bluuebunny/crossref_metadata_2025 huggingface dataset:
Spontaneous Thrombosis of the Internal Jugular Vein: Unknown Origin
Authors: Dogru Harun , Yasan Hasan , Tüz Mustafa , Uygur Kemal , Oyar Orhan
Published: April 2003

Internal jugular vein thrombosis (IJVT) is a vascular disorder that results from various clinical conditions. The vast majority of IJVT are considered to be complications of central venous catheterization. The list of associated conditions must also be expanded and should include the following: mediastinal tumors, low antithrombin III levels, tumors associated with hypercoagulability, previous central venous catheterization, neck surgery, intravenous drug abuse, neoplasms of the head and neck, Hughes-Stovin syndrome, which is associated with pseudotumor cerebri and seizures in children, and other conditions such as local inflammation from radiation therapy or sepsis and infective cervical adenopathy. There are several cases in the literature related to spontaneous IJVT. Spontaneous IJVT may occur when there are no apparent predisposing mechanical or inflammatory causes although a few of these patients may harbor an occult neoplasm.
Oral Appliances for the Treatment of Snoring and Obstructive Sleep Apnea
Authors: Senn Oliver , Bloch Konrad E. , Iseli Angelo
Published: April 2003

Background: Removable oral appliances are employed to treat obstructive sleep apnea and snoring. In this review we summarize the current state of the art of this therapy. Methods: We performed a systematic review of the medical literature on the effectiveness, side effects and practical aspects of oral appliance therapy for sleep-disordered breathing. Results: Several randomized, controlled trials demonstrate the improvement of symptoms and sleep-related breathing disturbances in obstructive sleep apnea and snoring by oral appliances that advance the mandible. Side effects are common but usually transient and rarely severe. Conclusions: Mandibular advancement devices are a valuable treatment modality for obstructive sleep apnea and snoring. Dental and medical examinations at regular intervals and polysomnographic follow-up are important during long-term treatment to avoid potential adverse effects and to assure continued effectiveness.
High-resolution genetic map of bovine chromosome 29 through focused marker development
Authors: Reed K.M. , Ihara N. , Mariani P. , Mendoza K.M. , Jensen L.E. , Bellavia R. , Ponce de León F.A. , Bennett G.L. , Sugimoto Y. , Beattie C.W.
Published: April 2003

Chromosome-specific libraries aid in the development of genetic maps and focus marker development in areas of the genome with identified quantitative trait loci (QTL). A small-insert BTA29 library constructed by microdissection of a 1:29 Rb-fusion cell line, was screened for dinucleotide repeats (CA)15 and/or (GA)15 with the goal of generating new genetic markers for this, the smallest bovine autosome. A total of 90 primer pairs were designed and 82 of these successfully amplified bovine genomic DNA by PCR. In addition to these 82 loci, primer pairs were developed for nine putative genes identified from the sequenced clones by BLAST searches of GenBank. A somatic cell panel was used to test for synteny of the new loci with two previously mapped BTA29 markers located on the MARC bovine linkage map. A total of 75 of the 82 microsatellite (ms) loci were integrated into the MARC bovine linkage map. Linkage analysis placed 69 ms markers on BTA29, five on BTAX and one on BTA1. Combined results of the somatic cell and linkage analyses place 79 new markers (ms and gene-related) on BTA29, six loci on BTAX and two loci on BTA1. The results of this effort significantly increase the marker density on BTA29, expanding the ability to fine map QTL associated with this chromosome.
B chromosomes of Korean field mouse Apodemus peninsulae (Rodentia, Murinae) analysed by microdissection and FISH
Authors: Karamysheva T.V. , Andreenkova O.V. , Bochkaerev M.N. , Borissov Y.M. , Bogdanchikova N. , Borodin P.M. , Rubtsov N.B.
Published: April 2003

Organization of B chromosomes in the Korean field mouse Apodemus peninsulae was analyzed. We painted its metaphase chromosomes with whole and partial chromosome paints generated by microdissection and DOP-PCR. The results of the painting indicated that all B chromosomes contained a large amount of repeated DNA sequences. The repeats could be classified in terms of their homology and predominant location. Pericentromeric repeats of B chromosomes were present in many copies in pericentromeric C-blocks of all autosomes and in non-centromeric C-blocks of the sex chromosomes. B arm specific type 1 repeats comprised the main body of the arms of almost all B chromosomes and were present in the arms of A chromosomes as interspersed sequences. B arm-specific type 2 repeats were found at the ends of some B chromosomes that did not undergo compaction at the interphase– metaphase transition and remained uncondensed. On the basis of comparative analysis of localization of B chromosome repeats in the chromosomes of two related species, A. peninsulae and A. agrarius, we suggest a hypothesis of B chromosome origin and evolution in the genus Apodemus.
Copy and paste: the impact of a new non-L1 retroposon on the gonosomal heterochromatin of Microtus agrestis
Authors: Neitzel H. , Kalscheuer V. , Singh A.P. , Henschel S. , Sperling K.
Published: April 2003

Mobile elements are most abundant in the mammalian genome, comprising at least 40–50% of the DNA. They are differentiated into two most prominent families: the LINE elements, which are preferentially located in the G-bands, and SINES, which are clustered in the R-bands. We report here a novel mammalian non-L1-retroposon, which invaded the genome of Microtus agrestis in a very short time from an evolutionary viewpoint. No relevant sequence homology could be demonstrated to known sequences in the NCBI database. However, cross-hybridizing sequences exist in the genomes of all other Microtus species analyzed, but not in Mus musculus, indicating the recent evolutionary origin of this element. This retroposon is enriched in the entire heterochromatin of the X and Y chromosomes, but is also interspersed in autosomal locations in euchromatic portions of the genome. We show that the retroposon is heavily transcribed from the heterochromatin during female meiosis prerequisite for the subsequent retrotransposition. The estimated rate of retrotransposition is at least 1–2 × 10–2 per generation, which is hundred-fold higher than that of the majority of invertebrate retroposons and also higher than the transposition rate of a murine L1 element, which was calculated to be 3 × 10–3 per generation.
Effects of the Nitric Oxide Donor Molsidomine on the Early Stages of Liver Damage in Rats with Bile Duct Ligation: A Biochemical and Immunohistochemical Approach
Authors: Öztürk H. , Yağmur Y. , Buyukbayram H. , Dokucu A.I. , Gurel A.
Published: April 2003

