bluuebunny/crossref_metadata_2025 huggingface dataset:
Boerhaave-Mimicking Esophageal Perforation with Subsequent Esophagobronchial Fistula Formation as the Primary Manifestation of Crohn’s Disease
Authors: Yekebas Emre , Busch Christoph , Soehendra Nib , Winzer Olof , Rogiers Xavier , Izbicki Jakob R.
Published: April 2003

Background: Spontaneous ruptures of the esophagus are rare, but may lead to deleterious courses, even if diagnosed early. Case Report: We report a case of Boerhaave’s syndrome-mimicking esophageal perforation due to a stricture of the distal esophagus as the primary manifestation of Crohn’s disease. Diagnosis was delayed resulting in a complicated clinical course. The presented patient is the first case in the literature with esophageal perforation related to a previously undiagnosed Crohn’s disease that lead to stenosis of the distal esophagus before becoming clinically apparent. Conclusion: Difficulties in differential diagnosis, problems related to initial misdiagnosis and consecutive mismanagment of spontaneous esophageal perforation, and treatment options including nonsurgical approaches are discussed.
Management of Presacral Venous Bleeding with the Use of Thumbtacks
Authors: Arnaud Jean-Pierre , Tuech Jean-Jacques , Pessaux Patrick
Published: April 2003

Massive bleeding from the sacral basivertebral vein is uncommon and can be fatal because conventional methods to control the bleeding are often futile. The authors report an effective technique of the occlusion of the bleeding site with a thumbtack.
Local Formalin Instillation: An Effective Treatment for Uncontrolled Radiation-Induced Hemorrhagic Proctitis
Authors: Ouwendijk R. , Tetteroo G.W.M. , Bode W. , de Graaf E.J.R.
Published: April 2003

Aim: The aim of this study was to evaluate the efficacy of local instillation of 4% formalin in the management of uncontrolled radiation-induced and ischemic hemorrhagic proctitis. Patients and Methods: Eight patients were reviewed. Operation characteristics, morbidity and long-term results were analyzed. Results: All patients were followed for a median of 18 months. In 5 patients the bleeding stopped after a single treatment and in 3 after a second one. During follow-up no recurrent rectal bleeding occurred, no further medical treatment was needed and in all patients the complaints had disappeared. Conclusion: Local instillation of 4% formalin is an effective treatment for uncontrolled radiation-induced and ischemic hemorrhagic proctitis.
Comparison of Buprenorphine and Methadone in the Treatment of Opioid Dependence
Authors: Uehlinger Claude , Déglon Jean-Jacques , Livoti Santino , Petitjean Sylvie , Waldvogel Doris , Ladewig Dieter
Published: April 2003

A three-centre, randomised, double-blind study was designed to compare the efficacy and safety of buprenorphine and methadone. This was the first European study to compare these agents and was based on a previous trial performed in the US. Opioid-dependent subjects were randomised to receive either sublingual buprenorphine or oral methadone daily. Both objective and subjective measures of efficacy were monitored weekly, and safety parameters were regularly monitored over the entire six-week study. Urinalysis showed that the two treatments were similar with a slight increase in opioid-negative urines noted in both groups. The retention rate in the buprenorphine group was lower than in the methadone group, although it has been suggested that the buprenorphine dose may have been too low for some patients. None of the side effects noted were considered serious and all were attributable to chronic opioid dependence. Experience of two years substitution treatment in Fribourg suggests that initial induction onto buprenorphine allows for patients to be subgrouped before being given the most appropriate maintenance agent. Further investigation is required into the different dose-related effects of buprenorphine seen in particular subsets of addicts.
Detection of Cerebral Aging,an Absolute Need: Predictive Valueof Cognitive Status
Authors: Forette Françoise , Seux Marie-Laure , Thijs Lutgarde , Le Divenah Aude , Pérol Marie-Bénédicte , Rigaud Anne-Sophie , Latour Florence , Bouchacourt Patrice , Staessen Jan A.
Published: April 2003

Cognitive performance is predictive of functional status, morbidity and mortality in the elderly. In the SYST-EUR study, the Vascular Dementia Project run on 3,111 subjects 60 years old and over, with isolated systolic hypertension, has shown that the cognitive status as measured by the MMSE was inversely correlated with systolic blood pressure (p < 0.001) and age (p < 0.001) and positively correlated with the level of education (p < 0.001). It is significantly lower in patients with cardiovascular complications (p = 0.0001). Moderate alcohol consumption is linked to a higher MMSE score in women (p < 0.001) but not in men. In this study, the incidence of dementia is low and significantly related to the baseline value of the MMSE score and further analysis will show the influence of the treatment of systolic hypertension with calcium antagonists as first step on this incidence.
Essential Investigations of Patients with Suspected TIAs
Authors: Anwer Ursula E.
Published: April 2003

