bluuebunny/crossref_metadata_2025 huggingface dataset:
The Use of Endo-GIA Vascular Staplers in Liver Surgery and Their Potential Benefit:A Review
Authors: Schemmer Peter , Friess Helmut , Dervenis Christos , Schmidt Jan , Weitz Jürgen , Uhl Waldemar , Büchler Markus W.
Published: July 2007

Stapling devices have been introduced for safety and to reduce the overall operative time in many surgical procedures. In hepatobiliary surgery, i.e. liver resection, several types of staplers are in use. While transection of hepatic vessels with vascular staplers is well established, their use in dissecting hepatic parenchyma has only been assessed recently. Its advantages were especially a low rate of biliary complications (i.e., bile fistulas, bilioma) and reduced bleeding. As expected, the operative time was decreased dramatically while both the complication rate in general and the overall costs for stapler hepatectomy were comparable with other techniques used in high-volume centers. Thus, endo-GIA vascular staplers can be safely used to dissect the hepatic parenchyma in a routine clinical setting with low incidence of surgical complications.
A Radiofrequency-Assisted Minimal Blood Loss Liver Parenchyma Dissection Technique
Authors: Milićević Miroslav , Bulajić Predrag , Žuvela Marinko , Dervenis Christos , Basarić Dragan , Galun Danijel
Published: July 2007

Background/Aims: Intraoperative blood loss is still a major concern for surgeons operating on the liver since it is associated with a significantly higher rate of postoperative complications and shorter long-term survival. An original radiofrequency (RF)-assisted minimal blood loss technique for transecting liver parenchyma is presented. Methods: In a prospective study, starting November 2001 and ending December 2005, a total of 90 RF-assisted liver resections were done. Pre-cut coagulative desiccation was produced by the Cool-tip™ (Valleylab, Tyco) water-cooled, single, RF tumor ablation electrode connected to a 480-kHz 200 W generator (Valleylab Cool-tip™ RF System). Vascular occlusion techniques and low central venous pressure anesthesia were not used. Results: Only 14 (15.5%) patients received blood transfusion (mean transfused blood volume 397 ml; mode 310 ml) and 10 of 14 patients received <310 ml of blood. There was no statistical difference between the patients who underwent major and minor liver resection in frequency of blood transfusion. Blood loss was associated with dense adhesions and difficult liver mobilization and not with liver transection. Conclusion: The ‘sequential coagulate-cut’ RF-assisted liver resection technique is a safe liver transection technique associated with minimal blood loss and it has facilitated tissue-sparing liver resection.
Bloodless Liver Resection Using Radiofrequency Energy
Authors: Ayav Ahmet , Jiao Long R. , Habib Nagy A.
Published: July 2007

Background: Liver surgery carries the risk of intraoperative bleeding. In order to avoid bleeding, transection of the liver can be performed after coagulating the parenchyma by using monoplolar or bipolar radiofrequency energy. Methods: 236 consecutive patients underwent liver resection with the radiofrequency-assisted technique using either a monopolar or a bipolar device. Data were collected prospectively to assess the outcome including, intraoperative blood loss, blood transfusion requirement, morbidity and mortality rates. Results: There were 41 major hepatectomies and 195 minor resections. Overall mean intraoperative blood loss was 157 ± 240 ml, while mean blood loss during liver transection was 90 ± 105 ml. 10 patients (4%) received blood transfusion. 50 patients (21%) developed postoperative complications including 5 bile leaks (2%). The mortality rate was 2.1%. No patient was reoperated for postoperative haemorrhage or bile leak. The mean postoperative stay was 11 ± 10 days. Conclusion: The radiofrequency-assisted liver resection technique offers hepatobiliary surgeons an additional method for performing liver resections with minimal blood loss, low transfusion requirement, and low morbidity and mortality rates.
The Phylogeography of African Brazilians
Authors: Gonçalves Vanessa F. , Carvalho Cláudia M.B. , Bortolini Maria Cátira , Bydlowski Sérgio P. , Pena Sérgio D.J.
Published: July 2007

Background/Aims: Approximately four million Africans were taken as slaves to Brazil, where they interbred extensively with Amerindians and Europeans. We have previously shown that while most White Brazilians carry Y chromosomes of European origin, they display high proportions of African and Amerindian mtDNA lineages, because of sex-biased genetic admixture. Methods: We studied the Y chromosome and mtDNA haplogroup structure of 120 Black males from Sao Paulo, Brazil. Results: Only 48% of the Y chromosomes, but 85% of the mtDNA haplogroups were characteristic of sub-Saharan Africa, confirming our previous observation of sexually biased mating. We mined literature data for mtDNA and Y chromosome haplogroup frequencies for African native populations from regions involved in Atlantic Slave Trade. Principal Components Analysis and Bayesian analysis of population structure revealed no genetic differentiation of Y chromosome marker frequencies between the African regions. However, mtDNA examination unraveled considerable genetic structure, with three clusters at Central-West Africa, West Africa and Southeast Africa. A hypothesis is proposed to explain this structure. Conclusion: Using these mtDNA data we could obtain for the first time an estimate of the relative ancestral contribution of Central-West (0.445), West (0.431) and Southeast Africa (0.123) to African Brazilians from Sao Paulo. These estimates are consistent with historical information.
Modeling Gene-Gene Interactions Using Graphical Chain Models
Authors: Foraita Ronja , Bammann Karin , Pigeot Iris
Published: July 2007

