bluuebunny/crossref_metadata_2025 huggingface dataset:
Is robotically assisted laparoscopic radical prostatectomy less invasive than retropubic radical prostatectomy? Results from a prospective, unrandomized, comparative study
Authors: Fracalanza Simonetta , Ficarra Vincenzo , Cavalleri Stefano , Galfano Antonio , Novara Giacomo , Mangano Angelo , Plebani Mario , Artibani Walter
Published: April 2008

OBJECTIVES

To evaluate whether robotically assisted laparoscopic prostatectomy (RALP) is less invasive than radical retropubic prostatectomy (RRP), as experimental studies suggest that the acute phase reaction is proportional to surgery‐induced tissue damage.

PATIENTS AND METHODS

Between May and November 2006, all patients undergoing RRP or RALP in our department were prospectively assessed. Blood samples were collected 24 h before (T0), during surgery (T1), at the end of anaesthesia (T2), and 12 (T3) and 24 h after surgery (T4), and assayed for interleukin(IL)‐6 and IL‐1α, C‐reactive protein (CRP), and lactate. The Mann‐Whitney U‐, Student’s t‐ and Friedman tests were used to compare continuous variables, and the Pearson chi‐square and Fisher test for categorical variables, with a two‐sided P < 0.05 considered to indicate significance.

RESULTS

In all, 35 and 26 patients were assessed for RALP and RRP, respectively; the median (interquartile range) age was 62 (56–68) and 68.5 (59.2–71.2) years, respectively (P < 0.009). Baseline levels (T0) of IL‐1, IL‐6, CRP and lactate were comparable in both arms. IL‐6, CRP and lactates levels increased during both kinds of surgery. The mean IL‐6 and CPR values were higher for RRP at T1 (P = 0.01 and 0.001), T2 (P = 0.001 and <0.001), T3 (P = 0.002 and <0.001) and T4 (P < 0.001 and 0.02), respectively. Lactate was higher for RRP at T2 (P = 0.001), T3 (P = 0.001) and T4 (P = 0.004), although remaining within the normal ranges. IL‐1α did not change at the different sample times.

CONCLUSIONS

This study showed for the first time that RALP induces lower tissue trauma than RRP.
Protecting Marine Biodiversity in Polar Areas Beyond National Jurisdiction
Authors: Rayfuse Rosemary
Published: April 2008

Relatively little is known about polar marine biodiversity, which faces increasing threats from extractive and non‐extractive activities and from the effects of climate change. The international legal regime for the protection of polar marine biodiversity in areas beyond national jurisdiction is currently inadequate, particularly in the Arctic. An important and useful outcome of this International Polar Year would be an international agreement for conservation and sustainable long‐term management of marine biodiversity in the central Arctic Ocean areas beyond national jurisdiction. This agreement should incorporate the best elements of the Antarctic Treaty System together with modern conservation and management principles, and it should recognize the legitimate interests of the international community as a whole in the conservation and management of polar marine biodiversity.
Standard‐dose efavirenz vs. standard‐dose nevirapine in antiretroviral regimens among HIV‐1 and tuberculosis co‐infected patients who received rifampicin
Authors: Manosuthi W , Mankatitham W , Lueangniyomkul A , Chimsuntorn S , Sungkanuparph S
Published: April 2008

Background

There is limited comparative data between efavirenz (EFV) 600 mg/day and nevirapine (NVP) 400 mg/day‐based antiretroviral therapy (ART) among HIV‐1 patients with tuberculosis (TB) and receiving rifampicin.

Methods

A retrospective cohort study was conducted in all ART‐naïve patients who were receiving rifampicin between January 2002 and December 2005.

Results

Of 188 patients, 77 and 111 patients were initiated on EFV‐based ART (EFV group) and NVP‐based ART (NVP group), respectively. Overall, median [interquartile range (IQR)] CD4 count was 36 (15–77) cells/μL and median (IQR) viral load was 5.6 (5.2–5.9) HIV‐1 RNA log copies/mL. At 48 weeks, 77.9% (60/77) in the EFV group and 67.6% (75/111) in the NVP group achieved HIV‐1 RNA <50 copies/mL (P=0.140, odds ratio =0.590, 95% confidence interval=0.302–1.153). At 24 and 48 weeks, respective median CD4 counts were 174 and 254 cells/μL in the EFV group and 156 and 218 cells/μL in the NVP group (P>0.05). By binary logistic regression, treatment group was not associated with HIV‐1 RNA <50 copies/mL (P>0.05). No patient in the EFV group and eight (7.2%) patients in the NVP group discontinued ART because of adverse reactions (P=0.084).

Conclusions

For HIV–TB co‐infected patients who receive rifampicin, efficacy of 600 mg EFV‐based and 400 mg NVP‐based ART may be similar, although adverse events tend to be higher in NVP‐based ART.
Impact of hepatitis B virus co‐infection on response to highly active antiretroviral treatment and outcome in HIV‐infected individuals: a nationwide cohort study
Authors: Omland LH , Weis N , Skinhøj P , Laursen AL , Christensen PB , Nielsen HI , Møller A , Engsig F , Sørensen HT , Obel N
Published: April 2008

Background

The impact of chronic hepatitis B virus (HBV) infection on viral suppression, immune recovery and mortality in HIV‐1 infected patients on highly active antiretroviral treatment (HAART) is a matter of debate. The impact of HBeAg status is unknown.

