
Effects of twice daily application of 2% dorzolamide on intraocular pressure in normal cats
Authors: Rainbow Marc E. , Dziezyc Joan
Published: May 2003

The effect of the topical carbonic anhydrase inhibitor, dorzolamide, on intraocular pressure in cats was studied. The intraocular pressure of both eyes of eight healthy cats was measured using applanation tonometery (Tono‐Pen) during two phases: control and treatment. Both eyes were treated with 2% dorzolamide twice a day during the treatment phase. Application of dorzolamide resulted in a significant decrease of intraocular pressure over the treatment phase. By the fourth and fifth day of treatment, the mean intraocular pressure (± standard deviation) was 9.7 (± 1.5) mmHg, whereas the mean (± standard deviation) for the last 2 days of the control period was 12.2 (± 2.0) mmHg. Based on this study, dorzolamide is a potentially effective treatment for glaucoma in cats, significantly lowering intraocular pressure.
Corneal esthesiometry in the healthy horse
Authors: Kaps Simone , Richter Marianne , Spiess Bernhard M.
Published: May 2003

Objective To determine corneal sensitivity in healthy adult horses in order to establish reference values.

Animals studied One hundred eyes of 50 healthy adult horses.

Procedure Corneal sensitivity was determined by evaluating the corneal touch threshold (CTT) in five different corneal regions using a Cochet‐Bonnet esthesiometer.

Results Comparing CTT values (in mm filament length) of the five prescribed corneal regions revealed regional variations in corneal sensitivity, with the central region (21.15 ± 6.23 mm) being the most sensitive, followed by the nasal (20.75 ± 5.14 mm), temporal (20.70 ± 5.37 mm), ventral (20.15 ± 5.88 mm) and dorsal (15.85 ± 3.70 mm) region. However, differences between the central, nasal, temporal and ventral regions were not statistically significant, whereas the dorsal region was significantly (P < 0.0001) less sensitive compared to the other regions. Division of the horses into three age groups revealed an insignificant decrease in corneal sensitivity with age in the nasal, temporal, ventral and central region, and an insignificant increase with age in the dorsal region. Correlation of corneal sensitivity with age was statistically significant in the central, ventral and temporal region. No statistically significant difference in the CTT was found between left and right eyes and between males and females.

Conclusions CTT values in 100 eyes of 50 healthy adult horses evaluated with a Cochet‐Bonnet esthesiometer generated reference values. Reference values are necessary to determine alterations of corneal sensation accompanying various eye diseases or systemic diseases.
IgA and secretory component (SC) in the third eyelid of domestic animals: a comparative study
Authors: Schlegel T. , Brehm H. , Amselgruber W. M.
Published: May 2003

ObjectiveThe third eyelid of domestic animals is important for the production and distribution of tears, in removing ocular debris and in protection of the globe, and has significant immunologic functions. Although it is known that tears contain antibodies of the immunoglobulin A (IgA) isotype which are produced mainly by plasma cells of the lacrimal gland, very little is known about the antibody repertoires in the third eyelid of domestic animals. To assess whether IgA is derived from local synthesis, we analyzed the location of IgA‐producing cells and the cellular distribution of secretory component (SC) in the third eyelid of domestic animals in a comparative study.

Animal studiedA total of 83 third eyelids of dogs, cats, pigs, cows, sheep, goats and horses were investigated in the course of this study.

ProceduresThird eyelids were obtained immediately after death, cut length‐wise, fixed overnight and processed for immunohistochemical detection of IgA and SC by the ABC technique.

ResultsThe results show that IgA‐producing plasma cells are densely populated in subepithelial spaces of the surface epithelium as well as in the nictitating gland in a species‐specific manner. In contrast, the SC could be demonstrated exclusively in glandular acinar and ductal epithelial cells and in different cell types of the surface epithelium, preferentially located on the bulbar side of the nictitating membrane.