Objective: To investigate whether graphical chain models are suitable to detect gene-gene interaction under different biological models. Methods: We conducted a simulation study comparing graphical chain models with logistic regression models regarding their ability to detect underlying biological interaction models. For both methods, we attempted to capture simulation data following 12 different biological models. We used 10 statistical models for both methods. Of the 12 different biological models, four contained no interaction effects, two were multiplicative, and six were epistasis models. For each situation, the choice for a statistical model was based on global model fit as judged by two different information criteria, the BIC and the AIC. Results: Both methods failed in most of the scenarios to capture the gene-gene interaction present in the simulation data. Only in very specific cases, when disease risk was high and both genes had a dominant effect, present gene-gene interaction was detected. Conclusions: Graphical chain models are, similar to logistic regression models, not able to capture gene-gene interactions for arbitrary biological models underlying the data.
Prenatal Maternal Paroxetine Treatment and Neonatal Mortality in the Rat: A Preliminary Study
Authors: Van den Hove Daniël L.A. , Blanco Carlos E. , Scheepens Arjan , Desbonnet Lieve , Myint Aye-Mu , Leonard Brian E. , Prickaerts Jos , Steinbusch Harry W.M.
Published: July 2007

Recent evidence has shown that prenatal maternal stress has negative consequences for the mental health of the adult organism. Our aim was to examine the efficacy of using the selective serotonin reuptake inhibitor, paroxetine, to alleviate the symptoms of prenatal maternal stress in Fisher 344 rats. Pregnant rats were subjected to daily restraint stress and concurrent paroxetine treatment (10 mg/kg p.o.) during the last week of gestation. Maternal paroxetine treatment led to a shortened gestational length, reduced birth weight and a 10-fold rise in neonatal mortality in both stressed and non-stressed litters. These results reiterate the need for further research on the effects of paroxetine treatment during gestation.
Effects of Patupilone (Epothilone B; EPO906), a Novel Chemotherapeutic Agent, in Hepatocellular Carcinoma: An in vitro Study
Authors: Mok Tony S.K. , Choi Eve , Yau Daisy , Johri Anandhi , Yeo Winnie , Chan Anthony T.C. , Wong Cesar
Published: July 2007

Purpose: In this study, the cytotoxic effects of patupilone (epothilone B; EPO906) were assessed in a panel of hepatocellular carcinoma (HCC) cell lines, and were compared with doxorubicin and the microtubule-stabilizing taxanes. Methods: The following HCC cell lines were used: PLC/PRF/5, HepG2, Hep3B, SNU-387, SNU-398, SNU-423, SNU-449, and SNU-475. Cells were treated with various concentrations of patupilone, paclitaxel, docetaxel, or doxorubicin for 72 h; 50% inhibitory concentrations (IC50) were determined by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide assay. P-glycoprotein expression was assessed using standard Western blotting techniques. Results: Patupilone was found to be the most potent drug in all 8 HCC cell lines. All cell lines except SNU-449 were 4- to19-fold more sensitive to patupilone than to paclitaxel and docetaxel, and 59- to 208-fold more sensitive than to doxorubicin. SNU-449, the most resistant cell line and the only one overexpressing P-glycoprotein, was 3- to 39-fold more resistant to paclitaxel, docetaxel, and doxorubicin than were other cell lines. The IC50 of patupilone in SNU-449 was 1.14 nmol, which was 108- to 529-fold lower than those of the other agents. Conclusion: Patupilone was more potent than taxanes and doxorubicin in HCC cell lines and may result in reduced clinical resistance by overcoming P-glycoprotein overexpression. A clinical study in HCC is warranted.
Assessment of the Efficacy and Safety of Intravenous Conivaptan in Euvolemic and Hypervolemic Hyponatremia
Authors: Zeltser David , Rosansky Steven , van Rensburg Hannes , Verbalis Joseph G. , Smith Neila
Published: July 2007

Background: Most cases of hyponatremia – serum sodium concentration ([Na+]) <135 mEq/l (<135 mM) – are associated with an elevated plasma arginine vasopressin level. This study investigated the efficacy and tolerability of intravenous conivaptan (YM087), a vasopressin V1A/V2-receptor antagonist, in treating euvolemic and hypervolemic hyponatremia. Methods: Eighty-four hospitalized patients with euvolemic or hypervolemic hyponatremia (serum [Na+] 115 to <130 mEq/l) were randomly assigned to receive intravenous placebo or conivaptan administered as a 30-min, 20-mg loading dose followed by a 96-hour infusion of either 40 or 80 mg/day. The primary efficacy measure was change in serum [Na+], measured by the baseline-adjusted area under the [Na+]-time curve. The secondary measures included time from first dose to a confirmed ≧4 mEq/l serum [Na+] increase, total time patients had serum [Na+] ≧4 mEq/l higher than baseline, change in serum [Na+] from baseline to the end of treatment, and number of patients with a confirmed ≧6 mEq/l increase in serum [Na+] or normal [Na+] (≧135 mEq/l). Results: Both conivaptan doses increased area under the [Na+]-time curve during the 4-day treatment (p < 0.0001 vs. placebo). From baseline to the end of treatment, the least-squares mean ± standard error serum [Na+] increase associated with placebo was 0.8 ± 0.8 mEq/l; with conivaptan 40 mg/day, 6.3 ± 0.7 mEq/l; and with conivaptan 80 mg/day, 9.4 ± 0.8 mEq/l. Conivaptan significantly improved all secondary efficacy measures (p < 0.001 vs. placebo, both doses). Conivaptan was generally well tolerated, although infusion-site reactions led to the withdrawal of 1 (3%) and 4 (15%) of patients given conivaptan 40 and 80 mg/day, respectively. Conclusion: Among patients with euvolemic or hypervolemic hyponatremia, 4-day intravenous infusion of conivaptan 40 mg/day significantly increased serum [Na+] and was well tolerated.
Hepatocytes Treated with HBV X Protein as Cytotoxic Effectors Kill Primary Hepatocytes by TNF-Alpha-Related Apoptosis-Induced Ligand-Mediated Mechanism
Authors: Yang Yida , Zheng Lin , Lv Guocai , Jin Xi , Sheng Jifang
Published: July 2007