Methods

This prospective cohort study included all adult Danish HIV‐1 infected patients who started HAART between 1 January 1995 and 1 December 2006 (3180 patients). Patients were classified as chronic HBV‐infected (6%), HBV‐negative (87%) or HBV‐unknown (7%). HBV‐positive patients were divided into HBeAg‐positive or ‐negative (3.0 vs. 2.6%). Study endpoints were viral load, CD4 cell count and mortality.

Results

HBV co‐infection had no impact on response to HAART regarding viral suppression or immune recovery. HBV co‐infection was associated with several outcomes: overall mortality [mortality rate ratio (MRR) 1.5; 95% confidence interval (CI) 1.1–2.1], liver‐related mortality (MRR 4.0; 95% CI 1.6–9.9) and AIDS‐related deaths (MRR 1.7; 95% CI 1.0–3.0). The presence of HBeAg did not influence patients' response to HAART.

Conclusions

In HIV patients, chronic HBV infection has no impact on response to HAART concerning viral load and increase in CD4 cell count. However, co‐infected patients have an increased mortality compared to HIV‐monoinfected patients.
Insight into diversity, body size and morphological evolution from the largest Early Cretaceous enantiornithine bird
Authors: Zhou Zhonghe , Clarke Julia , Zhang Fucheng
Published: April 2008

Most of Mesozoic bird diversity comprises species that are part of one of two major lineages, namely Ornithurae, including living birds, and Enantiornithes, a major radiation traditionally referred to as ‘opposite birds’. Here we report the largest Early Cretaceous enantiornithine bird from north‐east China, which provides evidence that basal members of Enantiornithes share more morphologies with ornithurine birds than previously recognized. Morphological evolution in these two groups has been thought to be largely parallel, with derived members of Enantiornithes convergent on the ‘advanced’ flight capabilities of ornithurine birds. The presence of an array of morphologies previously thought to be derived within ornithurine and enantiornithine birds in a basal enantiornithine species provides evidence of the complex character evolution in these two major lineages. The cranial morphology of the new specimen is among the best preserved for Mesozoic avians. The new species extends the size range known for Early Cretaceous Enantiornithes significantly and provides evidence of forelimb to hind limb proportions distinct from all other known members of the clade. As such, it sheds new light on avian body size evolution and diversity, and allows a re‐evaluation of a previously proposed hypothesis of competitive exclusion among Early Cretaceous avian clades.
Evidence for overlapping genetic influences on autistic and ADHD behaviours in a community twin sample
Authors: Ronald Angelica , Simonoff Emily , Kuntsi Jonna , Asherson Philip , Plomin Robert
Published: April 2008

Background:  High levels of clinical comorbidity have been reported between autistic spectrum disorders (ASD) and attention deficit hyperactivity disorder (ADHD). This study takes an individual differences approach to determine the degree of phenotypic and aetiological overlap between autistic traits and ADHD behaviours in the general population.

Methods:  The Twins Early Development Study is a community sample born in England and Wales. Families with twins born in 1994–6 were invited to join; 6,771 families participated in the study when the twins were 8 years old. Parents completed the Childhood Asperger Syndrome Test and the Conners’ DSM‐IV subscales. Teacher data were also collected on a sub‐sample. High scores on the Conners’ subscales were used to identify possible ADHD cases. Potential ASD cases were interviewed using the Development and Well‐Being Assessment. Multivariate structural equation model‐fitting was employed, as well as DeFries Fulker extremes analysis and liability threshold model‐fitting.

Results:  Significant correlations were found between autistic and ADHD traits in the general population (.54 for parent data, .51 for teacher data). In the bivariate models, all genetic correlations were >.50, indicating a moderate degree of overlap in genetic influences on autistic and ADHD traits, both throughout the general population and at the quantitative extreme. This phenotypic and genetic overlap still held when sex, IQ and conduct problems were controlled for, for both parent and teacher data. There was also substantial overlap in suspected cases (41% of children who met criteria for an ASD had suspected ADHD; 22% with suspected ADHD met criteria for an ASD).

Conclusions:  These results suggest there are some common genetic influences operating across autistic traits and ADHD behaviours throughout normal variation and at the extreme. This is relevant for molecular genetic research, as well as for psychiatrists and psychologists, who may have assumed these two sets of behaviours are independent.
Contrasting deficits on executive functions between ADHD and reading disabled children
Authors: Marzocchi Gian Marco , Oosterlaan Jaap , Zuddas Alessandro , Cavolina Pina , Geurts Hilde , Redigolo Debora , Vio Claudio , Sergeant Joseph A.
Published: April 2008

Background:  The object of this study was to analyze the executive functioning of children with attention deficit hyperactivity disorder (ADHD) or reading disability (RD) independent of their non‐executive deficits.

Methods:  Three carefully diagnosed groups of children, aged between 7 and 12 years (35 ADHD, 22 RD and 30 typically developing children), were tested on a wide range of tasks related to five major domains of executive functioning (EF): inhibition, visual working memory, planning, cognitive flexibility, and verbal fluency. Additional tasks were selected for each domain to control for non‐executive processing.

Results:  ADHD children were impaired on interference control, but not on prepotent and ongoing response suppression. ADHD showed deficits on visual working memory, planning, cognitive flexibility and phonetic fluency. RD children were impaired on phonetic fluency. The only EF measure that differentiated ADHD from RD was planning.