Transient ischemic attacks (TIAs) are warning episodes predicting that such patients are at high risk for stroke which potentially could be life-threatening or leave an individual with substantial disability. TIAs result from large or small vessel disease, cardiogenic embolic events and hematological abnormalities. The patient’s past and current medical history provides necessary clues suggesting which investigational tests should be conducted. Every patient presenting with a TIA should have a total blood count, electrocardiogram, and a brain imaging study. Patients with anterior circulation symptoms should undergo noninvasive carotid testing, usually by carotid duplex ultrasonography, to determine if there is a surgically remediable carotid stenosis. Patients with posterior circulation TIAs should undergo magnetic resonance angiography (MRA) or a conventional arteriogram which, if positive, may be an indication for anti-platelet or anticoagulation therapy. Other testing depends on the presumptive etiology of the TIA. In general, a TIA should be considered as a serious warning of impending stroke that requires rapid and efficient investigations to define and remedy the reasons for the cerebral ischemic events. TIAs by definition may last up to 24 h, but usually are self-terminating after a few minutes. They are a serious warning of possible future strokes that may result in substantial morbidity and mortality. Once TIAs are diagnosed, the major goal is to reduce the risk of future strokes. Patients with TIAs usually present in the Emergency Room or doctor’s office. They may seek immediate medical care or relate the history of the TIA during a routine visit. As soon as a diagnosis of a TIA is considered, a careful past and current medical history should be taken to substantiate the diagnosis. Conditions which mimic TIAs need to enter into the differential diagnosis and, if necessary, be ruled out. For example, a Todd’s transient paralysis can follow a partial focal seizure. Migraine auras may also mimic TIAs, particularly in the elderly. Any space-occupying lesions and arteriovenous malfunction may first present with a TIA-like complaint. Peripheral nerve disease must be recognized since it can cause transient weakness and/or numbness affecting one limb.
Diagnosis and Management of Diabetic Peripheral Neuropathy
Authors: Illa Isabel
Published: April 2003

Diabetic peripheral neuropathy (DPN) is one of the most commonly occurring major complications of diabetes. The disease may manifest in several clinical patterns: most frequently as distal symmetrical sensory polyneuropathy. Guidelines are available for the diagnosis of DPN by the primary care physician. These recommend that a review of diabetic patients, including a questionnaire and inspection and neurological examination of the feet, is undertaken annually. Techniques used for studying the disease process in clinical trials may include nerve conduction and quantitative sensory function tests, autonomic nervous system testing, post-ganglionic sudomotor function and skin biopsy. Current therapies for managing DPN are strict glycaemic control, palliative treatments and foot ulcer prevention. Future treatments aim to beneficially affect the underlying disease pathology and putative agents are currently being investigated.
Differential Regional Cerebral Uptake of 18F-Fluoro-2-Deoxy-D-Glucose in Alzheimer’s Disease and Frontotemporal Dementia at Initial Diagnosis
Authors: Santens P. , De Bleecker J. , Goethals P. , Strijckmans K. , Lemahieu I. , Slegers G. , Dierckx R. , De Reuck J.
Published: April 2003

In this paper, the cerebral uptake of 18F-fluoro-2-deoxy-D-glucose (FDG) was studied in a relatively small group of patients suffering from either clinically diagnosed Alzheimer’s disease (AD) or frontotemporal dementia during the initial differential diagnostic workup. The image analysis was done visually and semiquantitatively using three different reference regions. Visual analysis confirmed earlier literature findings on the distribution of decreased FDG uptake and demonstrated prevalent asymmetric patterns in both groups. Only semiquantitative analysis using the sensorimotor cortex as a reference region confirmed the visual findings. Moreover, there were no differences in medial temporal lobe activities between both groups, and there was no correlation of medial temporal lobe activity with dementia severity. In the AD group, a correlation of parietal FDG uptake with MMSE scores was found.
Experience of Severe Fatigue Long after Stroke and Its Relation to Depressive Symptoms and Disease Characteristics
Authors: van der Werf Sieberen P. , van den Broek Hans L.P. , Anten Herman W.M. , Bleijenberg Gijs
Published: April 2003

Although the experience of abnormal fatigue is recognised as a major disabling symptom in many chronic neurological diseases, little is known about the persistence of severe fatigue after an abrupt neurological incident like a stroke. Therefore, the objectives of this study were to test whether the experience of severe fatigue persists long after a stroke has occurred, and to assess the relation between experienced fatigue and levels of physical impairment and depression. Ninety stroke outpatients and 50 controls returned mailed questionnaires. Compared to age-matched controls, a significantly larger proportion (16 vs. 51%) of the stroke respondents experienced severe fatigue, while 20% of the patients and 16% of the controls had elevated depression symptom scores. The time which had elapsed since the stroke occurred could not explain levels of fatigue. In the control group, the number of depressive symptoms explained most of the variance in levels of fatigue, while impairment of locomotion explained most of the variance in the stroke group.
Appearance of New Lesions in Two Nonfamilial Cerebral Cavernoma Patients
Authors: Labauge Pierre , Brunereau Laurent , Coubes Philippe , Clanet Michel , Tannier Christian , Laberge Sophie , Lévy Claude
Published: April 2003

Cavernomas are vascular malformations mostly observed in the central nervous system. They occur in sporadic and familial forms. Familial forms are characterized by the presence of multiple lesions, an autosomal dominant pattern of inheritance and possible de novo lesions. We report two sporadic cases whose follow-up showed the appearance of new lesions.
Incidence and Predictive Factors of Cerebrovascular Events in 8,846 Elderly Treated Hypertensive Patients during a 3-Year Follow-Up: The PRESAGE Study
Authors: de Champvallins M. , Weber F. , Collard M. , Rancurel G.
Published: April 2003