This study aimed to evaluate the effects of the nitric oxide donor molsidomine on the early stages of liver damage and biochemical changes in rats with bile duct ligation (BDL). Forty prepubertal male Sprague-Dawley rats weighing 125–140 g were studied. Group 1 rats (sham-control, n = 10) were not subjected to any surgical manipulation. Group 2 rats (BDL/untreated, n = 10) were subjected to BDL but no drug was administered. Group 3 rats (BDL/L-NAME, n = 10) received a daily dose of NG-nitro-L-arginine methyl ester (L-NAME) intraperitoneally for 7 days after BDL. Group 4 rats (BDL/molsidomine, n = 10) received a daily dose of molsidomine by gastric tube for 7 days after BDL. After 1 week, biochemical and histological evaluations were performed and the liver hydroxyproline content was measured. Serum bilirubin and liver enzymes were significantly increased in the BDL/untreated, BDL/L-NAME and BDL/molsidomine groups in comparison with the sham-control group 1 week after BDL. However, the liver enzymes were significantly decreased in the BDL/molsidomine group in comparison with the BDL/untreated and BDL/L-NAME groups. In the BDL/L-NAME group, proliferation of portal and periportal biliary ductules with disorganization of the hepatocyte plates, dilated portal spaces and areas of polymorphonuclear leukocyte infiltration, fibrosis and hepatocyte necrosis were observed. In the BDL/molsidomine group, polymorphonuclear leukocyte infiltration, hepatocyte necrosis and fibrosis were rarely seen. The hydroxyproline content in the liver was increased 1 week after obstruction in the BDL/untreated and BDL/L-NAME groups when compared to BDL/molsidomine group. Collagen type-IV expression was not observed in the BDL/molsidomine group in contrast to the BDL/untreated and BDL/L-NAME groups. In conclusion, during 1 week of treatment, the nitric oxide donor molsidomine improved hepatic fibrosis in the hepatic parenchyma and did not affect serum bilirubin values, but positively affected the serum aspartate aminotransferase and alanine aminotransferase values.
Phagocytosis by Emigrated, Intra-Abdominal Neutrophils Is Depressed during Human Secondary Peritonitis
Authors: Holzer Katharina , Konietzny P. , Wilhelm Kerstin , Encke A. , Henrich D.
Published: April 2003

The phagocytic function of neutrophils is a crucial element in host defense against invading microorganisms. Patients with diffuse peritonitis depend on adequate reactivity of neutrophils, in particular locally in the peritoneal cavity as well as in the circulation. This study examined phagocytosis as well as numerical expression of Fcγ I–III (CD16, CD32, CD64) and complement receptors (CD18, CD35) of emigrated, intra-abdominal and circulating neutrophils during human secondary peritonitis using fluorescence-activated cell analysis. Optimally opsonized E. coli bacteria were used independently of the well-known low level of opsonic molecules during peritonitis. Compared with controls (abdominal surgery without peritonitis), the percentage of emigrated neutrophils which engulfed E. coli bacteria was significantly depressed until 48 h after diagnosis of, and surgery for, peritonitis. When patients with complicated peritonitis (septic shock, multiple organ failure) were compared with patients without complications, phagocytosis was even more depressed in patients with complications. Numerical expression of CD64 (Fcγ RI) and CD35 (CR1) increased significantly on emigrated polymorphonuclear leukocytes (PMNs) during peritonitis when compared to controls. There was no difference in CD18 and CD32 (Fcγ RII) expression between the two groups. Numerical expression of CD16 (Fcγ RIII) on emigrated PMNs decreased significantly in peritonitis. This was more pronounced in patients with complicated peritonitis. We conclude that there is a long-lasting depression of phagocytosis by emigrated PMNs during peritonitis, independent of the opsonic activity. Our data suggest that decreased phagocytosis might be correlated to the profound drop in CD16 on these cells.
Protective Effects of Urinary Trypsin Inhibitor (UTI) on Hepatic Microvasculature in Hypotensive Brain-Dead Rats
Authors: Itabashi K. , Ito Y. , Takahashi T. , Ishii K. , Sato K. , Kakita A.
Published: April 2003

Background/Aims: We examined the protective effects of a protease inhibitor, urinary trypsin inhibitor (UTI), on livers of brain dead rats associated with systemic hemodynamic instability. Methods: Brain death was induced by inflating a balloon catheter placed in the epidural space in rats followed by intravenous administration of UTI for 6 h. The hemodynamic, functional and morphological changes in the liver were examined. Results: The induction of brain death resulted in a significant decrease in both mean arterial pressure (MAP) and hepatic tissue flow (HTF), and an increase in serum AST and cytokines such as tumor necrosis factor (TNF)-α and cytokine-induced neutrophil chemoattractant (CINC). An increase in the number of sequestered neutrophils and enhanced expressions of intercellular adhesion molecules (ICAM)-1 and CINC were also noted in the liver. The treatment with UTI significantly restored HTF to basal level without affecting MAP, and decreased the number of sequestered neutrophils in the hepatic sinusoids, suppressed the expression of ICAM-1 and CINC in the sinusoids, inhibited the production of serum TNF-α and CINC, and inactivated Kupffer cells. Conclusion: Intravenous administration of UTI is likely to ease unfavorable effects on the hepatic microvasculature evoked by brain death.
Supplementing Bovine Milk Immunoglobulin G Prevents Rats Fed on a Vitamin E-Deficient Diet from Developing Peroxidation Stress
Authors: Zommara Mohsen A. , Toubo Hirokazu , Imaizumi Katsumi
Published: April 2003