Conclusions:  The present sample of ADHD children showed several EF deficits, whereas RD children were almost spared executive dysfunction, but exhibited deficits in phonetic fluency.
Preventing conduct problems and improving school readiness: evaluation of the Incredible Years Teacher and Child Training Programs in high‐risk schools
Authors: Webster‐Stratton Carolyn , Jamila Reid M. , Stoolmiller Mike
Published: April 2008

Background:  School readiness, conceptualized as three components including emotional self‐regulation, social competence, and family/school involvement, as well as absence of conduct problems play a key role in young children's future interpersonal adjustment and academic success. Unfortunately, exposure to multiple poverty‐related risks increases the odds that children will demonstrate increased emotional dysregulation, fewer social skills, less teacher/parent involvement and more conduct problems. Consequently intervention offered to socio‐economically disadvantaged populations that includes a social and emotional school curriculum and trains teachers in effective classroom management skills and in promotion of parent–school involvement would seem to be a strategic strategy for improving young children's school readiness, leading to later academic success and prevention of the development of conduct disorders.

Methods:  This randomized trial evaluated the Incredible Years (IY) Teacher Classroom Management and Child Social and Emotion curriculum (Dinosaur School) as a universal prevention program for children enrolled in Head Start, kindergarten, or first grade classrooms in schools selected because of high rates of poverty. Trained teachers offered the Dinosaur School curriculum to all their students in bi‐weekly lessons throughout the year. They sent home weekly dinosaur homework to encourage parents’ involvement. Part of the curriculum involved promotion of lesson objectives through the teachers’ continual use of positive classroom management skills focused on building social competence and emotional self‐regulation skills as well as decreasing conduct problems. Matched pairs of schools were randomly assigned to intervention or control conditions.

Results:  Results from multi‐level models on a total of 153 teachers and 1,768 students are presented. Children and teachers were observed in the classrooms by blinded observers at the beginning and the end of the school year. Results indicated that intervention teachers used more positive classroom management strategies and their students showed more social competence and emotional self‐regulation and fewer conduct problems than control teachers and students. Intervention teachers reported more involvement with parents than control teachers. Satisfaction with the program was very high regardless of grade levels.

Conclusions:  These findings provide support for the efficacy of this universal preventive curriculum for enhancing school protective factors and reducing child and classroom risk factors faced by socio‐economically disadvantaged children.
Meta‐analysis of randomized, controlled treatment trials for pediatric obsessive‐compulsive disorder
Authors: Watson Hunna J. , Rees Clare S.
Published: April 2008

Objective:  To conduct a meta‐analysis on randomized, controlled treatment trials of pediatric obsessive‐compulsive disorder (OCD).

Method:  Studies were included if they employed randomized, controlled methodology and treated young people (19 years or under) with OCD. A comprehensive literature search identified 13 RCTs containing 10 pharmacotherapy to control comparisons (N = 1016) and five cognitive‐behavioral therapy (CBT) to control comparisons (N = 161).

Results:  Random effects modeling yielded statistically significant pooled effect size (ES) estimates for pharmacotherapy (ES = .48, 95% CI = .36 to .61, p < .00001) and CBT (ES = 1.45, 95% CI = .68 to 2.22, p = .002). The results were robust to publication bias.

Conclusions:  This is the first meta‐analysis of treatment RCTs for pediatric OCD. CBT and pharmacotherapy were the only treatments effective beyond control in alleviating OCD symptoms. CBT showed a greater ES than pharmacotherapy. Previous meta‐analyses that included uncontrolled trials exaggerated the efficacy of both treatments.
Heterogeneity in antisocial behaviours and comorbidity with depressed mood: a behavioural genetic approach
Authors: Rowe Richard , Rijsdijk Fruhling V. , Maughan Barbara , Eley Thalia C. , Hosang Georgina M. , Eley Thalia C.
Published: April 2008

Background:  Antisocial behaviour is often comorbid with depressed mood but is itself a collection of heterogeneous behaviours. Using a genetically informative design, we examine heterogeneity in antisocial behaviour and overlaps between different forms of antisocial behaviour with depressed mood.

Methods:  Data were drawn from the G1219 large‐scale community sample containing self‐report questionnaire data from 941 twin pairs and 328 sibling‐pairs aged 12–21 years.

Results:  Inter‐correlations among oppositionality, physical aggression and delinquency, and between the antisocial subscales and depressed mood, were mediated by genetic and non‐shared environmental influences. Genetic factors generally contributed more to the correlations than the non‐shared environment.

Conclusions:  These results indicate that many genetic and non‐shared environmental influences were common to all the traits studied, but there was also evidence for trait‐specific effects.
Impact of the acidification process, hydrocolloids and protein fortifiers on the physical and sensory properties of frozen yogurt
Authors: SOUKOULIS CHRISTOS , TZIA CONSTANTINA
Published: April 2008

In our study, two acidification procedures, three stabilizers (guar gum, xanthan and carboxymethylcellulose) and two protein‐fortifying agents (skim milk powder and whey powder) were evaluated based on their impact on the quality characteristics of frozen yogurts. Indirect acidification (blending of plain acidified milk with ice cream mix) was found to favour texture while direct acidification (fermentation of ice cream mix with starter culture), although it improved viscosity of mixes, did not enhance the sensory acceptance of frozen yogurts. The addition of 0.2% xanthan gum and the partial substitution (at the ratio of 3 : 1) of skim milk powder by whey powder increased overall acceptance and creaminess.
Optimization of ingredients for the formulation of a direct acidified whey based lassi‐like beverage
Authors: NAIR KALYANI , THOMPKINSON D K
Published: April 2008