This epidemiological study was carried out as a 3-year follow-up project to assess the incidence of transient ischemic attacks (TIAs) and strokes; 8,846 treated hypertensive patients (mean BP, 149/84 mm Hg) aged 65 years or over (mean age, 73.7 ± 6.3 years), devoid of symptoms of dementia and with documented vascular risk factors were recruited from January 1994 to August 1995, by 1,598 general practitioners in connection with 36 referral university neurology units throughout metropolitan France. Among these patients, 506 (5.7%) had at least one cerebrovascular event during the follow-up period: 309 (3.5%) experienced one or more isolated TIAs, and 197 (2.2%) had a stroke with or without a preceding TIA. A total of 510 TIAs were reported. The stroke subtypes were ischemia, hemorrhage, and unclassified in 70, 16, and 15% of the cases, respectively. The estimated annual stroke incidence was 7.42‰. Of the 197 patients who developed strokes, 51 (26%) died. This case-fatality rate should be compared with the 4.5% mortality rate observed in the whole population during the study period. The 3 subgroups (with isolated TIAs, strokes, or no events during the study) were found to differ regarding age, sedentary lifestyle, past history of cardiovascular events, duration of hypertension, and evidence of complicated hypertension (univariate analysis). The factors identified as predictive of a stroke (multivariate analysis) were: the patient’s age; sedentary lifestyle; pulse pressure (SBP-DBP); identification of TIA at baseline, and presence of arrhythmias.
Double Dissociations between Neglect Tests: Possible Relation to Lesion Site
Authors: Schubert Franz , Spatt Josef
Published: April 2003

In 20 patients who had suffered a first right hemisphere stroke, we examined the prevalence of double dissociations between the results of a star cancellation and a line bisection test. Both are common methods to assess spatial hemineglect. Within the group of neglect patients, we found no significant correlation between the two tasks. Furthermore, 5 patients with impaired performance on one of the tests were within the normal range on the other one. In agreement with experimental studies, we argue that spatial hemineglect is not a unitary syndrome. Furthermore, the findings in one of our patients are compatible with the view that an isolated deficit on cancellation tasks might follow from a lesion in the right anterior cingulate gyrus.
The Predictive Value of Achieved Motor Milestones Assessed in 441 Patients with Infantile Spinal Muscular Atrophy Types II and III
Authors: Rudnik-Schöneborn Sabine , Hausmanowa-Petrusewicz Irena , Borkowska Janina , Zerres Klaus
Published: April 2003

Proximal spinal muscular atrophy (SMA) is classified into three main subtypes (I–III), defined by age at onset and achieved motor milestones. As age at onset can be very early in SMA II and III (IIIa, onset <3 years) and does not necessarily correlate with prognosis, the question arises whether the child can be correctly assigned to a specific SMA type at the time of presentation based on the assessment of motor function. Therefore we studied the motor milestones in 175 SMA type II and 266 SMA type III patients. In SMA II, 73% of the patients sat within the normal age range (up to 9 months), the remainder learned to do so at ages between 10 and 30 months. In SMA III, the walking milestone was passed with delay (given an upper normal limit of 18 months) in 10% of all and 16% of SMA IIIa patients (median age 13 months, range 9–53 months). There was a correlation between late sitting and walking in SMA III, since those who sat after 9 months were responsible for the majority of delayed walkers. The median age when becoming chairbound did not differ between early-onset SMA III patients who walked with delay and those who walked within the normal age range (10.2 versus 10.5 years). In conclusion, a significant proportion of patients with early-onset SMA classified as SMA II on the basis of achieved motor function turned out to be SMA III at later follow-up. It is important to reassess a child in the first 2–4 years, to determine whether walking can be achieved with or without aids, as children who start to walk late have a similar favourable outcome for ambulation compared to earlier walkers.
Tolerability and Efficacy of Almotriptan in the Long-Term Treatment of Migraine
Authors: Pascual J. , Falk R. , Docekal R. , Prusinski A. , Jelencsik J. , Cabarrocas X. , Segarra X. , Luria X. , Ferrer P.
Published: April 2003

Background: Almotriptan is a highly specific 5-HT1B/1D receptor agonist, which acts selectively on blood vessels of the brain. Short-term studies have demonstrated that almotriptan provides rapid, effective and reliable relief of migraine attacks, while offering excellent tolerability. Purpose: To assess the long-term tolerability and efficacy of oral almotriptan 12.5 mg administered for every migraine attack over a 1-year period. Methods: A total of 762 patients treated 13,751 attacks (1–97 per patient); 61.5% of attacks were treated with one 12.5-mg dose, while for 38.5% of attacks, patients took a second dose within 24 h. Results: Three hundred and ninety-one patients (51.3%) experienced a total of 1,617 adverse events (AEs). The majority (88.6%) of AEs were of mild-to-moderate intensity, and only 28.8% of AEs were considered to be related to the study drug. Only 2 patients experienced serious AEs possibly related to almotriptan, syncope and chest pain; both recovered without any sequelae. Patients reported at least 1 AE in 11% of attacks treated. The incidence of AEs decreased during the study. Only 6 (0.8%) study withdrawals were due to AEs considered to be related to almotriptan. Tolerability was not compromised in patients taking 2 doses of almotriptan or in those using migraine prophylactics. Patient age or sex did not influence the incidence of AEs. There was no evidence of tachyphylaxis in those patients completing the study. Pain relief at 2 h after the initial dose was achieved in 84.2% of moderate/severe attacks. Patients were pain free at 2 h after dose in 58.2% of all attacks. Older patients (>40 years) tended to respond better than younger ones (<40 years). Efficacy was not modified by use of migraine prophylactics or hormonal contraceptives. Efficacy measurements were consistent on treating repeated moderate/severe migraine attacks. Conclusion: This large, open study indicates that the new, specific 5-HT1B/1D agonist almotriptan, at a dose of 12.5 mg, is a well tolerated and effective treatment for migraine pain when used over a period of up to 1 year.
Genetic Association Analysis of Alpha-1-Antichymotrypsin Polymorphism in Parkinson’s Disease
Authors: Wang Ying-Chieh , Liu Hsiu-Chih , Liu Tsung-Yun , Hong Chen-Jee , Tsai Shih-Jen
Published: April 2003