Objective: To investigate the effect of HBV X protein (HBX) on TNF-α-related apoptosis-induced ligand (TRAIL) expression in HepG2 cells, and observe death of primary hepatocytes induced by HBX-transfected HepG2 cells. Methods: Western blot was used to detect the TRAIL expression in HepG2 cells transfected with mammalian expression plasmid pSG5UTPL-HBX. The reverse transcription-PCR was used to observe TRAIL mRNA transcription stimulated by HBX protein, and chromium release assay was used to detect death of primary hepatocyte induced by HBX-transfected HepG2 cells. Results: HBX could increase TRAIL expression and mRNA transcription in HepG2 cells in a dose-dependent manner. The C-terminal truncated version of HBX (HBXD1) is responsible for inducing TRAIL expression in HepG2 cells. Chromium release assay results showed that HBX-transfected HepG2 cells kill primary human hepatocytes by a TRAIL-mediated mechanism. Neutralizing anti-TRAIL inhibits the HepG2 killing. Conclusion: HBX protein increases TRAIL expression in HepG2 cells which induced death of primary hepatocytes. HBX protein may play an important role in mechanisms of hepatic cell death and hepatic inflammation caused by HBV infection.
HMG-CoA Reductase Inhibitors Reduce Nicotine-Induced Expression of Cellular Adhesion Molecules in Cultured Human Coronary Endothelial Cells
Authors: Cirillo Plinio , Pacileo Mario , De Rosa Salvatore , Calabrò Paolo , Gargiulo Annarita , Angri Valeria , Prevete Nella , Fiorentino Isabella , Ucci Grazia , Sasso Laura , Petrillo Gianluca , D’Amore Sergio Musto , Chiariello Massimo
Published: July 2007

Background: Smoking predisposes to the development of atherosclerosis and of its complications. The mechanisms responsible for these effects are not completely understood. We have investigated whether nicotine might promote a proatherosclerotic state in human coronary endothelial cells (HCAECs), studying the role of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors in preventing these phenomena. Methods and Results: Real-time PCR showed that nicotine induced a dose-dependent increase in mRNA levels for vascular cellular adhesion molecule-1 (VCAM-1)/intercellular adhesion molecule-1 (ICAM-1). Fluorescent-activated cell sorting analysis showed that nicotine induced expression of functionally active VCAM-1/ICAM-1, since they increased leukocyte adherence to HCAECs. Oxygen free radicals, Rho A and nuclear factor ĸB (NF-ĸB) play a pivotal role in modulating these effects. Indeed, nicotine caused oxygen free radical production as well as activation of Rho A and NF-ĸB pathways, evaluated by malondialdehyde levels, pulldown assay and by electrophoretic mobility shift assay, respectively. Superoxide dimutase, Rho A (Y-27639) and NF-ĸB inhibitors (pyrrolidine dithiocarbamate ammonium, Bay 11-7082) suppressed nicotine effects on CAM expression. HMG-CoA reductase inhibitors prevented these nicotine-mediated effects by inhibiting free radical generation and by modulating activation of Rho A and NF-ĸB pathways. Conclusions: Nicotine promotes CAM expression on HCAECs, shifting them toward a proatherosclerotic state. These effects might explain, at least in part, the deleterious cardiovascular consequences of cigarette smoking. HMG-CoA reductase inhibitors play an important role in preventing these phenomena.
Chronic Cystamine Treatment Inhibits Small Artery Remodelling in Rats
Authors: Eftekhari Ashkan , Rahman Awahan , Schæbel Louise Holm , Chen Hua , Rasmussen Claus Vitrup , Aalkjær Christian , Buus Carsten Leander , Mulvany Michael J.
Published: July 2007

Background/Aims: We investigated whether the tissue transglutaminase inhibitor cystamine is able to inhibit remodelling of small arteries in vivo, a possibility suggested by recent in vitro experiments. Methods: Using osmotic minipumps, phenylephrine, cystamine and/or amlodipine were infused for 1–2 weeks into 9-week-old Wistar rats. Small arteries were then removed for pressure myograph investigation. Results: Phenylephrine infusion caused inward remodelling of the small arteries compared to vehicle infusion. The remodelling was abolished by concomitant infusion with cystamine; blood pressure was unaffected. Second, we investigated whether cystamine was able to inhibit outward remodelling. Rats were first infused with phenylephrine for 1 week, and some were infused for a further week with amlodipine with or without cystamine. Amlodipine caused 24% outward remodelling compared to vessels from rats at completion of the phenylephrine infusion. The outward remodelling was attenuated 86% by concomitant cystamine infusion. A series of in vitro experiments supported the inhibitory action of cystamine on tissue transglutaminase. Conclusion: The ability of cystamine to inhibit inward remodelling independent of blood pressure is consistent with a role of tissue transgluaminase in this process. It remains to be determined if the ability of cystamine to inhibit outward remodelling also involves inhibition of tissue transglutaminase.
Temperament and Character in Patients with Borderline Personality Disorder Taking Gender and Comorbidity into Account
Authors: Barnow Sven , Herpertz Sabine C. , Spitzer Carsten , Stopsack Malte , Preuss Ulrich W. , Grabe Hans J. , Kessler Christoph , Freyberger Harald J.
Published: July 2007