Samples of direct acidified whey based lassi like beverage were prepared with different proportions of guar gum, CMC and inulin and were examined for sensory and physical attributes. The optimisation was carried out using central composite rotatory design (CCRD) of response surface methodology (RSM). Response surface analysis revealed that sensory scores for flavour, consistency, colour and appearance and overall acceptability of lassi like beverage varied from 6.50 to 7.25, 6.16 to 7.12, 6.20 to 7.41 and 5.96 to 7.20 respectively. The results of analysis showed that all the examined model solutions had significant influence on the different parameters indicating that the statistical model designed for these attributes fitted well in all the aspects of model efficiency check (R2 >85%).
Potentially probiotic açaí yogurt
Authors: DE ALMEIDA MARIO H B , ZOELLNER SIDNEY S , DA CRUZ ADRIANO G , MOURA MIRIAM R L , DE CARVALHO LUCIA M J , FREITAS MARIA CRISTINA J , DE S SANT’ANA ANDERSON
Published: April 2008

The aim of this work was to evaluate the suitability of yogurt containing açaí pulp as a food carrier of probiotic cultures. Probiotic yogurts containing increasing amounts of açaí pulp (3, 5 and 7%) were processed and submitted to a physicochemical analysis and viable microbial count during refrigerated storage. In general, all the physicochemical parameters showed variations proportional to the amount of açaí pulp in the product formulation. Probiotic activity was verified throughout refrigerated storage for all the products, although there was a fall of one logarithmic cycle for both micro‐organisms during this period (107–108 CFU/mL).
Influence of added calcium chloride on the heat stability of unconcentrated and concentrated bovine milk
Authors: SIEVANEN KATJA , HUPPERTZ THOM , KELLY ALAN L , FOX PATRICK F
Published: April 2008

The influence of added calcium chloride (1–10 mmol/L) on the heat‐induced coagulation of skim bovine milk was examined. Unconcentrated milk displayed a pH‐heat coagulation time (HCT) profile with a maximum at pH 6.6 and minimum at pH 7.0. Adding calcium chloride to unconcentrated milk progressively reduced the HCT at the maximum, increased the pH at which the maximum occurred and reduced the HCT at pH > 7.0. For concentrated milk, the shape of the pH‐HCT profile, that is, a maximum at pH 6.6, was not altered by added calcium chloride, but HCT was reduced progressively with increasing concentration of calcium chloride. Preheating (90°C for 10 min) shifted the maximum in the pH‐HCT profile of unconcentrated milk to a more acidic pH, and addition of 5 mmol/L calcium chloride to preheated milk induced changes in heat stability similar to those noted for unheated milk. Addition of calcium chloride to milk prior to preheating strongly reduced the stability of milk against heat‐induced coagulation. These data suggest that calcium has a strong destabilizing effect on the stability of milk systems against heat‐induced coagulation.
Compositional characteristics of Murcia al Vino goat's cheese made with calf rennet and plant coagulant
Authors: TEJADA LUIS , ABELLÁN ADELA , PRADOS FRANCISCO , CAYUELA JOSÉ MARÍA
Published: April 2008

The aims of the present study were to determine compositional characteristics of Murcia al Vino goat's cheese and to evaluate the effect of different types of coagulants (animal rennet and powdered vegetable coagulant obtained from the cardoon Cynara cardunculus) on the improvement of the technological quality of Murcia al Vino goat's cheese. Only the pH, TA and ash and Ca contents were affected in a significant way by the type of coagulant used. There was a decrease in the moisture and an increase in the sodium chloride during ripening, while other parameters were unchanged. The pH and titratable acidity (TA) values of the cheeses were affected significantly by the time of ripening. There was an increase of the Na as well as a significant decrease of the Ca, P, Zn, Cu and Fe components, as a consequence of the increase of the acidity of the cheese during ripening. The esterified fatty acids were not modified significantly by the type of coagulant or by the time of ripening. Those most abundant in this type of cheese were C16 and the C18 : 1.
Availability of glycogen and plasma FFA for substrate utilization in leg muscle of man during exercise
Authors: Gollnick P. D. , Pernow B. , Essen Birgitta , Jansson Eva , Saltin B.
Published: April 2008

Summary. Six men performed two‐legged cycle ergometer exercise at loads demanding 2–4 and 3–4 litres O2 min‐1 (62 and 84% of Vo2 max) for 20 min each or to exhaustion twice with 1 h rest between. An initial glycogen difference of 28 mmol glucose units kg‐1 of thigh muscle between the two legs was produced by one‐legged exercise on a previous day followed by the consumption of a low carbohydrate diet. During the 1 h rest nicotinic acid (NA) was administered to inhibit lipolysis. Total body Fo2 was unchanged by the NA administration. Work done by each leg, indicated by force on the pedals, was equal. RQ indicated a larger oxidation of fat in the leg with low glycogen. Muscle glycogen was 15 and 10 mmol kg‐1 in the normal and low glycogen leg at the end of the first exercise bouts and 3–8 mmol kg‐1 in both legs at exhaustion. The low glycogen leg extracted lactate from the blood whereas the normal leg released lactate and the uptake of glucose from the blood was greater by the low glycogen leg. These differences between the low glycogen and control legs did not persist during the NA condition when muscle glycogen content was equal in both legs. Further, the leg glucose uptake in the control and the NA conditions was positively related to the percentage of glycogen‐empty muscle fibres and inversely to the glucose‐6‐P04 concentration. Thus the magnitude of the local glycogen stores of muscle influences the uptake and use of blood‐borne substrates as well as determining endurance capacity during moderate to high intensity exercise.
Bronchial obstruction after oesophageal acid perfusion in asthmatics
Authors: Kjellén G. , Tibbling L. , Wranne B.
Published: April 2008