α1-Antichymotrypsin (ACT) gene has been suggested as a susceptibility factor for Parkinson’s disease (PD) and might be related to the onset of PD. We replicated these findings in a Chinese population. The results demonstrated that the ACT genotypic and allelic distributions showed no significant differences between the PD patient and the control groups. The age at onset was younger in the heterozygotes than in the homozygotes (p = 0.042). We suggest that the ACT polymorphism might play some role in the pathogenesis of PD, especially in the onset.
Comparison of Preference for Rizatriptan 10-mg Wafer versus Sumatriptan 50-mg Tablet in Migraine
Authors: Pascual Julio , Bussone Gennaro , Hernandez Jose Fernando , Allen Christopher , Vrijens France , Patel Krupa
Published: April 2003

Rizatriptan (MAXALTTM, a registered trademark of Merck & Co. Inc.) is a selective 5-HT1B/1D receptor agonist with rapid oral absorption and early onset of action in the acute treatment of migraine. This randomized, open-label, crossover outpatient study assessed the preference of 481 patients for rizatriptan 10-mg rapidly disintegrating tablets versus sumatriptan (IMIGRANTM, a registered trademark of GlaxoWellcome PLC) 50-mg tablets in the treatment of a single migraine attack with each therapy. Almost twice as many patients preferred rizatriptan 10-mg rapidly disintegrating tablet to sumatriptan 50-mg tablet (64.3 vs. 35.7%, p ≤ 0.001). Faster relief of headache pain was the most important reason for the preference, cited by 46.9% of patients preferring rizatriptan and 43.4% of patients who preferred sumatriptan. Headache relief at 2 h was 75.9% with rizatriptan and 66.6% with sumatriptan (p ≤ 0.001), with rizatriptan being superior to sumatriptan within 30 min of dosing. Fifty-five percent of patients were pain free 2 h after rizatriptan, compared with 42.1% treated with sumatriptan (p ≤ 0.001), rizatriptan being superior within 1 h of treatment. Forty-one percent of patients taking rizatriptan were pain free at 2 h and had no recurrence or need for additional medication, compared to 32.3% of patients on sumatriptan. Rizatriptan was also superior to sumatriptan in terms of the proportions of patients with no nausea, phonophobia or photophobia, and patients with normal function 2 h after treatment intake (p < 0.05). More patients were (completely, very or somewhat) satisfied 2 h after treatment with rizatriptan (73.3%) than 2 h after treatment with sumatriptan (59.0%) (p ≤ 0.001). Additionally, 2 h after the dose, more patients found rizatriptan to be very convenient, convenient or somewhat convenient (87.2%) than they did sumatriptan (76.3%) (p ≤ 0.001). Both active treatments were well tolerated. The most common side effects with rizatriptan and sumatriptan were nausea (6.6 and 6.9% of patients, respectively), dizziness (6.1 and 5.8%) and somnolence (7.4 and 6.7%).
The Role of Endothelin inEarly Renal Cortical Reperfusionin Renal Transplantation
Authors: Hammad F.T. , Davis G. , Zhang X. , Wheatley A.M.
Published: April 2003

The role of specific endothelin receptors in the early renal reperfusion and long-term survival in renal transplantation was investigated in Lewis rats. Left renal transplantation was performed following 2 h cold ischaemia without and with ETA receptor antagonism and following 16 h cold ischaemia with no treatment, with ETA receptor antagonism and with ETB receptor antagonism. The ETA and ETB receptor antagonists, BQ-610 and A-192621 respectively, were added to the preservation solution. Renal cortical perfusion (RCP) was measured postoperatively using laser Doppler flowmetry. All rats in the 2-hour groups survived for 15 days. Animals in the untreated 16-hour group or in the A-192621-treated group died between days 3 and 6 after surgery. Fifty percent of the rats in the 16-hour and BQ-610-treated group died between days 4 and 7 after surgery while the other 50% survived for 15 days. Survival rates correlated well with both the postoperative serum creatinine and the recovery of RCP. We conclude that addition of an ETA receptor antagonist to the preservation solution improves renal reperfusion and long-term survival following prolonged ischaemia, whereas ETB receptor antagonism does neither.
Increased Apoptosis in Acute Puromycin Aminonucleoside Nephrosis
Authors: Fernandez Lucas , Romero Maritza , Soto Haydee , Mosquera Jesús
Published: April 2003