This study examined correlations of borderline personality disorder (BPD) symptoms with scales from Cloninger’s psychobiological model taking gender and psychiatric comorbidity into consideration. Inpatients with BPD (n = 202) were compared to several control groups including psychiatrically healthy persons (n = 327), subjects with affective disorders (n = 46), alcohol use disorders (n = 47), cluster C personality disorders (n = 23) and antisocial personality disorder (n = 25). The results indicate that only males with BPD presented an ‘explosive’ temperament suggested by Cloninger, with simultaneously high levels of novelty seeking and harm avoidance. In contrast, women with BPD were characterized by high levels of harm avoidance, but not novelty seeking. Regarding temperament and character dimensions our analyses suggest that patients with BPD could be characterized, in particular, by a combination of high harm avoidance and very low self-directedness. The specific temperament configuration of BPD postulated by Cloninger’s psychobiological model could only partially be supported. The results provide support for the importance of controlling for gender effects when investigating the applicability of dimensional models with respect to personality disorders.
Body Image and Attitudinal Aspects of Eating Disorders in Rhythmic Gymnasts
Authors: Salbach Harriet , Klinkowski Nora , Pfeiffer Ernst , Lehmkuhl Ulrike , Korte Alexander
Published: July 2007

Background: Aesthetic sports, especially on a competitive level, are often considered as a risk factor for the development of an eating disorder. A few studies have examined this issue in rhythmic gymnasts, but no reports on body image disturbance exist for these athletes compared to anorectic patients. Sampling and Methods: Fifty elite rhythmic gymnasts (average age 14.8 years) including the German national team, 58 female patients with anorexia nervosa (AN; average age 15.5 years), and 56 high school girls (average age 14.9 years) completed the Eating Disorder Inventory-2 and the Test for Detecting Body Image Distortion in Children and Adolescents (Test zur Erfassung der Körperbildstörung bei Kindern und Jugendlichen). Furthermore, body weight and height, body mass index, presence of amenorrhea and frequency of exercise were surveyed. Results: Body mass index was significantly lower in the elite rhythmic gymnasts than in the high school students, and significantly higher than in the AN patients. Both the elite rhythmic gymnasts and the AN patients were significantly smaller than the high school students. The elite rhythmic gymnasts trained significantly more frequently compared with the AN group and the high school group. Regarding the Eating Disorder Inventory-2 and the Test for Detecting Body Image Distortion in Children and Adolescents, AN patients scored significantly higher on all explored subscales than both the elite rhythmic gymnasts and the high school students. Conclusions: Even though some physical similarities were found for the elite rhythmic gymnasts and the AN patients, contrary to previous studies, no noticeable problems related to attitudinal aspects of eating disorders were detected in the elite rhythmic gymnasts. A mildly distorted body image of the abdomen was identified in elite rhythmic gymnasts, while AN patients expressed a broad body image distortion and students expressed no body image distortion. Our data do not allow us to draw conclusions regarding prevalence rates, long-term effects or male athletes.
A Study of Theory of Mind in a Group of Schizophrenic Patients Using a Mental Verb Extension Task
Authors: López-Herrero Paz , Mendoza Lara Elvira , Muñoz López Juana , Fresneda López Maria Dolores , Carballo García Gloria
Published: July 2007

An individual has a theory of mind (ToM) if he imputes mental states to himself and others and applies this system to make predictions about the behaviours of others. Findings of cognitive impairment could help us to understand faulty processing mechanisms in schizophrenia. The proposition is that individuals with schizophrenia may be unable to internalize adequately the points of view of others. We tested 27 schizophrenic patients (ICD; WHO). The positive and negative symptom scale (PANSS) was used to assess psychopathology, and the three ToM tasks – first- and second-order false belief tasks and the mental verb extension task – were administered to each subject. Patients who perform well on the ToM first and second order stories do not show problems in the verb extension task. However, the mistakes made in the first and second order stories are also reflected in the verb extension task. The group having difficulties with the first-order story presented more problems in the mental verbs task than the group showing difficulties with the second-order story. This leads us to conclude that the impairments found on the first-order false belief task are more severe and profound than those on the second-order task, and such specific deficits are also seen in the organization of verbs of knowing. It would seem that some schizophrenic patients do not impute mental states to themselves and others, and therefore use the mental verbs wrongly.
Relationship between Self-Reported and Observer-Reported Ratings for Psychopathology in Psychiatric Inpatients
Authors: Biancosino Bruno , Barbui Corrado , Marmai Luciana , Fagioli Federico , Sabatelli Riccardo , Grassi Luigi
Published: July 2007

Objective: Psychopathology can be measured adopting the perspective of clinicians or the perspective of patients themselves. In the present study, we investigated the degree of coherence between these two viewpoints. Methods: During an 8-month recruitment period, all consecutive patients admitted to two Italian residential facilities were screened for inclusion. The 24-item version of the Brief Psychiatric Rating Scale-Expanded Version (BPRS-E) and the Brief Symptom Inventory (BSI) were administered within the first 3 days since admission and immediately before discharge. Results: During the study period, 71 patients with psychosis (code F20–F29) and 80 patients without psychosis (code F30–F39 and code F60–F69) were included. In patients with psychosis, no correlation was observed between the BPRS-E total score and the General Severity Index (GSI) score at admission and before discharge. However, statistically significant correlations were found between the BPRS depression and anxiety subscale and the BSI subscales investigating affective and neurotic dimensions. In patients without psychosis, no correlation was observed between the BPRS-E total score and the GSI score at admission; conversely, at discharge, a statistically significant correlation was found between the BPRS-E total score and the GSI score, and between the BPRS-E depression and anxiety subscale and the BSI subscales investigating affective and neurotic dimensions. Conclusions: Self-reported and observer-reported ratings hold different meanings and cannot be considered equivalent. In terms of symptom dimensions, data showed that individuals tend to preserve the ability of measuring/assessing their own affective disturbances, even in the presence of psychotic symptoms, but not the ability of measuring/assessing loss of contact with reality.
The Complexity of Age-Related Hearing Impairment: Contributing Environmental and Genetic Factors
Authors: Van Eyken E. , Van Camp G. , Van Laer L.
Published: July 2007