Summary. Fifteen patients with the combination of bronchial asthma and symptoms of gastro‐oesophageal reflux reproduced at endo‐oesophageal acid perfusion (group I) were investigated to detect bronchial obstruction, reflexly elicited from the distal oesophagus. Five patients with bronchial asthma but without symptoms of gastro‐oesophageal reflux (group 2) and five patients with symptoms of gastro‐oesophageal reflux but without respiratory symptoms (group 3) served as controls. The vital capacity (VC), the slope of the alveolar plateau (δN2) and the closing volume (CV) were measured with the single breath nitrogen test before and after acid perfusion of the oesophagus, and again after antacid and glucose perfusion of the oesophagus. In group 1 a significant decrease of VC by 0–21 (P<0–001) and a significant increase of δN2 by 0–9% (P<005) was seen while no change in CV was found. There was no change after acid perfusion in groups 2 or 3. After glucose and antacid the VC increased significantly in group 1 while no significant change was seen in δN2 or CV. These findings were taken as indirect evidence of bronchial obstruction induced by the acid infusion. Since the changes were provoked in the sitting position and only in asthmatics with a positive acid perfusion test and since no patient complained of acid taste in the mouth it is unlikely that the bronchial obstruction was due to aspiration. A neural oesophago‐bronchial reflex mechanism is suggested.
Immediate central and peripheral haemodynamic effects of a new vasodilating agent Pinacidil (P1134) in hypertensive man
Authors: Carlsen Jan E. , Kardel Troels , Hilden Tage , Tangø Mogens , Trap‐Jensen Jens
Published: April 2008

Summary. The purpose of this study was to evaluate the immediate central and peripheral haemodynamic effects of a new vasodilating agent P 1134, in hypertensive man.

After oral administration of 25 mg P 1134, the maximal haemodynamic changes were (mean±1 SEM): mean blood pressure fell from 121‐8 ±6‐5 to 80‐5 ±7–8 mmHg, heart rate increased 24‐2±4–5 beats/min, cardiac output rose 2–9±0–3 1/min and forearm blood flow increased 1 ‐0±0‐l ml/100 ml tissue/min. Stroke volume increased 17‐0 ±2‐1 ml and the inotropic state of the heart as judged from systolic time intervals increased. Total peripheral resistance and forearm vascular resistance were both reduced by approx. 50%. Linear correlations were found between the serum concentration of P 1134 and the change in mean blood pressure and total peripheral resistance. Changes in the other parameters mentioned above occurred progressively with changes in mean blood pressure and total peripheral resistance.

It can be concluded that P 1134 is a very potent hypotensive agent with a haemodynamic profile identical to that seen with vasodilators which preferably act on precapillary resistance vessels. Potency and maximal efficacy exceeds that of hydralazine and seems like that of minoxidil. P 1134 is remarkably free from side‐effects apart from causing water retention as all other vasodilators. It can be administered orally as well as intravenously. This makes P 1134 a very interesting compound in the treatment of moderate to severe hypertension, and further studies are well‐founded.
Pathophysiology of metabolic acidosis: effect of low pH on the hepatic uptake of lactate, pyruvate and alanine
Authors: Sestoft L. , Bartels P. D. , Folke M.
Published: April 2008

Summary.The uptake of lactate, pyruvate and alanine in perfused rat liver was investigated under normal perfusion conditions (pH 7.4, Pco240 mmHg) and under conditions mimicking partially compensated metabolic acidosis (pH 6·9, Pco220 mmHg).

At 1 mM lactate as well as 10 mM lactate in the medium a lowering of pH from 7.4 to 6.9 did not affect the lactate plus pyruvate uptake. A significant effect of the low pH was seen on pyruvate uptake which at 1 mM lactate was increased from 0·027 ± 0.008(4) μmol/min per g liver at normal pH to 0.084 ± 0.013(4) at low pH. At 10 mM lactate the liver produced pyruvate, but the production was significantly reduced by a lowering of the pH, being 0·45 ± 0·13(8) μmol/min per g liver at pH 7·4 and 0·22 ± 0·06(4) at pH 6·9. The counterbalancing changes in lactate metabolism were too small to attain statistical significance. The stimulation of gluconeogenesis by an increase in FFA from 0 to 1 mM in the medium was unaffected by pH. Alanine uptake was decreased from 0·48 ± 0·05(6) to 0·39 ± 0·07(3) by lowering of the pH from 7·4 to 6·9.

We conclude that metabolic acidosis does not in itself inhibit the capacity of the perfused rat liver to remove lactate and pyruvate from the blood. If the same is true in man, no beneficial effect of bicarbonate treatment on lactate clearance in patients with lactic acidosis should be expected.
Bone mass of the axial and the appendicular skeleton in women with Colles' fracture: its relation to physical activity
Authors: Krølner B. , Tøndevold E. , Toft B. , Berthelsen B. , Nielsen S. Pors
Published: April 2008