Background/Aims: Bovine milk whey, which mainly includes β-lactoglobulin (58%), α-lactalbumin (22%) and immunoglobulin G (IgG; 11%), is a source of a wide range of proteins with a useful nutritional and physiological function. We previously demonstrated antiperoxidative effects of whey-derived α-lactalbumin and β-lactoglobulin in rats. The aim of the present study was to investigate the role of the IgG in antiperoxidative properties. Methods: Four-week-old, male Sprague-Dawley rats were fed a vitamin E-deficient diet (control) or a diet supplemented with 2.5% of an IgG-rich fraction for 4 weeks. Different antiperoxidative parameters were measured in blood and liver from the rats. Results: In comparison to the rats fed the control diet, those fed the IgG-containing diet were resistant to peroxidation stress. The IgG diet resulted in a decreased concentration of thiobarbituric acid-reactive substances in red blood cells (RBC) and plasma, and increased activities of catalase, superoxide dismutase and glutathione peroxidase in the RBC and liver. The plasma density (d) < 1.063 g/ml lipoproteins from the IgG group were more resistant against the induced lipid peroxidation. Conclusion: These results demonstrate antiperoxidative properties of IgG. The underlying mechanism(s) remain to be determined.
The Effect of Profiled Hemodialysis on Intradialytic Hemodynamics when a Proper Sodium Balance Is Applied
Authors: Straver B. , de Vries P.M.J.M. , Donker A.J.M. , ter Wee P.M.
Published: April 2003

Background: Profiled hemodialysis (HD) has been claimed to ameliorate intradialytic complications such as hypotension. Frequently, these profiles are based on providing the patient with an accumulating sodium load. This increases the risk of interdialytic complications, such as hypertension and increased weight gain. The present study investigated the effect of profiled HD, without an accompanying sodium loading, on intradialytic hemodynamics in stable HD patients. Methods: In eight stable HD patients a standard hemodialysis (S-HD) was compared to a decreasing Na+-profiled hemodialysis (Na-HD), and an ultrafiltration profiled hemodialysis (UF-HD). Care was taken to have the sodium balances similar during these sessions. The patients were monitored non-invasively during dialysis with respect to their cardiac performance by means of electrical impedance cardiography, their variation in blood volume by means of an on-line optical measurement, and their hydration state by means of body impedance analysis. Results: Sodium balance and mean arterial sodium concentrations were similar in the three treatments. Intradialytic hemodynamics during UF-HD were similar to those of S-HD. However, Na-HD improved blood pressure preservation, remarkably without significant blood volume preservation, due to a better stroke volume preservation in the first hour of dialysis. Conclusion: Sodium-balanced, Na-profiled HD improves blood pressure preservation in stable HD patients without providing the patients with a sodium load. This effect is due to a better stroke volume preservation early in dialysis, without a significant reduction in blood volume decrease. UF-HD, as mono-therapy, has no beneficial effect on intradialytic hemodynamics in stable patients.
Noninvasive Transcutaneous Access Flow Measurement before and after Hemodialysis: Impact of Hematocrit and Blood Pressure
Authors: Ronco Claudio , Brendolan Alessandra , Crepaldi Carlo , D’Intini Vincenzo , Sergeyeva Olga , Levin Nathan W.
Published: April 2003

Background/Aim: The dialysis outcome is strongly affected by the function of the vascular access. It has been suggested that access clotting may be related to increased hematocrit (Hct) or excessive ultrafiltration during dialysis. The present study was designed to evaluate the changes of vascular access flow during hemodialysis in 18 end-stage renal disease patients with native arteriovenous fistulas and the possible correlations with Hct and mean arterial pressure (MAP). Methods: We utilized a noninvasive vascular access flow measurement technique, based on a transcutaneous optical sensor, to evaluate the flow in the access before and after a single hemodialysis session. At the beginning and at the end of the session, the blood flow was measured noninvasively, placing the sensor approximately 2 in from the point of insertion of the arterial needle. At the same time, Hct and MAP were measured directly. All patients were on hemodialysis for more than 3 months. Results: There was a significant increase in Hct, likely due to ultrafiltration and consequent hemoconcentration, from the beginning to the end of the dialysis session. In detail, the Hct increased from 32.6 ± 1.9 to 35.4 ± 1.8% (p < 0.001), while the MAP did not present significant variations. The blood flow did not show significant variations, increasing from 780 ± 312 to 919 ± 411 ml/min after the session. Because of the stability of the MAP, we could dissociate the effects of the Hct from those of the MAP on blood flow variations. Conclusions: Our study suggests that the blood flow in native fistulas is not affected by the acute rise in Hct due to ultrafiltration during hemodialysis. The transcutaneous access flow measurement technique appears to be reliable and accurate, and it could represent an important diagnostic tool.
Prolonged Sustained Ventricular Fibrillation without Loss of Consciousness in Patients Supported by a Left Ventricular Assist Device
Authors: Fasseas Panayotis , Kutalek Steven P. , Kantharia Bharat K.
Published: April 2003