ConclusionIt is suggested that most of the SC is locally produced by resident plasma cells and subsequently transferred through the surface epithelium and glandular duct cells by transcytosis. This indicates that the third eyelid is an important member of the secretory immune system in domestic animals.
Staphyloma in a cat
Authors: Skorobohach Brian J. , Hendrix Diane V. H.
Published: May 2003

A unilateral scleral staphyloma in an 18‐month‐old, female spayed Domestic Short‐haired cat was treated with excision, primary closure and fascial graft. Other ocular abnormalities noted on examination included iris coloboma, anterior cortical cataract, focal lens equator flattening and retinal dysplasia. The staphyloma was presumed to be congenital in origin.
Keratitis due toHistoplasmaspp. in a horse
Authors: Richter Marianne , Hauser Beat , Kaps Simone , Spiess Bernhard M.
Published: May 2003

A 5‐year‐old Holsteiner gelding from Germany was presented 2 months after a whitish discoloration of the left cornea was observed. Cytologic examination revealed intra‐ and extracellular globular structures, up to 4 µm in size, consisting of a central spherical deeply basophilic body surrounded by an unstained halo. The structures were morphologically consistent withHistoplasmaspp. Infection withHistoplasmaorganisms is not endemic in Europe. Topical use of fluconazole was successful in eliminatingHistoplasmaorganisms within 10 days of initiation of treatment.
Variations in percentage of body fat within different BMI groups in young, middle‐aged and old women
Authors: Movsesyan Lusine , Tankó László B. , Larsen Philip J. , Christiansen Claus , Svendsen Ole L.
Published: May 2003

Objectives: The objective of the present study was to characterize age‐dependent variations in percentage of body fat within different body mass index (BMI) classes in healthy Danish women.

Design: Cross‐sectional analysis.

Settings: The study was done at the Center for Clinical and Basic Research, Ballerup, Denmark.

Subjects: Four hundred and four healthy women aged 18–75 years were included in the present study.

Measurements: Fat tissue mass was estimated using dual‐energy X‐ray absorptiometry. Menopausal status and physical characteristics were also registered.

Results: Mean values of percentage of body fat calculated in the normal and overweight BMI groups were higher in middle‐aged and old women compared with young women. No significant differences were seen in the underweight and obese BMI groups. The cut‐off levels between normal and overweight and between overweight and obesity were 35–43% and 40–50%, respectively.

Conclusion: The percentage of body fat is dependent on both age and menopausal status within each of the following BMI classes: from 20 to 25 and from 25 to 30, further emphasizing that BMI has limitations when used generally as an indicator of body fatness, and argues for defining BMI cut‐off values age‐specifically.
Relation between the elastic properties and intima‐media thickness of the common carotid artery
Authors: Jogestrand T. , Eiken O. , Nowak J.
Published: May 2003

The purpose of the study was to describe the relation between wall elasticity and intima‐media thickness in the human carotid artery prior to the development of atherosclerotic plaques. Fifty‐eight apparently healthy men, aged 42–65 years (mean 55 years), without symptoms of cardiovascular disease were studied. Thickness and elastic properties of the common carotid artery wall were assessed using ultrasonography and non‐invasive arterial pressure measurements. The relation between the calculated intima‐media area and the pressure strain elastic modulus was positive and statistically significant on the right but not on the left side. No statistically significant relations were found between the calculated intima‐media area and the stiffness or between the intima‐media thickness and the elastic modulus or stiffness on either side. Thus, the relations between the common carotid artery intima‐media thickness/calculated intima‐media area and the common carotid artery elastic modulus/stiffness are weak. In regions without atherosclerotic plaques, the elastic properties of the human carotid artery wall do not seem to be influenced by the wall thickness in an important way.
Alveolar collapse and closure of airways: regular effects of anaesthesia
Authors: Hedenstierna Göran
Published: May 2003

Oxygenation is impaired in almost all subjects during anaesthesia, and hypoxaemia for shorter or longer periods is a common finding. Moreover, postoperative lung complications occur in 3–4% after elective surgery, and up to 20% in emergency operations. Rapid collapse of alveoli on induction of anaesthesia and more widespread closure of airways seem to explain the oxygenation impairment and may also contribute to postoperative pulmonary infection, Causative mechanisms to atelectasis and airway closure seem to be loss of respiratory muscle tone and gas resorption. Avoiding high inspired oxygen fractions during both induction and maintenance of anaesthesia prevents or reduces atelectasis, while intermittent ‘vital capacity’ manoeuvres, recruit atelectatic lung regions.
Nasal neutrophil activity and mucinous secretory responsiveness in COPD
Authors: Nihlén Ulf , Andersson Morgan , Löfdahl Claes‐Göran , Persson Carl G. A. , Montnémery Peter , Greiff Lennart
Published: May 2003