Acute puromycin aminonucleoside nephrosis (PAN) in rats is characterized by heavy proteinuria associated with renal hypercellularity. The role of apoptosis in the resolution of renal hypercellularity was investigated in PAN. To study the participation of apoptosis in PAN, renal tissues were collected from nephrotic and control rats on weeks 1, 2 and 7 after a single puromycin aminonucleoside injection. Apoptosis was evaluated by light and electron microscopy. Apoptotic DNA fragmentation was detected by TUNEL staining. Renal tissues were also evaluated by the presence of leukocyte common antigen (LCA), ED1 (macrophages) and proliferating cell nuclear antigen (PCNA) with corresponding monoclonal antibodies. An increased number of apoptotic (TUNEL+) cells was observed in the glomerulus at week 1. Electron microscopy analysis showed glomerular apoptosis mainly in endothelial cells. In the interstitium and tubules, increased apoptosis was observed at weeks 1 and 2. Increased apoptosis was accompanied with increased LCA+, ED1+ and PCNA+ cells in the interstitium and with increased PCNA+ cells in tubules. There was a high significant correlation between the number of apoptotic cells and the number of interstitial LCA+, ED1+ and PCNA+ cells. Tubular PCNA expression was correlated with tubular apoptosis. We also observed significant correlation between glomerular, interstitial and tubular apoptosis with proteinuria during the nephrosis. Double staining analysis showed that about 13% of interstitial or tubular apoptotic cells were positive for PCNA. All these values returned to normal by week 7. These results indicate that apoptosis is involved in the repairing process of this disease model.
Effect of Tissue Processing on the Ability to Recover Nucleic Acid from Specific Renal Tissue Compartments by Laser Capture Microdissection
Authors: Tanji Nozomu , Ross Michael D. , Cara Andrea , Markowitz Glen S. , Klotman Paul E. , D’Agati Vivette D.
Published: April 2003

The anatomic heterogeneity of the nephron poses obstacles to microdissection of individual renal compartments for analysis of gene expression. We have systematically analyzed the effects of fixation time and nuclear staining on the ability to recover nucleic acid from individual renal compartments by laser capture microdissection (LCM). Formalin-fixed kidney sections from Wistar rats and archival human renal biopsies were used for DNA analysis. From 1 to 10 individual glomeruli and from 1 to 10 individual proximal tubules were captured sequentially onto polymer films. DNA for β-globin could be amplified by PCR from even a single glomerulus or tubule. Optimal conditions for DNA amplification were brief (1- or 2-day) formalin fixation. Use of nuclear counterstains, including Weigert’s hematoxylin, Harris’s hematoxylin, Mayer’s hematoxylin, or methyl green, did not adversely affect the ability to extract and amplify DNA. For RNA extraction, glomeruli and tubules were microdissected from renal cryostat sections stored for up to 6 months. By RT-PCR, mRNA expression of the glomerulus-specific gene, Wilms’ tumor-1, was identified in as few as 5 microdissected glomeruli and of the tubule-specific gene, aminopeptidase N, in as few as 5 microdissected tubules, with no cross-contamination between renal compartments. Our findings indicate that the LCM method can successfully microdissect pure glomerular and tubular tissue compartments and that the optimal fixation and staining conditions are those employed routinely for renal biopsies, namely overnight formalin fixation and hematoxylin counterstain for DNA extraction, and cryostat sectioning with hematoxylin counterstain for RNA extraction. The specificity of LCM coupled with the sensitivity of RT-PCR should prove a powerful tool for the analysis of gene expression in specific renal compartments from archival human renal biopsies.
Molecular Cloning and Characterization of Profilin-3: A Novel Cytoskeleton-Associated Gene Expressed in Rat Kidney and Testes
Authors: Hu Erding , Chen Zunxuan , Fredrickson Todd , Zhu Yuan
Published: April 2003

Profilin is a small actin-binding protein that is involved in diverse functions such as maintaining cell structure integrity, cell mobility, tumor cell metastasis, as well as growth factor signal transduction. In this paper, we describe the molecular cloning and characterization of a novel form of profilin, termed profilin-3, from rat kidney using a PCR-based procedure for isolating tissue-specific genes. The profilin-3 cDNA encoded 137 amino acids, and it shared extensive homology to profilin-1 and profilin-2 from mice and humans. More strikingly, the expression of profilin-3 was highly selective, and its mRNA was only found in the kidney and to a much lesser extent in the testis. The size of the mRNA for profilin-3 in the testis was 1.2 kb, while in kidney it was approximately 4.4–5 kb, suggesting the presence of tissue-specific transcription from different promoters. In addition, we also found that the expression of profilin-3 mRNA was significantly elevated in two types of renal diseases: diabetic nephropathy (db/db mice) and polycystic kidney diseases (cpk mice). Similar to profilin-1 and profilin-2, profilin-3 was localized in the cytoplasmic domain. Furthermore, it was capable of interacting with actin and poly-L-proline in an in vitro assay as well as in transfected cells. These results strongly suggest that, contrary to the ubiquitous presence of profilin-1 and profilin-2, there is a tissue-specific form of these cytoskeleton-regulatory proteins and that the kidney/testes-specific profilin-3 may play a unique role in renal and/or reproductive functions.
Expression of Bone Morphogenetic Protein Receptors in the Developing Mouse Metanephros
Authors: Martinez Gemma , Loveland Kate L. , Clark Amander T. , Dziadek Marie , Bertram John F.
Published: April 2003