Patients with cardiomyopathy of either ischemic or nonischemic origin are at increased risk for malignant ventricular arrhythmias. Normally sustained ventricular fibrillation (VF) leads to death very rapidly. We report two patients who remained in sustained VF, supported by a left ventricular assist device, for a prolonged period of time. Perfusion pressure through the device was sufficient to allow the patients to remain awake and responsive for several hours while in VF. The cases represent two of the longest reported episodes of sustained VF recorded in awake patients implanted with such devices.
Elevated IgA and IgM Anticardiolipin Antibodies in Acute Kawasaki Disease
Authors: Gupta Monesha , Johann-Liang Rosemary , Bussel James B. , Gersony Welton M. , Lehman Thomas J.A.
Published: April 2003

There is marked activation of the endothelium and immune system in Kawasaki disease. Anticardiolipin antibodies (aCL) can cause activation of the endothelium. We measured aCL levels in acute Kawasaki disease patients and compared them to other febrile patients to see whether their aCL responses were different. Twenty-one patients with acute Kawasaki disease and 16 patients with an acute febrile illness were recruited. The aCL levels were measured in the sera of febrile patients and in Kawasaki disease patients prior to immunoglobulin therapy. There was no significant difference between the IgG aCL levels (p = 0.87) between the Kawasaki disease and febrile patients. However, the IgM (p = 0.01) and IgA (p = 0.03) aCL were significantly higher in patients with acute Kawasaki disease than in febrile children. Elevation of IgA aCL has been reported in association with other vasculitides and IgA-secreting plasma cells have been demonstrated in the vascular tissue in Kawasaki disease.
Imiquimod 5% Cream in the Treatment of Human Papillomavirus-16-Positive Erythroplasia of Queyrat
Authors: Kaspari Markus , Gutzmer Ralf , Kiehl Peter , Dumke Pia , Kapp Alexander , Brodersen Jens P.
Published: April 2003

Erythroplasia of Queyrat is a human-papillomavirus-associated carcinoma in situ of the penis. Imiquimod, a new topically applied immunomodulatory agent, has been successfully used in the treatment of anogenital warts. We report the complete clearance of HPV-16-positive erythroplasia of Queyrat with 5% imiquimod cream.
Cry Characteristics of 172 Healthy 1- to 7-Day-Old Infants
Authors: Michelsson Katarina , Eklund Kenneth , Leppänen Paavo , Lyytinen Heikki
Published: April 2003

A total of 1,836 cry signals from 172 healthy babies, 1–7 days old, were analysed with sound spectrography. The mean values for the 8–15 cries from each infant were calculated and used for the statistical analyses. The mean duration of the cry signals was 1.4 ± 0.6 s. The mean fundamental frequency was 496 ± 95 cps (Hz). Fifty percent of the mean fundamental frequencies in the 8–15 cries analysed from each baby varied between 450 and 520 Hz. Of the children, 93% had cries with a mean fundamental frequency below 600 Hz. The mean value of the highest point of the fundamental frequency was 583 ± 151 Hz and of the lowest point 398 ± 75 Hz. The melody type had mainly a rising-falling contour, though the difference between the highest and the lowest point was often rather small. There were no significant differences noted in the cry characteristics according to gender, the age of the infants or the gestational age when they were born.
X-Ray Study of a Professional Soprano’s Postural Strategy for Increasing Laryngeal Mobility
Authors: Scotto Di Carlo Nicole
Published: April 2003

This paper presents a case study of a professional soprano with reduced laryngeal mobility caused by substantial calcification of the laryngeal cartilage. Unlike other singers, she lowers her head when singing high notes. A cephalometric analysis revealed a compensatory posture in the upper register consisting of moving the occipital bone backwards and upwards in such a way that the styloid and mastoid processes are also tipped in those directions. This in turn causes the hyoid bone, which is connected to the styloid and mastoid processes by the lesser cornua, to move up and back. Becoming more vertical, it pulls on the superior cornua of the thyroid cartilage to which it is connected by the hyothyroid membrane. This considerably tilts the thyroid cartilage on the cricoid. In reality, this soprano does not lower her head to sing in the upper register; she moves her occipital bone upwards and backwards in order to achieve greater and thus more effective tilting of the thyroid cartilage.
Pharmacokinetics of High-Dose Meropenem in Adult Cystic Fibrosis Patients
Authors: Bui Khanh Q. , Ambrose Paul G. , Nicolau David P. , Lapin Craig D. , Nightingale Charles H. , Quintiliani Richard
Published: April 2003

Because patients with cystic fibrosis (CF) have pulmonary exacerbations secondary to multi-antibiotic-resistant Gram-negative bacilli, antibiotics, like meropenem, are often utilized. We studied the pharmacokinetics of meropenem (2 g i.v. administered every 8 h in clinically stable CF patients to determine if the recommended maximum doses could sustain adequate concentrations during the dosing interval. These pharmacokinetic data were similar to those obtained in non-CF populations. Using this regimen, concentrations of meropenem exceed the susceptibility breakpoint (4 µg/ml) for 50% of the dosing interval, and therefore provide optimization of the pharmacodynamic profile of the compound.
Isolation and Antimicrobial Susceptibility Testing of Fecal Strains of the Archaeon Methanobrevibacter smithii
Authors: Dermoumi Heide L. , Ansorg Rainer A.M.
Published: April 2003

Background: The archaeon Methanobrevibacter smithii is regarded as part of the indigenous microflora of the human intestine but may be connected with pathological conditions. The microbe is extremely oxygen intolerant and is not detectable by anaerobic culture techniques for bacteria. Accordingly, to date quantitative antimicrobial susceptibility data of human isolates are missing. Methods: The anoxic Hungate technique and a three-step culture procedure using media supplemented with antibiotics were applied to isolate M. smithii from randomly selected human feces. The minimum inhibitory concentrations (MICs) of 15 isolates and the reference strain DSM 861 were determined using a broth macrodilution test resembling the procedure for testing anaerobic bacteria. Results: The 16 strains were highly resistant (MICs >64 mg/l) against penicillin G, cephalothin, vancomycin, streptomycin, gentamicin, ciprofloxacin, and clindamycin. Metronidazole inhibited the strains at MICs between 0.5 and 64 mg/l. Conclusions: Multiple-antibiotic-resistant Methanoarchaea occur in the human gut. They may be selected during therapy with common antibacterial agents and may be eliminated by the application of metronidazole.
Effect of Sub-MICs of Antibiotics on the Hydrophobicity and Production of Acidic Polysaccharide by Vibrio vulnificus
Authors: Farzam Farnam , Plotkin Balbina J.
Published: April 2003