Patients with chronic obstructive pulmonary disease (COPD) frequently report nasal symptoms. In the present study, we have examined whether or not COPD is associated with any nasal inflammation. Plasma exudation evoked by histamine challenges has been employed to improve the recovery of inflammatory indices in nasal lavage fluids. In 23 COPD‐patients and 26 healthy subjects, all without history or signs of allergic rhinitis, nasal polyposis, or chronic rhinosinusitis, nasal saline‐lavages were performed with and without histamine. α2‐Macroglobulin, fucose, eosinophil cationic protein (ECP) and myeloperoxidase (MPO) were determined as indices of plasma exudation, mucinous secretion, eosinophil activity and neutrophil activity, respectively. The difference in MPO‐levels between the histamine and the saline lavage was greater in COPD patients compared with healthy subjects (P<0·05). Also, COPD patients reporting nasal symptoms presented an increase in MPO at histamine challenge (P<0·05, cf. saline) and greater differences in MPO and fucose, respectively, between the histamine and the saline lavage (P<0·05, cf. patients without symptoms). We conclude that COPD is not associated with any marked nasal inflammation. However, our observation on increased MPO‐levels at histamine challenge suggests some degree of increased neutrophil activity in this condition. Furthermore, when associated with nasal symptoms, COPD may be associated with an increased nasal secretory responsiveness.
Oxygen tension under hyperbaric conditions in healthy pig brain
Authors: van Hulst Robert A. , Haitsma Jack J , Klein Jan , Lachmann Burkhard
Published: May 2003

Objective: To investigate the effect of hyperbaric conditions on brain oxygenation, intracranial pressure and brain glucose/lactate levels in healthy non‐brain‐traumatized animals.

Design and setting: Prospective animal study in a hyperbaric chamber.

Subjects: Twelve adult Landrace/Yorkshire pigs.

Interventions: The animals were normoventilated in a pressure‐controlled mode according to the open lung concept first at normobaric pressures (FiO2 of 0·4 and 1·0) and subsequently in the hyperbaric chamber at 1·9 and 2·8 bar (both at an FiO2 of 1·0). Under these conditions brain oxygen tension and intracranial pressure were recorded and brain glucose/lactate levels were measured by microdialysis.

Results: At normobaric conditions, increasing the FiO2 from 0·4 (baseline) to 1·0 resulted in a significant increase in brain oxygen tension from 33 ± 14 to 63 ± 28 mmHg (P<0·05). Compared with baseline, both hyperbaric conditions (at an FiO2 of 1·0) led to a significant increase in brain oxygen tension to 151 ± 65 mmHg (P<0·001) at 1·9 bar and to 294 ± 134 mmHg (P<0·001) at 2·8 bar.

Conclusions: If there is a need for increased oxygenation in the brain, then one way to achieve this is to apply hyperbaric conditions at 100% oxygen. Compared with an atmospheric pressure with a FiO2 of 0·4, a nine‐fold increase (900%) in PbrO2 values can be reached by increasing the FiO2 to 1·0 and the pressure to 2·8 bar. In this study, hyperbaric oxygen pressure in the brain did not lead to changes in intracranial pressure or in brain glucose/lactate levels.
Hyperbaric hyperoxia induces a neuromuscular hyperexcitability: assessment of a reduced response in elite oxygen divers
Authors: Jammes Yves , Arbogast Sandrine , Faucher Marion , Montmayeur Alain , Tagliarini Ferdinand , Meliet Jean Louis , Robinet Claude
Published: May 2003