While bone morphogenetic proteins (BMPs) 2, 4 and 7 have recently been implicated in aspects of metanephric development, and expression patterns of these ligands have been described in the developing metanephros, the distribution of BMP receptors in developing metanephroi remains unknown. In the present study, in situ hybridisation histochemistry was used to localise mRNAs for BMP type-I receptors (BMPR-IA and BMPR-IB) and the BMP type-II receptor (BMPR-II) in developing mouse metanephroi. At embryonic day 12.5 (E12.5) and E14.5 transcripts for BMP type-I receptors were localised to the tips and body of the branching ureter as well as mesenchymal condensates, developing vesicles and comma-shaped bodies. Localisation of BMPR-II transcripts was similar although expression was not observed in the body of the ureter. At E17.5, transcripts for all three receptors were localised in the nephrogenic zone including ureteric tips, vesicles, comma- and S-shaped bodies as well the body of the ureter and in tubules. BMP type-I and type-II receptor transcripts co-localised with each other, in agreement with the well-documented evidence that BMPs signal via heterotetrameric complexes of type-I and type-II receptors and with the previously reported metanephric expression pattern of BMPs. These patterns of receptor expression suggest that these molecules are important regulators of epithelial-mesenchymal interactions, nephron development and ureteric branching morphogenesis.
Distribution of Stanniocalcin 1 in Rat Kidney and Its Regulation by Vitamin D3
Authors: Ookata Kayoko , Tojo Akihiro , Onozato Maristela Lika , Kashiwagi Masahide , Honda Shinji , Hirose Shigehisa
Published: April 2003

Stanniocalcin is a glycoprotein hormone first described in fish as a hypocalcemic factor, and recently its mammalian counterpart has been identified. Localization of stanniocalcin 1 and its regulation of expression were determined in control and 1α,25-dihydroxyvitamin D3-treated rats. Immunoreactivity for stanniocalcin 1 was detected in the loop of Henle, macula densa cells, distal convoluted tubule (DCT), and cortical collecting duct (CCD), and also faintly in the medullary collecting ducts. Pre-embedding electron-microscopic immunocytochemistry revealed stanniocalcin 1 in the apical membrane of cells of loop of Henle, DCT, and principal cells of CCD. The expression of stanniocalcin 1 was increased by elevated plasma calcium via 1α,25-dihydroxyvitamin D3 treatment. In conclusion, stanniocalcin 1 was expressed in the apical membrane of distal nephron segments and enhanced by vitamin D3.
Fundamental Frequency, Intensity, and Vowel Duration Characteristics Related to Perception of Cantonese Alaryngeal Speech
Authors: Ng M.L. , Gilbert H.R. , Lerman J.W.
Published: April 2003

Fundamental frequency (F₀), F₀ contours, vowel duration, and intensity associated with Cantonese alaryngeal speech, and their relation to the perception of meaning were studied. Thirty adult male native Cantonese speakers participated in the study: 10 esophageal, 10 electrolaryngeal, and 10 laryngeal speakers. Results indicated that perceptually, listeners were able to identify what the Cantonese esophageal speakers were saying, particularly for words associated with high-level, low-falling and high-rising tonal contours. Acoustic analysis of the speech signals of the esophageal speakers indicated that intensity and durational data did not contribute to the perception of meaning. The F₀ contours appeared to be the acoustic cues associated with the signal that contributed most to the perception of meaning.
Intraoral Air Pressure Discrimination under Conditions of Partial and Complete Resistance
Authors: Williams William N. , Brown Jr. W.S. , Payne Amy , Turner Glenn E. , Wharton Paul W.
Published: April 2003

This study assessed a sample of normal-speaking individuals’ ability to discriminate differences in their self-generated intraoral air pressures. Two conditions were employed: (1) open tube in which subjects had to sustain an expiratory breath stream to maintain the target pressure, and (2) closed tube in which there was complete resistance to the subjects’ breath stream. Analysis of variance revealed no significant difference (p > 0.05) in subjects’ ability to discriminate differences in their self-generated intraoral air pressure as a function of open or closed tube conditions. However, subjects’ discrimination scores significantly increased (p < 0.05) as the standard pressure was increased.
Educating Speech-Language Pathologists for a Multicultural World
Authors: Cheng L. , Battle D. , Murdoch B. , Martin D.
Published: April 2003

This paper presents critical elements and current needs in educating speech-language pathologists for a multicultural world. A proposed paradigm shift in clinical teaching using the UK model is also introduced. In addition, a case study on the American Speech Language Hearing Association’s efforts in implementing the Multicultural Action Agenda by networking with the Asian Pacific Islander caucus is described. A survey of multicultural elements in programs in Australia and New Zealand is included. Finally, suggestions for collaboration with those in established professional bodies to meet the increasing needs of a multicultural world are provided.
Significance of Cultural Variables in Assessment and Therapy
Authors: Semela Jacob Japane Mohale
Published: April 2003

Language is a function of culture. Within the African culture traditional and faith healers play an essential role in counseling the community on various personal and communal health- and life-related conditions. This kind of practice is particularly observed among the native populations, among those less affected by Western influences, and among those who have less opposition from Western and Asian religions. It is in this context that diagnosis and treatment of the bilingual child with potential language disorders were examined from the point of view of the African culture. The present study examines the degree to which the traditional or/and faith healers diagnose and explain the nature of the child’s problem to the parent(s). The impact of the African traditional healer is compared to the diagnosis made by the modern medical practitioner who adheres to the Cartesian dualism model which seeks to treat the patient by applying medical and surgical procedures. Speech-language pathologists need to recognize and consider the healer’s impact on any child with a potential language disorder.
Vertical Clingers and Sleepers1: Seasonal Influences on the Activities and Substrate Use of Lepilemur leucopus at Beza Mahafaly Special Reserve, Madagascar
Authors: Nash Leanne T.
Published: April 2003