Background: Subinhibitory concentrations of antibiotics, which can occur in vivo, have been demonstrated to alter the production of bacterial virulence factors, including the capsule, or the interaction between microorganism and phagocyte by affecting surface hydrophobicity. Methods: Using a microtiter assay system, the effect of subinhibitory concentrations of amikacin, gentamicin, cephalothin and doxycycline on the surface hydrophobicity and production of acidic polysaccharide by Vibrio vulnificus (8 human isolates, 8 environmental isolates) was determined. Results: All four drugs, in a dose-dependent manner, caused alterations in adherence to polystyrene, a measure of surface hydrophobicity, and the production of acidic polysaccharides, as determined by Alcian blue staining. Conclusion: The changes in capsule production and surface hydrophobicity measured in response to sub-MICs of antibiotics appear to be independent variables.
The Antibacterial Effects of Ornidazole on Primary Molars with Infected Pulps
Authors: Kargül B. , Kadir T.
Published: April 2003

The purpose of this study was to investigate the antibacterial effects of a short-term topical application of ornidazole on anaerobic microorganisms. The antibacterial properties of such materials against organisms at infected primary root canals have not been well documented. Twenty infected primary molars in this study were treated using ornidazole (Biteral, Roche). The bacterial contents of the roots were collected with sterile paper points before the application. Freshly mixed ornidazole and sterile saline were placed into the root canals. After 1 week, the bacterial contents of the root canals were collected again. Microbiological analyses were made. Based on our results, it appears that the antibacterial activity of ornidazole caused significant changes in rates of microorganisms (94.53% reduction).
Ceftriaxone for the Treatment of Febrile Episodes in Nonneutropenic Patients with Hematooncological Disease or HIV Infection: Comparison of Outpatient and Inpatient Care
Authors: Egerer G. , Goldschmidt H. , Müller I. , Karthaus M. , Günther H. , Ho A.D.
Published: April 2003

Background: Patients with hematooncological disease or HIV infection and febrile episodes are usually treated in hospital with broad-spectrum antibiotics. The aim of this observational study was to assess the feasibility of ambulatory parenteral antibiotic therapy in hematooncological or HIV-infected patients with confirmed or suspected infection. Methods: The results in an outpatient treatment group were compared with those obtained in a group initially treated in hospital. Data were gathered on 90 outpatients and 72 inpatients. The inclusion criteria were fever ≧37.5°C with an identified focus of infection, fever ≧38.0°C of suspected bacterial origin with no identified focus of infection, leukocytosis ≧9,000/µl or C-reactive protein elevation ≧10 mg/l. Results: Eighty outpatients and 69 inpatients were evaluable. Treatment in the outpatient group was begun with ceftriaxone. This led to defervescence in 87.5% of cases. The mean treatment duration was 7.1 days. Comparison of results in the outpatients with those initially hospitalized for treatment showed similar success rates. The mean hospital stay in the latter group was 12.9 days. Conclusions: Ceftriaxone represents an effective treatment for outpatient management of febrile episodes in patients with hematooncological disease or HIV infection. Outpatient treatment is more cost-effective than inpatient care.
Detection of JC Virus Type 1 in Peripheral Lymphocytes, Brain and Cerebrospinal Fluid from Two Korean AIDS Patients with Progressive Multifocal Leukoencephalopathy
Authors: Jeong Byung-Hoon , Jin Jae-Kwang , Choi Eun-Kyoung , Kim Kyung-Hoon , Choi Kang-Won , Oh Myoung-Don , Shin Ki-Chul , Kim Yong-Sun
Published: April 2003

The human polyomavirus JC virus (JCV) is the etiologic agent of the fatal demyelinating central nervous system disease progressive multifocal leukoencephalopathy (PML), which occurs in 4–7% of AIDS patients. Two Korean AIDS patients with PML were assayed for JCV, and the virus was genotyped by polymerase chain reaction, DNA sequencing and phylogenetic analysis. Using immunohistochemical analysis, we also examined the distribution of JCV antigen in the brains of the patients. The JCV genome was detected in peripheral lymphocytes, brain and cerebrospinal fluid from these Korean PML patients. Although type 2 is the most common genotype in Asia, the genotype of the JCV in these two AIDS patients was characterized as type 1, which is of European origin. We found that JCV antigen was selectively detected in oligodendrocytes and astrocytes of the brains from these patients. Compared to the prototype type 1 (Mad-1), two different nucleotides (G→C) in the KOR-1 strain identified here were found at positions 2488 and 2490 of the major capsid protein VP1 gene. In summary, this is the first report of PML in Korean AIDS patients; it is also the first isolation of JCV type 1 in PML in East Asians.
Interaction of Adeno-Associated Virus Rep78 with SV40 T Antigen: Implications in Rep Protein Expression Leading to the Inhibition of SV40-Mediated Cell Proliferation
Authors: Batchu Ramesh B. , Shammas Masood A. , Wang Jing Yi , Shmookler Reis Robert J. , Munshi Nikhil C.
Published: April 2003