We compared the changes in compound muscle mass action potential (M‐wave) recorded in vastus lateralis in response to hyperbaric hyperoxia (HBO) in nine combat divers who dived daily while breathing 100% O2 or O2‐enriched mixture (O2 divers) to those measured in eight recreational divers who dived occasionally using compressed air/21% O2 (air divers). The O2 divers completed a 6‐h HBO exposure in which the inspired oxygen pressure (PiO2) varied from 1·15 to 2·7 absolute atmospheres (ATA), PiO2 being maintained at 1·15 ATA throughout the first 2‐h period, whereas the air divers only completed a 2‐h HBO exposure with PiO2 constant at 1·15 ATA. Before HBO exposure, there were no intergroup differences between baseline M‐wave characteristics (amplitude and duration), but the conduction time was significantly shorter in O2 divers compared with air divers. After 90 min of HBO (1·15 ATA) the air divers demonstrated neuromuscular hyperexcitability, as evidenced by an increased M‐wave amplitude (13%, P<0·01 versus baseline), shortened M‐wave duration (5%, P<0·05 versus baseline), and reduced conduction time (5%, P<0·01 versus baseline). In O2 divers, similar HBO‐induced M‐wave changes were only observed when PiO2 was greater than 1·50 ATA. We conclude that HBO elicites neuromuscular hyperexcitability, attenuated in elite O2 divers.
Effects of experimental changes in nasal airway pressure on mucosal output of plasma
Authors: Berg Søren , Wollmer Per , Andersson Morgan , Persson Carl G. A. , Greiff Lennart
Published: May 2003

Microvascular extravasation, lamina propria flooding and luminal entry of plasma are key features of airway inflammation. We have suggested that the extravasated plasma moves across the epithelial lining along hydrostatic pressure gradients. The present study, involving healthy subjects, tests this hypothesis by examining effects of experimentally applied negative and positive luminal pressures on nasal output of plasma at baseline and at histamine‐induced plasma exudation. The negative (−10 cmH2O) and positive (10 cmH2O) pressures were applied for 10 min after nasal spray administrations of diluent (saline) and histamine (0·5 mg). The mucosa was then lavaged and the lavage fluid levels of α2‐macroglobulin were measured as index of plasma exudation. Nasal administrations of diluent and histamine (0·5 mg) were also carried out without any pressure applications. Histamine produced significant mucosal exudation of plasma. The negative luminal pressure augmented this response significantly as well as the baseline appearance of α2‐macroglobulin in mucosal surface liquids. We conclude that extravasated plasma may be moved across the epithelium by a hydrostatic pressure‐operated epithelial mechanism.
Effect of non‐hypotensive haemorrhage on plasma catecholamine levels and cardiovascular variability in man*
Authors: Haberthür Christoph , Schächinger Hartmut , Seeberger Manfred , Gysi Christine Stebler
Published: May 2003

Background: It is well known from animal research that non‐hypotensive haemorrhage produces sympathoexcitatory responses assessable by both the rise in plasma catecholamine levels and the shift of autonomic influences on the heart to more sympathetic and less parasympathetic control. Data in humans are restricted.

Methods: Heart rate variability (HRV), systolic blood pressure (FINAPRES) variability (BPV), and catecholamine plasma levels were measured before and after haemorrhage in 30 healthy blood donors and compared with those from 10 control subjects without blood loss. Spectral power of HRV and BPV in very low (0·02–0·06 Hz), low (0·07–0·14 Hz), and high (0·15–0·40 Hz) frequency bands were calculated by Fourier analysis. Catecholamine plasma levels were assayed by dual column reverse‐phased high‐performance liquid chromatography (HPLC).

Results: Haemorrhage of 5·6 ± 1·2 ml kg−1 body weight increased plasma norepinephrine levels (215 ± 92 pg ml−1 versus 254 ± 95 pg ml−1; P = 0·002), increased BPV in the low frequency band (Mayer waves; 1·8 ± 1·0 ln [mmHg2] versus 2·0 ± 0·9 ln [mmHg2]; P = 0·021), and decreased the vagally transmitted high frequency HRV (6·9 ± 1·1 ln [MI2] versus 6·5±1·2 ln [MI2]; P<0·0001), but did not induce significant changes in heart rate (66 ± 11 bpm versus 67 ± 11 bpm; P = 0·79) and arterial blood pressure (mean values: 84 ± 13 mmHg versus 87 ± 13 mmHg; P = 0·12).