Age-related hearing impairment (ARHI) is the most common sensory impairment seen in the elderly. It is a complex disorder, with both environmental as well as genetic factors contributing to the impairment. The involvement of several environmental factors has been partially elucidated. A first step towards the identification of the genetic factors has been made, which will result in the identification of susceptibility genes, and will provide possible targets for the future treatment and/or prevention of ARHI. This paper aims to give a broad overview of the scientific findings related to ARHI, focusing mainly on environmental and genetic data in humans and in animal models. In addition, methods for the identification of contributing genetic factors as well as possible future therapeutic strategies are discussed.
Signaling Axis in Osteoclast Biology and Therapeutic Targeting in the RANKL/RANK/OPG System
Authors: Tanaka Sakae
Published: July 2007

Bone integrity is maintained through a balance between bone formation and bone resorption, and osteoclasts are primary cells involved in bone resorption. Recent studies have revealed an essential role of macrophage colony-stimulating factor (M-CSF) and receptor activator of nuclear factor kappa-B ligand (RANKL) in the development of osteoclasts, and detailed molecular cascades that induce osteoclast differentiation, activation and apoptosis have been clarified. Osteoclasts are involved in various pathologic conditions, such as osteoporosis, rheumatoid arthritis and tumor-induced bone disease, which are characterized by abnormal bone resorption, and the finding of RANKL has provided us a good therapeutic target for such pathologic conditions.
Peroxisome Proliferator-Activated Receptor-Alpha Deficiency Protects Aged Mice from Insulin Resistance Induced by High-Fat Diet
Authors: Cha Dae Ryong , Han Jee Young , Su Dong Ming , Zhang Yahua , Fan Xuefeng , Breyer Matthew D. , Guan Youfei
Published: July 2007

Background/Aims: Insulin resistance is a central feature of the metabolic syndrome and progressively increases with age, resulting in excessively high incidence of type II diabetes in the elderly population. Peroxisome proliferator-activated receptor-α (PPARα) is widely expressed in insulin target tissues, including those of the liver, kidney, and muscle, where it mediates expression of genes promoting fatty acid β-oxidation. The aim of this study was to evaluate the potential role of PPARα in insulin resistance in aging mice induced by a high-fat diet. Methods: We used male PPARα knockout (KO) mice and wild-type (WT) littermates that were 18 months old. Animals were fed with a high-fat diet (HFD) for 4 weeks, and metabolic parameters associated with insulin sensitivity were assessed. Results: Following HFD treatment, WT mice showed more severe insulin resistance than did mice lacking the PPARα gene, as assessed by both the glucose tolerance test (GTT) and insulin tolerance test (ITT). In addition, WT mice exhibited significantly higher HOMA-IR, plasma total cholesterol levels and urinary albumin-creatinine ratio but less liver weight than did PPARα KO mice. Conclusion: These data suggest that PPARα gene deficiency may protect aged mice from developing insulin resistance and albuminuria induced by a HFD.
Progressive Cervical Length Changes versus Single Cervical Length Measurement by Transvaginal Ultrasound for Prediction of Preterm Delivery
Authors: Dilek Talat Umut Kutlu , Yazici Gurkan , Gurbuz Ayfer , Tasdelen Bahar , Gulhan Sitki , Dilek Burcu , Dilek Saffet
Published: July 2007

Background: To evaluate cervical length changes as predictors of preterm delivery. Methods: Two hundred and fifty-seven pregnant women underwent transvaginal ultrasound examination at 16 and 24 weeks of gestation. Cervical length was measured and the difference between the 2 measurements was calculated. The sensitivity, specificity, positive predictive value and negative predictive value of cervical length and cervical length changes were calculated and these methods were compared by receiver-operating characteristic (ROC) curve analysis. Results: Preterm delivery (before 37 weeks of gestation) occurred in 19 patients (7.4%). The mean cervical length was shorter in the preterm group, the area under the ROC curve for prediction of preterm delivery was 0.914, ultrasound had a sensitivity of 84.2% to predict preterm delivery with a false-positive rate of 18.5%, and the relative risk was 4.56 at the 34.3-mm cutoff value at 24 weeks of gestation. In contrast, a cervical length change on transvaginal ultrasound had a sensitivity of 73.3% to predict preterm delivery with a false-positive rate of 18.1%, and the relative risk was 4.08 at the 6.6-mm cutoff value. Conclusion: A single cervical length measurement obtained at 24 weeks of gestation can predict preterm delivery as accurately as cervical length change.
Role of Oxidative Stress in Intrauterine Growth Restriction
Authors: Biri Aydan , Bozkurt Nuray , Turp Ahmet , Kavutcu Mustafa , Himmetoglu Özdemir , Durak İlker
Published: July 2007