Lepilemur leucopus was the subject of an 11-month field study at Beza Mahafaly Special Reserve, Madagascar. Radio-tracking provided point samples of activities and foods eaten for the 5 subjects (4 males, 1 female) across the hot, wet season and the cool, dry season. Across all seasons and animals, about 50% of the time was spent resting and/or self-grooming and about 30% of the time feeding. The majority of foods eaten were leaves and species diversity of the diet was low. During the cooler season, all 5 subjects rested significantly more and travelled significantly less than in the warmer season. Across seasons, feeding time did not change significantly. This species appears to cope with a poor quality diet through inactivity which increases during times of thermoregulatory stress. Substrates used were primarily more vertical and of small (<5 cm) diameter. Substrates did not change markedly across seasons.
Two-Year Decline in Vision but Not Hearing Is Associated with Memory Decline in Very Old Adults in a Population-Based Sample
Authors: Anstey Kaarin J. , Luszcz Mary A. , Sanchez Linnett
Published: April 2003

Background: Recent cross-sectional research in cognitive aging has demonstrated a robust association between visual acuity, auditory thresholds and cognitive performance in old age. However, the nature of the association is still unclear, particularly with respect to whether sensory and cognitive function are causally related. Objective: This study aimed to determine whether marked declines in performance on screening measures of either visual acuity or auditory thresholds have an effect on cognitive decline over 2 years. Methods: The sample from the Australian Longitudinal Study of Ageing (n = 2,087) were assessed in 1992 and 1994 on measures of sensory and cognitive function as part of a larger clinical assessment. A quasi-experimental design involving comparison of extreme groups using repeated measures MANCOVA with age as a covariate was used. Results: Group performance on measures of hearing, memory, verbal ability and processing speed declined significantly. Decline in visual acuity had a significant effect on memory decline, but not on decline in verbal ability or processing speed. Decline in hearing was not associated with decline in any cognitive domain. Conclusion: The common association between visual acuity, auditory thresholds and cognitive function observed in cross-sectional studies appears to be disassociated in longitudinal studies.
Characteristics of Single Fallers and Recurrent Fallers among Hospital In-Patients
Authors: Vassallo Michael , Sharma Jagdish C. , Allen Stephen C.
Published: April 2003

Background: Recurrent fallers constitute a minority of patients who fall but contribute considerably to the total number of falls recorded. Objective: To study the characteristics of recurrent fallers in a hospital setting. Methods: In a prospective observational study we investigated the characteristics of 1,025 patients admitted to a geriatric non-acute hospital. Patients were followed until discharge and were classified as non-fallers, single fallers or recurrent fallers. Results: We identified 824 non-fallers, 136 single fallers and 65 recurrent fallers contributing 175 falls. Compared to non-fallers, recurrent fallers were more likely to have pre-admission falls (p = 0.004), confusion (p < 0.0001), an unsafe gait (p = 0.0001) and be on tranquillisers (p = 0.018) and antidepressants (p = 0.006). They had longer stays in hospital (p < 0.0001) and more nursing home discharges (p = 0.0001). There was considerable overlap with risk factors for single fallers but compared to this group they were more likely to be confused (p = 0.027), and on antidepressant medication (p = 0.009). They also had a longer length of stay (p < 0.001) and more nursing home discharges (p = 0.03). Confusion (p = 0.0001), unsafe gait (p = 0.0006) and antidepressants (p = 0.018) were independently associated with recurrent falls. Conclusions: It is important to recognise the risk factors that prospectively identify a recurrent faller because of the significant contribution to total falls by a relatively small number of patients. This may be useful not only in trying to reduce total falls but also in trying to reduce injury.
Add-Back Therapy: Extending Safety and Efficacy of GnRH Analogues in the Gynecologic Patient
Authors: Surrey Eric S.
Published: April 2003

GnRH analogues have been demonstrated to be effective medical therapy for symptomatic endometriosis. The use of these agents has been limited to 6 months due to hypoestrogenic side effects. A variety of steroidal and nonsteroidal add-back regimens have been used in an effort to eliminate such side effects while maintaining efficacy in order to enhance compliance, safety and duration such side effects while maintaining efficacy in order to enhance compliance, safety and duration of administration of these agents. Only 3 regimens have been shown to be efficacious in prolonging analogue use beyond 6 months by reducing vasomotor symptoms as well as preventing significant bone mineral density loss. These include daily norethindrone acetate 5 mg alone or in conjunction with conjugated equine estrogens 0.625 mg daily, as well as norethindrone 2.5 mg daily in conjunction with an organic bisphosphonate. With further investigation, such regimens may allow safe prolongation of GnRH analogue use without sacrificing efficacy in those endometriosis patients with severe pelvic pain.
Coelomic Metaplasia Theory of Endometriosis: Evidence from in vivo Studies and an in vitro Experimental Model
Authors: Matsuura Kohei , Ohtake Hideyuki , Katabuchi Hidetaka , Okamura Hitoshi
Published: April 2003