Conclusions: As suggested by plasma norepinephrine levels, systolic BPV and HRV, non‐hypotensive haemorrhage produces sympathoexcitatory responses as well as vagal withdrawal of heart rate control in humans.
Reference values for the physical work capacity on a bicycle ergometer for men – a comparison with a previous study on women
Authors: Wohlfart Björn , Farazdaghi Gholam R.
Published: May 2003

The aim of the study was to collect new reference values for the clinical ramp exercise test on bicycle, because in our experience, the commonly used values were too low. A group of healthy men (n = 81, 20–80 years) was randomly selected from the local municipal register to achieve an even distribution in age. Data were compared with those obtained in a similar, previous study on women (n = 87). The subjects were encouraged to cycle until exhaustion (19 on the Borg scale) when maximal load, heart rate and systolic blood pressure were recorded. Maximal load (Wmax) was related to age (years) and height (m) using a non‐linear function: Wmax = (244·6 × height − 92·1)/{1 + exp[0·038 × (age − 77·3)]}. Maximal heart rate (HRmax) was described by a similar function: HRmax = 203·7/{1 + exp[0·033 × (age − 104·3)]}. The maximal systolic blood pressure (BPmax) was described by a linear function based on age: BPmax = 0·505 × age + 192. Similar functions for the women are also given. It is suggested that 80–120% of the predicted maximal load can be taken as a reference interval for both men and women and similarly 90–110% of the maximal heart rate. In this study, 84% of the men reached a maximal load within the reference interval and 93% maximal heart rate within the reference interval. The reported values for maximal load were 104–132% of the reference values published by others.
Postural sway in normal subjects aged 20–70 years
Authors: Røgind H. , Lykkegaard J. J. , Bliddal H. , Danneskiold‐Samsøe B.
Published: May 2003

So far, no population‐based reference material of postural sway has been presented in the literature. This study evaluated postural control by measuring posturographic parameters, with the aim of establishing useful standards with regard to gender, age, body weight, cigarette smoking, alcohol consumption and articular hypermobility. This was performed in an age‐stratified random sample of 195 subjects from the Copenhagen City Heart Study, of whom, 133 agreed to participate. Measurement of postural sway was performed the Balance Master Pro®. Outcome parameters were average angular velocity, target sway area, per cent maximum stability and per cent ankle strategy. Using SAS Proc Mixed, backward stepwise elimination was performed and 95% prediction intervals were obtained. Sway increased with increasing difficulty of the test (P<0·001) and with increasing age (P<0·001). No differences were found between the sexes. Ankle‐strategy did not change with age, but decreased with increasing body weight, and increased in subjects reporting a consumption of modest amounts of alcohol (P<0·001), or with the finding of increased hypermobility (P = 0·006). The present material may be used as a reference in further studies of postural control.
Vascular dementia from a viewpoint of cerebral blood flow and oxygen metabolism
Authors: Tanaka Makoto , Kondo Susumu , Okamoto Koichi , Hirai Shunsaku
Published: May 2003

Vascular dementia is as common as Alzheimer's disease in Japan, although its importance has not been duly appreciated and its pathoetiology has not attracted proper attention. This article reviews the importance and pathophysiology of vascular dementia, presenting data obtained from our positron emission tomography (PET) study. Moreover, PET, ultrasonic quantitative blood flow measurements and magnetic resonance imaging findings on two ischemic conditions that may lead to vascular dementia are shown; chronic cerebral circulatory insufficiency (CCCI) and asymptomatic cerebral infarction. The review begins by describing the brief history, definition and classification of vascular dementia. Then, a detailed description of our PET study on patients with dementia as a result of cerebral infarction follows. Vascular dementia includes a large infarction in the territory of the right middle cerebral artery (LID), Binswanger‐type infarction (BiD), multiple infarcts in the white matter and the basal ganglia (MID) and left anteromedial thalamic infarction (ThD). In addition, patients with a large infarction in the territory of the right middle cerebral artery (LIN), who did not have dementia, were used as a control group for LID. Healthy volunteers were also examined. This study demonstrates two types of dementia. Dementia observed in LID, MID and BiD reveals an overall reduction of blood flow and oxygen metabolism, which is accentuated in the frontal lobes. The second type, observed in ThD, shows a significant reduction in blood flow and oxygen metabolism in a relatively localized area in the left frontal lobe and the ipsilateral infarcted area. The etiological difference between the two types of dementia and the possible importance of frontal lobe hypoperfusion and hypometabolism are discussed. The review also examines the most important factor in dementia with multiple lacunae, concluding that widespread cerebral ischemia appears to be the most crucial factor. Finally, data on CCCI and asymptomatic cerebral infarction are described, which reveal that even these pre‐stroke conditions have mild but significant hypoperfusion, concluding that preventive measures should be taken before ischemia advances.
Ischemic white matter damage and cognitive impairment
Authors: Yamauchi Hiroshi
Published: May 2003