Adeno-associated virus (AAV) type 2 is a nonpathogenic human parvovirus that is dependent on a helper virus, usually adenovirus, for its replication. The left half of AAV encodes the multifunctional nonstructural proteins required for replication of its DNA. Here, we present evidence that SV40 provides a helper function for the expression of AAV Rep protein, as demonstrated by Western blot analysis of cell extracts from SV40-transformed human fibroblasts infected with AAV. We also show, using a luciferase reporter system, that SV40-mediated transcriptional transactivation of ‘S’-phase genes is substantially inhibited by the presence of AAV. Because the SV40 T antigen is critical to oncogenicity and cellular DNA proliferation, we investigated its interaction with AAV Rep protein. The physical interaction between these two molecules was confirmed by electrophoretic mobility supershift assay and affinity chromatography. These results show, for the first time, the possible molecular mechanisms behind the AAV-mediated inhibition of SV40 oncogenicity and provide the basis for further investigation into the direct and indirect role of AAV Rep in controlling viral transforming activity.
Successful Treatment of Pulmonary Artery Aneurysms Secondary to Possible Behçet’s Disease
Authors: Mahendran C. , Singh P. , Mani N.B.S. , Jindal S.K.
Published: April 2003

Pulmonary artery aneurysm (PAA) secondary to Behçet’s disease (BD) is a rare condition. The commonest presentation is hemoptysis, which can be fatal. Though the classical triad of recurrent oral and genital ulcers and relapsing iritis is present in most patients of BD, isolated pulmonary artery involvement termed as incomplete BD has been reported. Prompt diagnosis and immunosuppressive therapy can cause regression of aneurysm and prevent fatal hemoptysis. We report a case of PAA due to BD who presented with hemoptysis and responded to steroid therapy.
Influence of Respiratory Behavior on Ventilation, Respiratory Work and Intrinsic PEEP during Noninvasive Nasal Pressure Support Ventilation in Normal Subjects
Authors: Vanpee Dominique , El Khawand Charbel , Rousseau Laurent , Jamart Jacques , Delaunois Luc
Published: April 2003

Background: In clinical practice, patients have different inspiratory behaviors during noninvasive pressure support ventilation (PSV): some breathe quietly, others actively help PSV by an additional effort, and others even resist the inspiratory pressure of PSV. Objective: What is the influence of patient collaboration (inspiratory behavior) on the efficiency of PSV? Methods: We ventilated 10 normal subjects with nasal PSV (inspiratory/expiratory: 10/0 and 15/5 cm H2O) and measured their flow and volume with a pneumotachograph and their esophageal and gastric pressures during three different respiratory voluntary behaviors: relaxed inspiration, active inspiratory work and resisted inspiration. Results: When compared with relaxed inspiration with 10/0 cm H2O PSV: (1) an active inspiratory effort increased tidal volume (from 789 ± 356 to 1,046 ± 586 ml; p = 0.006), minute ventilation (from 10.40 ± 4.45 to 15.77 ± 7.69 liters/min; p < 0.001), transdiaphragmatic work per cycle (from 0.55 ± 0.33 to 1.72 ± 1.40 J/cycle; p = 0.002) and inspiratory work per cycle (from 0.14 ± 0.20 to 1.26 ± 1.01 J/cycle; p = 0.003); intrinsic positive end-expiratory pressure (PEEPi) increased from 1.23 ± 1.02 to 3.17 ± 2.30 cm H2O; p = 0.002); (2) a resisted inspiration decreased tidal volume (to 457 ± 230 ml; p = 0.007), minute ventilation (to 6.93 ± 3.04 liters/min; p = 0.028) along with a decrease in transdiaphragmatic work but no change in PEEPi. Data obtained during a bilevel PSV of 15/5 cm H2O were similar to those obtained with the 10/0 cm H2O settings. Conclusions: Active inspiratory effort increases ventilation during PSV at the expense of an increased breathing work and PEEPi. Resisted inspiration inversely decreases inspiratory work and ventilation with no air trapping. These differences between inspiratory behaviors could affect the expected beneficial effects of PSV in acutely ill patients.
An Investigation into the Mechanism of Action of Almitrine on Isolated Rat Diaphragm Muscle Fatigue
Authors: Markos F. , Campion D.P. , Carey M. , O’Connor J.J.
Published: April 2003

Background: Previous studies have shown that almitrine bismesylate, a respiratory stimulant which acts on the mitochondrial electron transport chain, enhances recovery of rat diaphragm muscle from fatigue. Objectives: Our aim is to investigate if the enhanced recovery is due to an anti-oxidant property of almitrine, since the electron transport chain is a major site of intracellular free radical production. Methods: A low-frequency fatigue protocol was used (30 Hz; 250 ms; delivered once every 2 s for 5 min), and the effects of almitrine before and after fatigue onset were compared to those of the anti-oxidant compound N-acetylcysteine (NAC). Results: Almitrine (6 and 10 µg/ml) given before fatigue gave better recovery rates than postfatigue application. In contrast, NAC (100 µM) application before fatigue onset was not as effective as NAC given immediately after the cessation of the fatigue protocol. However, almitrine (6 µg/ml) completely reversed the reduction in baseline twitch tension brought about by a free-radical-producing mixture of FeCl3 + ADP (1 mM + 2.5 mM, respectively). Conclusion: The results of this study confirm that almitrine enhances recovery from fatigue and, in contrast to NAC prefatigue application, is more effective. Also, almitrine was shown to have an anti-oxidant effect, but it does not act like a typical anti-oxidant.
Lung Function Values in Healthy Non-Smoking Urban Adults in Iran
Authors: Boskabady M.H. , Keshmiri M. , Banihashemi B. , Anvary K.
Published: April 2003