Aims: The objectives of this study were to determine the role of oxidative stress in intrauterine growth restriction (IUGR) and to investigate the possible molecular mechanism(s) leading to oxidant stress in IUGR. Methods: Parameters of the oxidative and antioxidant system were evaluated in maternal plasma, umbilical cord blood, and placental tissue of pregnant women with IUGR fetuses. The same samples were obtained from women with normal pregnancies and were evaluated. Results: The results of this study indicate that while the levels of malondialdehyde (MDA) and xanthine oxidase (XO) were higher in maternal plasma, umbilical cord plasma, and placental tissues of the patients with IUGR when compared to the control group [MDA: 142.8 ± 18.0 vs. 86.4 ± 22.5 nmol/ml, 151.6 ± 25.8 vs. 93.3 ± 7.4 nmol/ml, and 0.72 ± 0.19 vs. 0.42 ± 0.09 nmol/mg protein, respectively (for all p < 0.0005); XO: 1.251 ± 0.674 vs. 0.20 ± 0.019 mIU/ml (p < 0.0005), 1.97 ± 0.73 vs. 0.237 ± 0.143 mIU/ml (p < 0.0005), and 0.023 ± 0.0012 vs. 0.012 ± 0.004 mIU/ml (p < 0.025), respectively], the levels of antioxidant potential were identified to be lower in maternal plasma, umbilical cord plasma, and placental tissues of the patients with IUGR: 63.3 ± 11.9 vs. 198.0 ± 31.9 U/ml (p < 0.0005), 32.6 ± 3.7 vs. 206.5 ± 27.1 U/ml (p < 0.0005), and 0.56 ± 0.23 vs. 1.16 ± 0.29 U/ml (p < 0.0005), respectively. On the other hand, the activities of adenosine deaminase of the IUGR patients were higher than those of the control group in maternal plasma (204.8 ± 103.5 vs. 115.6 ± 31.8 U/l, p < 0.01) and umbilical cord blood samples (584.2 ± 285.2 vs. 147.9 ± 44.8 U/l, p < 0.0005) which may suggest that oxidative stress has a role in IUGR. Moreover, an increased superoxide dismutase activity in maternal plasma (128.2 ± 37.4 vs. 88.8 ± 16.6 U/ml, p < 0.005) and cord blood (162.1 ± 37.0 vs. 116.6 ± 20.7 U/ml, p < 0.005) and an increased glutathione peroxidase activity in maternal plasma (1.83 ± 0.26 vs. 1.47 ± 0.31 IU/ml, p < 0.01) and placental tissue (0.007 ± 0.0015 vs. 0.003 ± 0.0012 IU/ml, p < 0.0005) were detected, while decreased catalase activities in cord blood (23,717 ± 3,538 vs. 16,397 ± 2,771 IU/ml, p < 0.0005) and placental tissue (47.2 ± 17.2 vs. 70.7 ± 11.3 IU/ml, p < 0.005) were identified in IUGR groups. Conclusions: In the light of the results of this study, it can be stated that the oxidative stress increases in patients with IUGR. Providing high-risk patients with an antioxidant may be useful in the prevention or treatment of IUGR, although it is a condition with no certain treatment outcome.
Side-Branched AAA Stent Graft Insertion Using Navigation Technology: A Phantom Study
Authors: Manstad-Hulaas F. , Ommedal S. , Tangen G.A. , Aadahl P. , Hernes T.N.
Published: July 2007

Objective: To evaluate the feasibility of a side-branched stent graft inserted in an artificial abdominal aortic aneurysm (AAA), using navigation technology, and to compare procedure duration and dose of radiation with control trials. Methods: A custom-made stent graft was inserted into an artificial AAA using navigation technology in combination with fluoroscopy. The navigation technology was based on three-dimensional visualization of computed tomography data and electromagnetic tracking of microposition sensors. The stent graft had integrated position sensors in side branch and introducer and was guided into proper position with the aid of three-dimensional images. Control trials were performed with fluoroscopy alone. Results: It was feasible to insert a side-branched stent graft using three-dimensional navigation technology. The navigation-guided trials had a significantly lower X-ray load (p < 0.001), but showed no difference in the duration of the procedures (p = 0.34) as compared with controls. Conclusions: Inserting a side-branched stent graft in an artificial AAA using navigation technology is feasible. Side-branched stent grafts and navigation systems may become useful in the endovascular treatment of complicated aortic aneurysms.
Predictors of Hospitalization in Patients on Peritoneal Dialysis: The Missouri Experience
Authors: Trivedi Hariprasad S. , Tan Seng Hoe , Prowant Barbara F. , Sherman Ashley , Voinescu C. Gentiana , Atalla Jamal , Khanna Ramesh , Nolph Karl D.
Published: July 2007

Background: We analyzed a large number of demographic and biochemical variables to identify predictors of hospitalization in subjects on peritoneal dialysis (PD). Methods: All patients initiated on PD at our center from January 1990 through December 1999 were included. The following variables at the initiation of PD were included: demographics, clinical data, nutritional and adequacy parameters, transport characteristics, and various co-morbidities. Co-morbidities were graded for severity using a modified version of the Index of Coexistent Disease. Variables included during the course of PD consisted of weighted time average of a number of laboratory, adequacy, and nutritional parameters along with the number of peritonitis episodes per year. Stepwise linear regression was used following a univariate screening procedure to identify independent predictors of the outcome of hospitalization days per month on PD. Results: The subject population consisted of 191 subjects (105 men, 86 women; 180 Caucasians, 10 African-American, 1 Asian). The mean age was 61 ± 13 (SD) years and mean duration of follow-up was 21 ± 18 months. The baseline variable analysis revealed that the presence of partner to perform PD predicted increased hospitalization (p < 0.0001). Additionally, the presence and severity of peripheral vascular disease and residual renal Kt/V at baseline (negative association) predicted increased hospitalization. In the analyses of ongoing variables, stepwise linear regression solely identified weighted time average albumin as a strong negative predictor of hospitalization (p < 0.0001). Conclusion: A comprehensive analysis of a large number of variables revealed that serum albumin during the course of PD (negative association) and the need for partner to perform PD strongly predicted increased hospitalization in PD subjects.
Evidence for a Selective Decrease in Type 1 Phosphatidylinositol Kinase Activity in Brains of Patients with Alzheimer's Disease
Authors: Bothmer J. , Markerink M. , Jolles J.
Published: July 2007