White matter damage may play an important role in the pathogenesis of vascular dementia. White matter abnormalities are easily visualized as white matter high‐intensity lesions (WML) on T2‐weighted magnetic resonance images. The extent of WML may be an indicator of cognitive impairment, in particular, impairment related to frontal lobe dysfunction. However, it is unclear whether the extent of WML is an independent predictor of cognitive impairment. In patients with extensive WML, atrophy of the corpus callosum may be an important predictor of global cognitive impairment. We investigated the relationship between the extent of WML and callosal size with cognitive function in patients who had been diagnosed with lacunar stroke or no specific neurological disease. Multivariate analysis showed that only callosal size and age were significant independent predictors of mini‐mental state examination scores (a measure of global cognitive function), whereas only the extent of WML was an independent predictor of the score on the verbal fluency task (a measure of frontal lobe function). Callosal atrophy may be an important predictor of global cognitive impairment in patients with WML, whereas the extent of WML per se may be related to impairment of frontal lobe function independent of callosal atrophy. White matter high‐intensity lesions with callosal atrophy may indicate a severe form of white matter damage with axonal loss, the degree of which may determine the severity of global cognitive impairment. Our longitudinal study revealed an association between progression of WML and vascular risk factor status during follow up in patients with initially mild WML. Early detection of WML without callosal atrophy at a stage of subtle cognitive impairment and slowing the progression of WML to a severe form with callosal atrophy might prevent the development of dementia.
Prevention and early intervention for vascular dementia in community dwelling elderly: Findings from the Nakayama study
Authors: Ikeda Manabu
Published: May 2003

Cerebrovascular disease (CVD) may be the single most common risk factor for age‐associated dementia (in particular for vascular dementia (VaD)), and there is definite potential for prevention and treatment of CVD. After one of the most comprehensive and precise type‐specific prevalence surveys of dementia (first Nakayama study), we have continued the preventive and early interventional approaches to CVD and VaD, including treatment of cardiovascular risk factors. In this cohort study, 88% of patients with ‘vascular cognitive impairment without dementia’, who were alive at 3‐years follow up, were still diagnosed with ‘vascular cognitive impairment without dementia’ and only 12% progressed to dementia. Compared with the results of previous studies, active control of risk factors and prevention of recurrent stroke may reduce the incidence of dementia and slow the progression of cognitive impairment in patients with ‘vascular cognitive impairment without dementia’.
Effects of low‐dose quetiapine on psychotic symptoms in elderly patients with physical illnesses: Report of eight cases
Authors: Hattori Hideyuki , Matsumoto Masayuki , Morimoto Shigeto , Iwai Kunimitu , Tsuchiya Hiroshi , Miyauchi Eiji , Takasaki Mikihiro , Nakahashi Tsuyoshi , Okaishi Kohya , Murai Hiroshi , Nishimura Yukiharu , Owari Yuhki , Nomura Kohji , Kato Shozaburo , Kong Ling Yu
Published: May 2003