Summary. The aim of this investigation was to elucidate whether Colles' fractures in middle‐aged women were indicative of generalized bone loss (osteopenia) and whether bone mass of the axial and the appendicular skeleton was related to the extent of daily physical activity. Thirty‐six patients (aged 50–73 years) with previous Colles' fracture were studied. The median time elapse after the injury was 18 months (range 9–20·5 months). Bone mineral content of the 2nd, 3rd, and 4th lumbar vertebrae (lumbar BMC) and both distal forearms (forearm BMC) were determined by dual‐photon (153Gd) absorptiometry. The physical activity level was graded according to a standard interview and a bicycle ergo meter test. Mean lumbar BMC was reduced by 9% compared to age‐matched normal women (P < 0·05), mean forearm BMC was reduced by 5% (NS). Twenty patients showed spinal osteopenia by either conventional radiography or absorptiometry (95% confidence limits 38–72%). The fracture‐related bone loss from the forearms was most prominent when the fracture had occurred in the dominant forearm, suggesting that the loss of ‘dominant’ forearm activity per se results in bone loss. No relation between working capacity and forearm BMC was found. However, the working capacity was positively related to lumbar BMC (P < 0·01), even if the common relationship to age was eliminated (P < 0·05). The data suggest that the bone mass of the axial skeleton reflects the extent of daily physical activity. Patients with Colles' fractures represent an easily definable population which might benefit from prophylactic measures against vertebral bone loss and compression fractures. One of these could be physical exercise.
Ventilatory patterns during steady state and progressive exercise
Authors: Szekely Otto , Askanazi Jeffrey , Rosenbaum Stanley H. , Foster Robert , Milic‐Emili J. , Kinney J. M.
Published: April 2008

Summary. This study was conducted to differentiate the ventilatory and metabolic response to supine exercise at low levels (V̇O2, < 1000 ml/min) from the well‐documented response to high level upright exercise. Further, the respiratory cycle during exercise is analysed in terms of inspiratory time, flow and expiratory time as well as tidal volume and frequency. Using a canopy system for non‐invasive measurement of breathing patterns and gas exchange, nine male subjects were studied while performing steady state (SSE) and progressive exercise (PRE). Work loads were: SSE 1·5 Kgm/sec for 17 min; PRE 1·5, 2·5, 3·75 and 5·0 Kgm/sec with 2 min increments. Total work was the same (1548 Kg·m) in both types of exercise. With SSE tidal volume (VT) and respiratory rate (f) rose 70% and 30%, respectively. Minute ventilation (V̇E) rose 113%. With PRE, f rose during the first work level, then remained stable, while VT and VE rose with each incremental exercise level. In both cases a decrease in expiratory time accounted for the major component of the decrease in total cycle time. With the onset of exercise, the rate of increase of inspiratory time and respiratory frequency exceeded that of tidal volume and inspiratory flow. This would suggest that these two groups of parameters are controlled by separate mechanisms, possibly, timing being under neurogenic control and flow determined by humoral factors. The respiratory quotient decreased with both forms of exercise and remained low throughout the exercise period.
Renal function and digoxin clearance during quinidine therapy
Authors: Schenck‐Gustafsson Karin , Juhlin‐Dannfelt Anders , Dahlqvist Rune
Published: April 2008

Summary. To investigate further the handling of digoxin by the kidneys during quinidine therapy, clearances of digoxin, 51Cr‐EDEA, PAH and endogenous creatinine were measured together with β2‐microglobulin in the urine before and during quinidine therapy in 10 patients on maintenance digoxin therapy. Renal clearance of digoxin (corrected for 30% plasma binding) decreased on the average by 55% (137 ± 73 to 73 ± 25 ml/min, mean ± SD). The steady state plasma concentration of digoxin increased more than twofold (1·0 ± 0·34 to 2·5 ± 0±79 nmol/l, mean ± SD). The clearances of 51Cr‐EDTA and PAH were not altered during quinidine therapy, indicating that neither glomerular filtration nor total renal blood flow changed when quinidine was added. The ratio of the renal clearance of unbound digoxin to that of the glomerular filtration rate was above one for all 10 patients before quinidine, indicating the involvement of tubular secretion in the renal elimination of digoxin. After the administration of quinidine this ratio decreased in all patients (from 1·51 ± 0·30 to 0·83 ± 0·38, mean ± SD). Some patients had ratios well below one suggesting re‐absorption of digoxin. β2‐microglobulin excretion was unchanged during treatment with quinidine. It is concluded that a significant portion of the renal elimination of digoxin in man results from tubular secretion and that this excretory mechanism is inhibited by quinidine.
Non‐invasive determination of the distribution of cardiac output in man at rest and during exercise
Authors: Svensson S‐E. , Lomsky M. , Olsson L. , Persson S. , Strauss H. W. , Westling H.
Published: April 2008

Summary.The distribution of cardiac output, as expressed by the regional uptake of thallium‐201 following injection, has been studied by whole body scanning with a gamma‐camera in six healthy persons and eight patients with aortic valvular disease. In the patients, cardiac output at rest and during exercise was also measured by the dye dilution technique. Combining the values of cardiac output and regional thallium uptake enabled the calculation of organ blood flow.

The myocardial uptake of thallium at rest was 3·2 ± 0·32% in the control group, which is significantly lower than 8·3 ± 1·52%, found in the patients. The corresponding values measured in the kidneys were 12·5 ±1·91% in the healthy subjects and 7·1 ± 0·50% in the patient material.

Myocardial uptake increased and kidney uptake decreased in both groups following injection at peak exercise. Thallium uptake in the legs increased from about 13% at rest to about 39% at exercise in both groups. Distribution of thallium after injection at peak exercise did not, however, vary significantly between the two groups in the kidneys, abdominal area or the legs.