Background: The values of lung function tests (LFTs) are dependent on height, age, and sex. In addition, there is evidence of LFT variation in different ethnic groups. Objective: We have therefore derived prediction equations for LFTs from a healthy, non-smoking, urban adult population in the city of Mashhad (northeast Iran). Methods: Predicted equations for normal lung function have been derived from 572 healthy, non-smoking subjects including 326 men (height 154–195 cm) and 246 women (height 144–174 cm) aged 18–65 years. The subjects underwent measurement of spirometric flow and volume. The following variables were measured: forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), maximal mid-expiratory flow (MMEF), peak expiratory flow (PEF) and maximal expiratory flow at 75, 50 and 25% of the FVC (MEF75, MEF50, and MEF25, respectively). Regression analysis using height and age as independent variables was applied to provide predicted values for both sexes. Results: There was a negative correlation between each lung function and age. The largest negative correlations were found for FEV1 and FVC in men and women, respectively. All parameters correlated positively with height; the largest positive correlation was observed for FVC in both sexes. Comparison of LFTs derived from the equations of the present study showed significant differences with those of several previous studies. Conclusion: In this study, a set of LFT reference values and prediction equations for both sexes have been derived using a relatively large, healthy, non-smoking Iranian, adult population which was different from several other prediction equations.
Decrease in Urinary Excretion of Aquaporin-2 Associated with Impaired Urinary Concentrating Ability in Diabetic Nephropathy
Authors: Nakamura Tomoatsu , Saito Takako , Kusaka Ikuyo , Higashiyama Minori , Nagasaka Shoichiro , Ishibashi Shun , Ishikawa San-e
Published: April 2003

Aquaporin-2 (AQP-2) is known to be expressed in the renal collecting duct cells and participates in urinary concentration in response to arginine vasopressin (AVP). The present study was undertaken to determine whether progression of renal dysfunction affects urinary excretion of AQP-2 in diabetic nephropathy. The study was composed of 8 control subjects and 14 patients with type 2 diabetes classified into two groups according to serum creatinine level (cut-off point; 1.5 mg/dl). After an 8-hour water deprivation, both urinary osmolality (Uosm) and urinary excretion of AQP-2 significantly decreased in the diabetic patients with chronic renal failure as compared to the control subjects (p < 0.0001, p < 0.05, respectively). After a water load (10 ml/kg), no differences were found in plasma osmolality (Posm), AVP levels and Uosm, whereas urinary excretion of AQP-2 significantly decreased in the patients with chronic renal failure as compared to the control subjects (p < 0.05). These results indicate that the decreased urinary excretion of AQP-2 in diabetic nephropathy is due to the impaired cellular signaling of AVP in collecting duct cells, which may be partly involved in the urinary concentrating defect in renal failure.
Quantitative Analysis of Glomerular Type IV Collagen Alpha3–5 Chain Expression in Children with Thin Basement Membrane Disease
Authors: Ueda Taku , Nakajima Mitsuru , Akazawa Hideki , Maruhashi Yoshiyuki , Shimoyama Hironobu , Sakagami Yoshitugu , Takagawa Ken , Kamitsuji Hidekazu , Naito Ichiro , Sado Yoshikazu , Yoshioka Akira
Published: April 2003

Thin basement membrane disease (TBMD) and Alport syndrome, two forms of childhood nephritis, have generally been considered to be hereditary diseases. In Alport syndrome, several reports have demonstrated pathogenic mutations of the genes encoding type IV collagen α3, 4 and/or 5 chain [α3, 4 and/or 5(IV)]. Previous immunohistochemical studies indicated that these antigens were absent from the glomerular basement membrane (GBM) in Alport syndrome, whilst a normal labeling pattern was maintained in TBMD. In order to understand the role of the α3, 4 and/or 5(IV) antigens in TBMD, we used confocal laser scanning microscopy (CLSM) to examine cryosections of renal biopsies from 12 children with TBMD and 11 control children with IgA nephropathy (IgAN) without proteinuria. All tissue sections were stained with a mixture of FITC-conjugated rat monoclonal antibodies directed against human α3(IV), α4(IV) or α5(IV) and a Texas red-conjugated rat monoclonal antibody raised against human α2(IV). CLSM was performed and quantitative analysis of the ratio of the staining signal for α3(IV), α4(IV) or α5(IV) to α2(IV) [α3(IV), α4(IV) or α5(IV)/α2(IV)] along the GBM was determined. The average number of pixels for α3(IV), α4(IV) or α5(IV)/α2(IV) was 3.52 ± 1.49, 3.54 ± 1.25 and 1.09 ± 0.49 in TBMD and 3.62 ± 1.46, 3.99 ± 1.53 and 1.77 ± 0.47 in control subjects, respectively. Statistical analysis indicated that α5(IV)/α2(IV) ratio was significantly lower (p < 0.01) in children with TBMD compared to controls. These findings raise the possibility that TBMD might be caused by an abnormality of the α5(IV) antigen along the GBM.
Plasma Neuropeptide Y Concentrations in Patients on Hemodialysis
Authors: Akagi Shigeru , Nagake Yoshio , Sugimoto Taro , Nakao Kazushi , Yamasaki Hiroko , Ichikawa Haruo , Makino Hirofumi
Published: April 2003