We have previously shown that phosphatidylinositol (PI) kinase activity is 40–50% lower in cytosolic fractions of neocortical regions from brains of patients with Alzheimer''s disease (AD) in contrast to phosphatidylinositol phosphate (PIP) kinase activity, which was not affected. After preparing different enzyme fractions by solubilization, the PI kinase activity in the salt-solubilized protein preparation of the temporal cortex of AD brains was predominantly affected (70% decrease). PIP kinase activity in AD brains was not different from that of control brains in any of the fractions tested. PI kinase in the salt-solubilized fractions was inhibited (–75%) by 1% Triton X-100, whereas the PI kinase in the detergent solubilized protein preparation was stimulated (+80%) by 1% Triton X-100. PI kinase activity in the salt-solubilized protein preparation was almost unaffected by adenosine in contrast to PI kinase activity in the detergent solubilized protein preparation, which was strongly inhibited by adenosine. These results indicate that the PI kinase that is specifically affected in AD is the PI 3-kinase, or type 1 PI kinase, because the fraction which was affected most severely has (1) a cytosolic localization; (2) a high sensitivity to inhibition by the non-ionic detergent Triton X-100, and (3) an insensitivity to adenosine inhibition, which are characteristic features of type 1 PI kinase. The relevance of our findings is that type 1 PI kinase is thought to be involved in the regulation of cytoskeletal turnover processes. In this context, changes in the type 1 PI kinase activity could be related to the cellular pathology of AD because neurofibrillary tangles, which are a prominent feature of AD, are partially composed of wrongly phosphorylated cytoskeletal components.
Dementia in Parkinson's Disease
Authors: Friedman Andrzej , Barcikowska Maria
Published: July 2007

The prevalence of dementia, assessed on the basis of the Wechsler scale (WAIS), was determined in a group of 88 patients with idiopathic Parkinson''s disease (PD) lasting longer than 4 years. In this group, 19 patients (22%) were diagnosed as demented. They were significantly older at the time of evaluation (72.9 ± 8.1 vs. 63.6 ± 11.9), and also at the onset of the disease (61.1 ± 10.6 vs. 54.4 ±12.1) than nondemented patients. Their parkinsonism, as judged on the base of the Activity of Daily Living Scale, was more pronounced (57.4 ± 13.7 vs. 73.3 ± 15.6) and they developed psychotic side-effects of L-DOPA treatment (53% vs. 9%) more often. A weak negative correlation between age and intellectual quotient (IQ) was found, and a much stronger positive correlation between education and IQ. 25 patients of those diagnosed previously as non-demented were reassessed for dementia after another 5 years of disease. Only two of them were found demented. Both died and an immunohistochemical study of their brains was performed. In the 2 cases we found neuropathological features of both PD (Lewy bodies) and Alzheimer''s disease (AD) – neurofibrillary tangles (NFT) and senile plaques (SP). This finding may support the hypothesis that, at least in some cases, dementia in PD could be due to an accompanying AD.
Age-Specific Hospital Incidence Rates in Dementia
Authors: Ryan D.H.
Published: July 2007

A random sample (n = 101,104) was taken from total general hospital admissions to Scottish hospitals (1:25 fraction) during the period 1968–1977. Record linkage was used to connect general hospital and psychiatric hospital morbidity records (SMR 1 and SMR 4). Patients with a subsequent admission with dementia (principal diagnosis ICD 9 290) were identified from the general hospital sample on follow-up. Age-specific first-admission rates for dementia were calculated for the hospital population considered. First-admission rates ranged from 41.9 (per 100,000 person-years-at-risk, PYR) for male patients aged 60–64 years to 514.2 in the age band 80 years and over. The equivalent figures for female patients were 40.8 (per 100,000 PYR) and 723.1. Epidemiological research has shown an approximate doubling of prevalence rates every 5 years after the age of 60 years, and the age-banded hospital admission rates in the present study are consistent with this underlying pattern. Expected first-admission rates in dementia were calculated from admission rates in dementia and community prevalence reported in previous studies. Expected rates were contrasted with the rates observed in the present study. An estimated 6-7% of prevalent dementia cases and between 11 and 14% of ‘expected dementia admissions’ achieved a recorded main diagnosis of dementia, and proportions were stable across age bands in the case of both measures. The wide discrepancy between expected and observed admission rates suggests relative underreporting of dementia as a principal diagnosis in hospital statistics.
Clinical Deterioration in Probable Alzheimer's Disease Correlates with Progressive Metabolic Impairment of Association Areas
Authors: Mielke R. , Herholz K. , Grond M. , Kessler J. , Heiss W.D.
Published: July 2007