Further methodological work is required before it can be ascertained to what extent the regional thallium uptake reflects the distribution of cardiac output. We nevertheless propose that the technique should be explored further, since it appears to be a simple non‐invasive means of visualizing the distribution of the cardiac output in man under certain conditions.
Effect of cigarette smoking on basal and carbon dioxide stimulated cerebral blood flow in man
Authors: Wennmalm Åke
Published: April 2008

Summary. The effect of cigarette smoking on the basal cerebral blood flow (CBF) and on the cerebral hyperemia induced by CO2 breathing was investigated in healthy human volunteers. CBF was measured with the N2O‐wash‐in technique in the basal state and during inhalation of 5% CO2, before and after smoking of two commercial filter tipped cigarettes. In parallel the (arterial‐jugular venous) difference in O2 content, arterial and jugular venous pCO2, pulmonary ventilation, heart rate and systemic blood pressure were followed.

During smoking there was a 10–15 mmHg increase in systemic blood pressure and a parallel elevation of heart rate (+20 beats/min). Cerebral blood flow increased by about 25%, and cerebral vascular resistance fell about 15%. The cerebral metabolic rate of oxygen (CMRO2) was elevated by about 30% above control. Inhalation of 5% CO2 by itself markedly increased CBF and decreased cerebral vascular resistance, while leaving CMRO2 unaffected. Cigarette smoking did not significantly change either of these effects of CO2 breathing.

From these data it is concluded that cigarette smoking elevates systemic blood pressure and decreases cerebral vascular resistance, and thereby augments basal CBF. This flow‐promoting effect of smoking is probably due to an increased cerebral consumption of oxygen. Furthermore, the data demonstrate that smoking does not interfere with the cerebral vascular response to increased arterial pCO2.
Lung surfactant for replacement therapy
Authors: Robertson Bengt
Published: April 2008

Summary. In recent years, several attempts have been made to treat, or prevent, the neonatal respiratory distress syndrome (RDS) with exogenous surfactants. The most successful clinical trial so far reported concerned a series of artificially ventilated RDS‐patients who were treated with a mixture of bovine natural surfactant and the synthetic phospholipids dipalmitoylphosphatidylcholine (DPPC) and unsaturated phosphatidylglycerol (PG). The rationale of this combination is that enrichment of natural surfactant with DPPC and PG strikingly modifies the in vitro surface properties of the surfactant preparation, reducing surface tension to very low values already at moderate surface compression. In other similar clinical trials, promising results have been obtained with natural surfactant suspended with CaCl2, with human surfactant purified from amniotic fluid, and with protein‐free natural surfactant from bovine lungs. Encouraging results have also been reported from a recent trial in which a dry, artificial surfactant, composed of DPPC and unsaturated PG, was administered prophylactically into the airways of premature babies shortly after birth. More studies, involving a combination of in vitro and in vivo experiments, are nevertheless needed to identify the optimal composition of an artificial surfactant and to evaluate the long‐term effects of surfactant replacement on the premature lung.
Oesophageal transit of a radionuclide solid bolus in normals
Authors: Kjellén Gerhard , Svedberg John S.
Published: April 2008

Summary. The purpose of this study was to evaluate the physiological transit pattern of a compact bolus through the oesophagus in normal subjects. A standard gelatine bolus labelled with 99mTechnetium pertechnetate was swallowed in the erect and the supine positions and traced by a gamma‐camera in 20 subjects. In the erect position, the mean overall transit time was 5·5 ± 1·1 s (SD) which differed significantly (P< 0·001) from the longer mean overall transit time of 6·9 ± 1·4 s (SD) in the supine position. The transit patterns differed between erect and supine positions. In the erect position, the bolus travelled at a constant velocity until the most distal part of the oesophagus where a slight retardation of the velocity occurred, whilst in the supine position, a uniform retardation of the velocity was seen which was slightly accentuated in the most distal part.

The present data provide a basis for the evaluation of studies on the bolus transport in patients with suspected oesophageal dysfunction.
Transcapillary escape rate of albumin in juvenile hypertension
Authors: Roztoč;l K. , Přerovský I. , Jandová R. , Widimský J. , Oliva I.
Published: April 2008

Summary.The transcapillary escape rate of albumin was studied in 24 juvenile hypertensives and in 13 controls on the basis of the radioactivities determined in the blood during 60 min after i.v. injection of human131I–labelled albumin. In addition, the central haemodynamics of all hypertensive subjects was examined at rest and during exercise. The patients were grouped according to their pressure during the investigation at rest. The group whose mean arterial pressure did not exceed 100 mmHg, thus being within the range of normotension, did not exhibit a significant deviation from controls. The group with mean arterial pressure exceeding this limit (corresponding to the range of borderline hypertension) showed a significantly higher escape rate of albumin (9.3 ± 50%/h) than controls (5.2 ± 1.6%/h). The albumin escape rate was significantly correlated to the mean pulmonary artery pressure during exercise but not to the remaining central haemodynamic parameters at rest or during exercise. No difference was seen in the magnitude of plasma volumes of juvenile hypertensives and controls. The findings suggest that secondary changes of capillary functions are present already in the early stages of hypertension.
A method for the calculation of renal clearance based on a single plasma sample
Authors: Jacobsson Lars
Published: April 2008