Quetiapine, which is a new atypical antipsychotic agent, was administered at low doses (25–50 mg/day) for psychotic symptoms in eight elderly patients with physical illnesses. Delirium and hallucination were alleviated by the administration of low doses of quetiapine, and the cause–effect relationship between the administration and alleviation of symptoms was evident, particularly in one patient with delirium, because delirium was alleviated after administration began, was exacerbated after discontinuation of quetiapine, and was alleviated again after administration was resumed. Little improvement was observed in delusions or mood disorders. None of the patients showed exacerbation of physical symptoms or abnormalities in clinical laboratory tests. The results of this study suggest that quetiapine might be effective in reducing delirium and hallucination that often accompany physical illness in elderly people and could be used without adverse effects.
Involvement of Rho‐associated kinase in neurite sprouting and amyloid beta production of rat cortical neurons cultured in insulin‐free medium
Authors: Matsumoto Naohiko , Nakamura Yu , Kashiwagi Yujiro , Hashimoto Ryota , Kudo Takashi , Tanaka Toshihisa , Shinosaki Kazuhiro , Takeda Masatoshi
Published: May 2003

Background: Abnormal sprouting of neurites is one of the neuropathological features of Alzheimer's disease. The mechanism of neurite sprouting of cultured neurons remains unknown. Among small guanosine triphosphate binding proteins, participation of the Rho family has been speculated.

Methods: The involvement of Rho‐associated kinase in neurite sprouting and in amyloid beta (Αβ) production was investigated in primary cultured rat cortical neurons using morphometric analysis, immunohistochemistry and ELISA assay.

Results: In a serum‐free medium, Y‐27632, a Rho‐associated kinase specific inhibitor, was found on the neurite outgrowth; however, there was no effect of Y‐27632 on Neurobasal/B27. A custom medium without insulin was prepared because insulin potentially influences neurite formation. In the insulin‐free medium, 10 µmol/L Y‐27632 appeared to promote neurite outgrowth, showing significant increases in neurite length and in the number of neurite terminals. Y‐27632 generated abnormal neurites, which were positively stained by both MAP2 and neurofilament‐L. Furthermore, the effect of Y‐27632 on Αβ production in primary cultured rat cortical neurons was investigated. Inhibition of Rho‐associated kinase increased the ratio of Αβ 42 /40+42.

Conclusion: Our findings indicated that Rho‐associated kinase might be involved not only in neurite sprouting, but also in Αβ production in primary cultured neurons. Considering these two effects, inhibition of Rho‐associated kinase activity might be involved in the pathology of Alzheimer's disease.
Neurophysiological evaluation of late paraphrenia: Comparison with chronic schizophrenia and dementia of the Alzheimer type
Authors: Taguchi Satoki , Fujimoto Osamu , Takamori Nobutaka , Hanatani Takashi , Sumi Noriaki , Nan’no Hisashige , Takeda Masatoshi
Published: May 2003

Background: Late paraphrenia (LP) is a clinical entity first proposed by Roth in 1955. Recently, neuroimaging studies have described the organic changes in the brain that are associated with LP. We performed a neurophysiological study on patients with LP, chronic schizophrenics and patients with dementia of the Alzheimer type (DAT) to examine the cognitive function of patients with LP and to differentiate LP patients from these other groups.

Methods: We investigated somatosensory‐evoked response (SER), contingent negative variation (CNV) and P300 in 30 LP patients, 22 chronic schizophrenics and 31 patients with DAT. Thirty‐four age‐matched healthy volunteers served as a control group. SER was performed by applying a mechanical stimulus to the right or left palm. CNV was performed by presenting a clicking sound (S1) and a flash of light (S2) to the subjects, with an interval between S1 and S2 of 2 s. P300 was performed using an auditory oddball paradigm.

Results: The mean N3 peak latency of SER was significantly prolonged in patients with LP and in patients with DAT, compared with the control group. The mean CNV amplitude was significantly decreased in schizophrenics compared with the control group, but it did not decrease in patients with LP. The mean N200 and P300 latencies were significantly prolonged in patients with DAT compared with the control group, LP patients and schizophrenics, but the latencies of patients with LP were not prolonged compared with the control group.

Conclusion: Based on these results, we propose that patients with LP have impaired cerebral reactivity to the stimulus, but their attention, motivation, recognition and differentiation are relatively intact. The present findings are consistent with former investigations, indicating that patients with LP are less likely to show negative symptoms, such as personality deterioration, and more likely to show organic changes in the brain relative to schizophrenics arising in early life.