Ultrastructure studies of pelvic peritoneal tissue from women undergoing laparotomy suggest that before endometriosis has become established in the peritoneum, there might be a metaplastic change by peritoneal mesothelial cells into endometrial glandular cells. A new in vitro experimental model of endometriosis using human ovarian surface epithelium cells has shown evidence that endometriotic lesions can arise by a process of metaplasia from the ovarian surface epithelium. In this model, when both ovarian surface epithelium and ovarian stromal cells were cocultured with 17β estradiol in a three-dimensional collagen gel lattice, the ovarian surface epithelium cells formed a lumen structure, surrounded by endometrial stromal cells with an epithelial mesenchymal structure. Immunoreactivity for epithelial membrane antigen and cytokeratin was shown in the glandular cells and cilia, as well as in the microvilli. Electron microscopy showed evidence of tight junctions on cell surfaces. These findings suggest that endometriosis may manifest as a serial change from the adjacent mesothelial cells.
Immunohistochemical Study of Angiogenic Factors in Endometrium and Endometriosis
Authors: Fujishita Akira , Hasuo Atsuko , Khan Khaleque Newaz , Masuzaki Hideaki , Nakashima Hisayoshi , Ishimaru Tadayuki
Published: April 2003

The proliferative activity and angiogenic factors of pelvic endometriosis and uterine endometrium and their correlation with different pigmented lesions are important throughout the menstrual cycle. The proliferative activity and/or expression of angiogenic factors appears to be different between endometrium and endometriosis, and also different in each pigmented lesion. Immunohistochemical studies using computerized image analysis have shown that in normal endometrium, the PCNA index shows cyclic variation, but no cyclic change is observed in endometriosis. In the pelvic peritoneum, the PCNA index is higher in red lesions compared to black and white lesions. There is no difference in VEGF expression among different pigmented lesions. However, a cyclic variation of VEGF concentration was found in the peritoneal fluid of patients with endometriosis. As a newly determined angiogenic factor, the number of endoglin-positive cells and the mean endothelial area were higher in red lesions than in black or white lesions. These results suggest that the pathogenesis and activity of endometriosis possibly depends on internal angiogenesis. The cellular activity of endometriotic lesions may not necessarily coincide with the regulation of angiogenesis, and may not be synchronized in each pigmented pelvic lesion of endometriosis.
Malignant Transformation of Ovarian Endometriosis
Authors: Nishida Masato , Watanabe Kyoko , Sato Nakako , Ichikawa Yoshihito
Published: April 2003

One hundred forty-seven cases of ovarian endometriosis, encountered from 1976 to 1999 at Tsukuba University Hospital, were studied to clarify the incidence of malignant transformation. There were 18 cases (12.2%) of atypical endometriosis, among which we found a case (5.6%) of ovarian cancer arising from endometriosis not diagnosed before surgery. This is accounted for 0.7% of all ovarian endometriosis cases. Because the incidence was equal to that of the previous reports, it is most likely that the malignant change in ovarian endometriosis occurred in 0.7% of this disease.
Endocrine and Metabolic Effects of Insulin Sensitizers in the Treatment of Patients with Polycystic Ovary Syndrome and Hyperinsulinaemia
Authors: Ciotta L. , De Leo V. , Farina M. , Pafumi C. , La Marca A. , Cianci A.
Published: April 2003

We evaluated 16 women with polycystic ovary syndrome (PCOS) and 67 controls, aged 18–34 years. All subjects had an oral glucose tolerance test (OGTT), showing a normal response. They were subdivided into 2 groups (normoinsulinaemic, hyperinsulinaemic) undergoing 7 days of octreotide treatment. This caused modifications in body mass index, waist-hip ratio and blood pressure. No modifications were observed in basal luteinizing hormone (LH), follicle-stimulating hormone, androgens, 17α-hydroxyprogesterone, oestradiol, sex-hormone-binding globulin (SHBG), prolactin and cortisol serum concentrations in normoinsulinaemic patients. A significant decrease in the concentration of LH, androgens, and a significant increase in SHBG were observed in the hyperinsulinaemic patients. In hyperinsulinaemic patients, the treatment restored a regular insulinaemic response to an OGTT. No modifications of glycaemic response were detected in normoinsulinaemic ones. In hyperinsulinaemic patients, a decompensation of the glycaemic response was observed. Several agents (insulin sensitizers) decrease insulin secretion and androgen concentration. They could be considered an approachable long-term therapy for hyperinsulinaemic hyperandrogenic patients. In the next few years the pharmacotherapy for PCOS could be greatly expanded, allowing some patients, such as hyperinsulinaemic ones, to be treated with insulin sensitizers.
Expression of Ki-67 in Cervical Epithelial Cells in Preneoplastic Lesions of Patients with AIDS
Authors: Calore Edenilson Eduardo , Cavaliere Maria José , Perez Calore Nilda Maria , de Souza Dias Suzana , Paes dos Santos Regina , Vilela-de-Almeida Lis
Published: April 2003

The objective of the present investigation was to study the expression of the proliferation marker Ki-67 in cervical intraepithelial lesions in women with AIDS. We studied 18 low-grade cervical intraepithelial lesions (Lo-CIN) and 8 high-grade cervical intraepithelial lesions (Hi-CIN ) in AIDS patients and 18 Lo-CIN and 14 Hi-CIN in patients from the general population. Positive Ki-67 nuclei were counted. A significantly higher number of Ki-67-positive cells (p < 0.001) was found in Lo-CIN of AIDS patients (mean 29.18 ± 10.44) as compared with Lo-CIN of general-population women (mean 17.08 ± 7.40), whereas no significant difference in positive Ki-67 nuclei was observed in the Hi-CIN of AIDS patients and of patients from the general population (p > 0.05). We conclude that the proliferative potential of cervical cells in Lo-CIN – as studied by the expression of the proliferation marker Ki-67 – is higher in AIDS patients than in the general population.