Regional cerebral glucose metabolism (rCMRGl) measured by positron emission tomography of 18F-2-fluoro-2-deoxy-D-glucose was studied longitudinally (interval ranging from 6 to 27 months) in 25 patients with probable Alzheimer''s disease (AD). A significant decline of rCMRGl was noted in the whole brain (p = 0.02) which was most pronounced in the temporoparietal (p = 0.002), frontal (p = 0.01), superior parietal (p = 0.01) and occipital (p = 0.03) association cortex. A similar decline was also present in the thalamus (p = 0.04) but not in the primary visual and sensorimotor cortex, basal ganglia, cerebellum and brainstem. The changes of rCMRGl in the temporoparietal, frontal and occipital association cortex were related to the change of the Mini Mental State Examination score (temporoparietal: r = 0.49, p = 0.01; frontal: r = 0.40, p = 0.05; occipital: r = 0.44, p = 0.03). The rate of clinical and metabolic decline was not related to age at onset, sex, family history or duration of disease. The results suggest that clinical deterioration and metabolic impairment in probable AD are closely related and dependent on progression of pathological changes in cortical association areas.
Correlation of Dementia, Neuropsychological and MRI Findings in Multiple Sclerosis
Authors: Tsolaki M. , Drevelegas A. , Karachristianou S. , Kapinas K. , Divanoglou D. , Routsonis K.
Published: July 2007

Twenty patients diagnosed as having multiple sclerosis (MS) were examined by MRI and 9 neuropsychological scales: MMSE, BCRS, RMB, SDMT, BNT, VM, FAS, Benton and Hamilton. The number and distribution of the lesions, and cerebral and corpus callosum atrophy were evaluated by MRI. MR images were generated by a 0.5 Tesla instrument utilizing T1WI, PD and T2WI imaging techniques. The results reveal (1) that patients with MS are impaired in a broad range of cognitive functions but mainly memory is affected; (2) number of lesions in the corona radiata, insula and hippocampus is correlated with cognitive impairment, and (3) enlargement of the IIIrd ventricle is an indicator of memory impairment in MS patients.
Age-Related Changes in Nerve Growth Factor Receptor Immunoreactive Neurons in the Magnocellular Basal Forebrain System in Rat Brain – an Immunocytochemical and Morphometric Study
Authors: Kobayashi K. , Miyazu K. , Seki M. , Fukutani Y. , Hayashi M. , Aoki T. , Muramori F. , Yamaguchi N.
Published: July 2007

Morphometrical changes with aging in nerve growth factor receptor (NGFR) immunoreactive neurons in the basal forebrain were studied in juvenile and aged rat brains by means of NGFR immunohistochemistry. The nucleus basalis of Meynert (NBM) had cell loss and atrophy of NGFR immunoreactive neurons, and the horizontal nucleus of diagonal band of Broca (HNDB) showed only atrophy of these neurons. The medial septal nucleus and vertical nucleus of diagonal band of Broca had no significant change. Neuropil NGFR immunostaining was reduced in its intensity in the aged rats. As nerve growth factor is synthesized in the target areas and retrogradely transported to the nerve cell body within the basal forebrain and NGFR immunoreactive neurons are largely cholinergic ones, degeneration of NGFR-positive neurons in the basal forebrain may be related to a decreased cholinergic activity. The degeneration of the dendrites of NGFR-immunoreactive neurons were reported to be extensively found in the basal forebrain nuclei, in contrast, degeneration of the cell body of NGFR-immunoreactive neurons was confined to those in the NBM and HNDB in the present study. These findings suggest that atrophic changes in the dendrites precede those in the cell bodies of NGFR-immunoreactive neurons.
Brain Membrane Serine Protease Activity in Human Cortex Compared with Rat: Implication for Alzheimer's Disease
Authors: Stratmann G.C. , Webster M.-T. , Francis P.T. , Procter A.W. , Bowen D.M.
Published: July 2007

Cerebral cortex from humans and rats was extracted sequentially with detergent-containing and low-ionic-strength buffers. The resulting pellet was extracted with detergent/high-ionic-strength buffer to yield a soluble enzyme preparation. This was incubated with substrate prepared from rat cerebral cortical membranes containing amyloid precursor protein-like immunoreactivity (APPLIR) of 116 kD approximate apparent molecular mass. The effectiveness of various enzyme preparations to degrade APPLIR was: routine-post-mortem (pm)-delay human samples > rat pup > short-pm-delay human samples >> adult rat. In incubations with human samples only a 100-kD product accumulated. The activity in human brain was inhibited by phenylmethylsulphonylfluoride, insensitive to Ca2+, correlated with pyramidal neurone numbers but not those of astrocytes and was not significantly higher in Alzheimer''s disease compared with controls. These data are discussed in terms of other approaches for studying proteolytic activity to explain the deposition of β-amyloid protein in this disease.
Long-Term Effects of Phosphatidylserine, Pyritinol, and Cognitive Training in Alzheimer's Disease
Authors: Heiss W.-D. , Kessler J. , Mielke R. , Szelies B. , Herholz K.
Published: July 2007

70 patients with probable Alzheimer''s disease were randomly allocated to four groups: 17 patients received only social support, 18 cognitive training twice a week, in 17 cognitive training was combined with pyritinol 2 x 600 mg/day and in 18 cognitive training was combined with phosphatidylserine 2 x 200 mg/day. Treatment duration was 6 months. Before and after treatment, the patients underwent neuropsychological testing as well as measurement of the regional cerebral metabolic rate for glucose using positron emission tomography and 18F-2-fluoro-2-deoxy-D-glucose. Before treatment the groups were comparable in respect to resting and activated glucose pattern achieved by a visual recognition task. Electrophysiological changes were assessed as EEG power, globally and in 4 frequency bands. This 6-month study in four groups of patients with Alzheimer''s disease indicated that phosphatidylserine treatment has an effect on different measures of brain function. Since neuropsychological improvements were best documented after 8 and 16 weeks and faded towards the end of the treatment period, it must be concluded that this symptomatic therapy is mainly of short-term benefit and was overcome by the progressive pathological changes at the end of the treatment period.