Summary. A formula has been derived for the calculation of renal clearance with the use of a single plasma sample. The formula is based on a one‐compartment model. A small correction for non‐immediate mixing and non‐uniform distribution of the tracer was calculated from empirical data. The accuracy in the calculation method depends on how exactly the distribution volume is known and at what time the blood sample is taken. The expected standard deviation in the clearance value was calculated from data of mean value and spread for the distribution volume of 99Tcm‐DTPA. In an investigation of 39 subjects with 99Tcm‐DTPA, a standard deviation of 5 to 6 ml/min was obtained in comparison with a standard method for clearance calculation. This value is in good agreement with the expected one.
Estimation of digital circulation and its correlation to clinical signs of ischaemia‐a comparative methodological study
Authors: Jogestrand Tomas , Berglund Bo
Published: April 2008

Summary. Five different methods were used to evaluate the arterial blood supply to 29 toes from 15 patients with atherosclerotic disease: digital pulse plethysmography, systolic toe blood pressure recording, skin temperature recording, vital capillary microscopy and dynamic fluorescein angiography. An optimal discrimination between legs with and without ischaemic ulcers or gangrene was obtained with the following borderlines: inclination time non‐measurable because of very low or no recordable pulse curve, systolic toe blood pressure < 20 mmHg, skin temperature (after vasodilatation) < 29°C, capillary stage > 3 (indicating the presence of capillary haemorrhages or more advanced changes) and fluorescein appearance time > 45 s. The results of the study provide no basis for the opinion that one method is superior to the others in discriminating between arteriosclerotic feet with and without existing skin necrosis.
Depressed protein synthesis is the dominant characteristic of muscle wasting and cachexia
Authors: Rennie M. J. , Edwards R. H. T. , Emery P. W. , Halliday D. , Lundholm K. , Millward D. J.
Published: April 2008

Summary. Wasting of skeletal muscle is a characteristic of many conditions besides those involving primary muscle disease, for example, cancer, cachexia and postoperative catabolism. There is now strong evidence from studies in animals, normal men and in patients with a variety of diseases to suggest that the muscle mass is regulated primarily by alterations in the protein synthetic rate and that changes in muscle protein degradation are largely secondary and adaptive. If this is so, attention should be focused on possible means of therapeutic intervention to increase protein synthesis rather than on ways of decreasing protein degradation.
Vascular recruitment in forearm muscles during exercise
Authors: Palm T. , Nielsen S. L. , Lassen N. A.
Published: April 2008

Summary. Blood flow and filtration of water across the vascular bed in human forearm muscles were studied at rest and during graded exercise with a hand ergometer. Blood flow was measured by dye dilution and water filtration was determined after injection of hyperoncotic albumin solution (23%) in the brachial artery creating a tissue to blood ultrafiltration measurable as a dilution in the effluent blood. The filtration constants were expressed as a filtration coefficient Fe (ml water/ml plasma mmHg increase in oncotic pressure), and, multiplying by the plasma flow, as a filtration capacity Kf (ml water/100 ml tissue min mmHg increase in oncotic pressure). During the increase in plasma flow induced by exercise, Fe remained constant at about 0·0007, but Kf increased in parallel with the hyperaemia from 0·0031 to 0·038 when plasma flow increased from 4 to 48 ml (100 ml min)‐1.

The data suggest a more massive recruitment of exchange area during exercise (a factor 12) than suspected on the basis of ultrafiltration in animals made with the prolonged venous stasis technique (showing a factor 2–5). The estimated variability in exchange surface area indicates, that animal studies of muscle circulation, whether pertaining to capillary permeability or capillary filtration should gain by an independent estimate of the number of capillaries that are flowing during the particular experimental situation.
Human myocardial and skeletal muscle enzyme activities: creatine kinase and its isozyme MB as related to citrate synthase and muscle fibre types
Authors: Sylvén Christer , Jansson Eva , Olin Christian
Published: April 2008

Summary. Activities of myocardial and skeletal muscle total creatine kinase (CK) and its isozyme MB were related to the oxidative capacity [measured as the citrate synthase (CS) activity] and to the contractile characteristics (estimated as the percentage of type I muscle fibres). Skeletal muscle biopsies were obtained both from physically trained and untrained men and myocardial biopsies from patients subjected to open‐heart surgery performed because of mitral or aortic valve disease. Enzyme activities were determined on freeze‐dried muscle specimens.

The CK‐MB activity was about twice as high in trained skeletal muscle as in untrained ones reaching the myocardial level. The total CK activity was about three times higher in skeletal muscle than in myocardium; the myocardium, however, had CS activity 3–4 times larger than that of skeletal muscle. A close correlation was demonstrated between activities of CK‐MB on one hand and CS (r= 0·76) or percentage type I fibres (r= 0·83) on the other hand suggesting a connection between CK‐MB activity and the oxidative capacity of the cell. This was in contrast to total CK where different regressions were obtained when comparing the myocardium and the skeletal muscle of trained or untrained men. In conclusion, CK‐MB activity in trained skeletal muscle in athletes were similar to that in myocardium. CK‐MB was related to the oxidative capacity and formation of cellular energy in skeletal and heart muscle.
How often may a Read rebreathing test be repeated?
Authors: Scamman Franklin L. , Ghoneim M. M.
Published: April 2008

Summary. The minimum duration of the rest period between repeated Read re‐breathing tests required to prevent interference between tests is yet unknown. Four male and four female volunteers performed eight Read rebreathing CO2 response tests in a period of 2·5 h. The test‐to‐test interval was as short as 10 min. No major differences in slope or intercept were found according to time in either the group as a whole or as male and female groups taken separately. There was a slight but nonsignificant depression in slope for the 3rd to 5th tests. The females responded less to a CO2 challenge than did the males. It is concluded that a test‐to‐test interval as short as 10 min does not effect the results of the Read rebreathing test.