Background: Neuropeptide Y (NPY) is a 36-amino-acid peptide that was originally isolated from the porcine brain. NPY, in contrast to leptin, is one of the most potent appetite stimulants. In some previous studies, NPY was found to be correlated with mean blood pressure (MBP) and fluid volume in patients on hemodialysis (HD), contributing to volume-induced hypertension. However, it is still unclear which NPY-sensitive neuronal pathways are responsible for the various changes seen in response to central NPY administration. In this study we analyzed the correlation of circulating levels of NPY with parameters of nutritional conditions, and we investigated the relationships between NPY concentrations and clinical markers of fluid volume in patients on HD. We also evaluated the effects of high-flux dialysis membranes on plasma NPY levels as compared with those of low-flux membrane. Methods: Plasma NPY concentrations in patients on regular HD were measured using commercially available radioimmunoassay (RIA) kits. We examined the relationship between plasma NPY concentration and other clinical indices in patients on HD. Results: Plasma NPY concentrations were inversely correlated with the serum urea nitrogen levels (r = –0.32) as well as protein catabolic rate (PCR) (r = –0.28). Plasma NPY was also correlated with the increase in body weight between HD sessions (r = 0.29). On the other hand, plasma NPY concentrations were not correlated with MBP, atrial natriuretic peptide (ANP), or adrenomedullin (AM). The reduction rate of plasma NPY with a high-flux dialysis membrane was significantly higher than that with a low-flux dialysis membrane. Conclusions: The secretion of NPY may be enhanced in a poor state of nourishment and stress induced by fluid volume overload in patients on HD, and plasma NPY is removed by a high-flux dialyzer.
Renal Vein and Inferior Vena cava Thrombosis Associated with Acute Pancreatitis
Authors: Ma Seong Kwon , Kim Soo Wan , Kim Nam Ho , Choi Ki Chul
Published: April 2003

Renal vein thrombosis (RVT) is a well-recognized complication of the nephrotic syndrome, but it is extremely rare in patients with acute pancreatitis. Vascular thrombosis complicating pancreatitis is thought to be due to release of proteolytic enzymes from the pancreas and direct vasculitis. Peripancreatic vessels are most commonly involved in the complications associated with pancreatitis. Renal vein and inferior vena cava (IVC) thrombosis, however, is an exceptionally rare complication of pancreatitis. Awareness of this complication will help physicians in its early diagnosis and management. We report a case of renal vein and IVC thrombosis in a patient with acute pancreatitis.
Is Isoniazid Ototoxic in Patients Undergoing Hemodialysis?
Authors: Altıparmak Mehmet Rıza , Pamuk Ömer Nuri , Pamuk Gülsüm Emel , Ataman Rezzan , Serdengeçti Kamil
Published: April 2003

Drug-induced ototoxicity might sometimes be a problem in end-stage renal failure (ESRF) patients. However, ototoxicity secondary to isoniazid intake has not been reported in ESRF until now. During the last decade, ototoxicity was diagnosed in 16.6% (7/42) of our ESRF patients undergoing hemodialysis (HD) who also used antituberculosis therapy. Streptomycin was not included in any of these regimens, isoniazid was used by all 7 patients with ototoxicity and there was reversal of hearing loss in 2 of these patients after discontinuation of isoniazid. In our ESRF-HD patients who developed ototoxicity during the course of antituberculosis therapy, isoniazid was probably the responsible agent either alone or it added to the side effects of other drugs.
Changes in Urinary Levels and Renal Expression of Uroguanylin on Low or High Salt Diets in Rats
Authors: Fukae Hiroko , Kinoshita Hiroshi , Fujimoto Shouichi , Kita Toshihiro , Nakazato Masamitsu , Eto Tanenao
Published: April 2003

Background: The novel peptide, uroguanylin, is mainly produced in the intestine and causes natriuresis via cyclic GMP (cGMP) activation. Uroguanylin plays an important role in sodium transport in the gastrointestinal tract and functions as an intestinal natriuretic hormone during oral salt load. However, the role and behavior of uroguanylin in the kidneys during high salt load remains unknown. Methods: We measured the uroguanylin concentrations in the urine and plasma of rats fed with low or high salt diets for 1 week, using a sensitive radioimmunoassay (RIA). Urinary cGMP and electrolyte excretion was also measured. Intestinal and renal expression of uroguanylin mRNA was evaluated by Northern blotting and by reverse transcription-polymerase chain reaction (RT-PCR). Results: The urinary excretion of immunoreactive (ir-) uroguanylin in rats on the high salt diet was significantly higher than that in the low salt group (425 ± 107 vs. 128 ± 8.5 pmol/day, p < 0.01) and significantly correlated with urinary Na+ and cGMP excretion. Plasma ir-uroguanylin levels between the two groups did not significantly differ. Uroguanylin mRNA expression was increased both in the intestine and kidneys of rats on the high salt diet. Conclusion: These findings suggest that uroguanylin regulates sodium metabolism in the intestine and kidneys during oral salt load in an autocrine and paracrine manner.
Hemolysate Pretreatment Ameliorates Ischemic Acute Renal Injury in Rats
Authors: Yoneya Rika , Nagashima Yoji , Sakaki Kyohei , Hagiwara Kiyokazu , Teraoka Hirobumi , Ozasa Hisashi , Horikawa Saburo
Published: April 2003

Heme oxygenase-1 (HO-1) is an antioxidant enzyme and is believed to protect against oxidative stress-induced tissue injury. Renal ischemia-reperfusion (IR) injury seems at least in part to be caused by the oxidative stress. The aim of this study was to improve the renal IR injury by clinically available means. When littermate hemolysate was intravenously administered into rats, HO-1 was markedly induced in the kidneys. To investigate whether prior induction of HO-1 by the hemolysate injection ameliorates the subsequent renal IR injury, we assessed the levels of blood urea nitrogen (BUN) and serum creatinine (SCr), markers for renal injury, in rats with 45 min of ischemia followed by 18 h of reperfusion. To avoid the nephrotoxicity induced by hemolysate, small but effective amounts of hemolysate was injected into rats at 48 h prior to the ischemia. The levels of BUN and SCr values were significantly improved as compared to the rats with renal IR injury alone. Administration of HO inhibitor abolished the efficacy of hemolysate pretreatment. Our findings indicated that the prior induction of HO-1 by treatment of littermate hemolysate ameliorated the subsequent renal IR injury. Prior injection of self-hemolysate would be clinically useful for the protection against the renal IR injury induced by kidney transplantation and kidney surgery without immunological and infectious problems.