bluuebunny/crossref_metadata_2025 huggingface dataset:
Fluoride Concentration and pH of Iced Tea Products
Authors: Behrendt Annekathrin , Oberste Volker , Wetzel Willi Eckhard
Published: April 2003

The objective of this study was to determine the fluoride concentration and pH of 44 iced tea samples and hence to assess the possible role of these beverages as systemic fluoride source as well as their potential cariogenic and erosive character. Ten tea samples were available as a granular instant powder, and 34 as ready-to-drink liquid products. The iced teas contained different types of sugar alone or in combination with maltodextrin, glucose syrup and noncaloric sweeteners. In one product, only acesulfame and aspartame were established. All samples contained lemon juice or citric acid as an additive. The pH ranged from 4.04 to 2.63 and the titrated amount of base to pH 7.0 from 0.75 to 2.39 mmol NaOH/50 ml. The fluoride concentrations measured were <0.6 ppm in 14 products, 0.6–1.0 ppm in 10 products, 1.1–1.5 ppm in 16 products, 1.6–2.0 ppm in 2, and >2.0 ppm in another 2 products. In conclusion, most of the iced teas studied contained considerable fluoride concentrations. If infants ingest larger amounts of them because of their sweet taste, there is a risk of uncontrolled overdosing as a result of additional fluoride intake from other sources at the same time. Furthermore, the majority of the products revealed a highly cariogenic character and finally, all the iced teas appear to be acidic enough to cause dental erosion if these refreshments were excessively consumed from nursing bottles.
Role of the Progesterone Receptor in Restrained Glutamic Acid Decarboxylase Gene Expression in the Hypothalamus during the Preovulatory Luteinizing Hormone Surge
Authors: Brann Darrell W. , Unda Richard , Mahesh Virendra B.
Published: April 2003

Previous work by our laboratory demonstrated that activation of the progesterone receptor through exogenous administration of progesterone suppressed glutamic acid decarboxylase-67 (GAD67) mRNA in the hypothalamus of the estrogen-primed ovariectomized rat. Since GAD67 is the major synthetic enzyme for the inhibitory transmitter, γ-aminobutyric acid, the finding raised the possibility that the endogenous activation of the progesterone receptor may act to restrain GAD67 expression during the natural preovulatory gonadotropin surge during proestrus in the rat, thereby allowing GnRH secretion and the resultant LH surge. To test this hypothesis, the progesterone receptor antagonist, RU486, was administered to regularly cycling proestrous rats and the effect on GAD67 and GAD65 mRNA levels in the preoptic area (POA) and medial basal hypothalamus (MBH) was examined. Serum luteinizing hormone (LH) levels were also examined in order to identify correlations between changes in POA and MBH GAD levels and production of the LH surge. GAD67 mRNA levels in the POA were increased in the cycling rat during proestrus at 18.00 h at the peak and just preceding the termination of the LH surge. There was no change in GAD67 mRNA levels in the MBH, and GAD65 expression was also unchanged during proestrus in the POA and MBH. Treatment with the antiprogestin RU486 resulted in an increase in GAD67 mRNA levels at 12.00 and 14.00 h in the POA, and in the MBH at 14.00, 16.00, and 18.00 h during proestrus, effects which preceded and correlated with the attenuated LH surge in RU486-treated rats at 18.00 h. GAD65 mRNA levels were also elevated by RU486 at 14.00 and 16.00 h in the POA, and at 14.00 h in the MBH during proestrus. These findings suggest that the progesterone receptor plays a role in restraining GAD expression in the hypothalamus during proestrus, and that this effect may be important for the production of the GnRH and LH surge.
Empfinden als kollektive Hilfsfunktion – Ein anderer Aspekt der Typologie
Authors: Hansen Volker
Published: April 2003

Leider besteht für diesen Artikel keine Zusammenfassung. Als Einstieg stellen wir den Textanfang zur Verfügung. Aus Jungs Schriften zur Typologie ragt eine bekannte Stelle hervor. Hier gibt Jung einen erstaunlich klaren und einfachen Hinweis dafür, wie seine Typologie therapeutisch fruchtbar angewandt werden kann: «Der Zugang zum Unbewussten und zu der am meisten verdrängten Funktion aber erschliesst sich sozusagen von selbst und mit genügender Wahrnehmung des bewussten Standpunktes, wenn der Entwicklungsweg über die sekundäre Funktion geht, also im Falle eines rationalen Typus über die irrationale Funktion» [Jung, 1921, § 739]. («Sekundäre Funktion» verwendet er gleichsinnig mit «Hilfsfunktion» [1921,§ 735–738].)
Das Selbst und die therapeutische Beziehung bei frühgestörten Kindern und Jugendlichen1
Authors: Rossetti-Gsell Verena
Published: April 2003

Die Intention der Autorin ist es, eine Verbindung zwischen dem «archetypischen Selbst» der Analytischen Psychologie und dem «persönlichen Selbst» herzustellen. Sie betrachtet den Selbstarchetyp als den Archetyp des individuellen psychischen Lebens, bedingt und begrenzt durch dessen archetypischen Gegensatz, den psychischen Tod. Der Selbstarchetyp ist das Modell für die Entstehung eines individuellen persönlichen Selbst, welches sich in der zwischenmenschlichen Beziehung verwirklicht. Die Autorin beschreibt die elementaren interpersonalen Bedürfnisse für die Entwicklung eines persönlichen Selbst. An praktischen Beispielen aus der therapeutischen Arbeit mit frühgestörten Kindern und Jugendlichen zeigt sie, wie die archetypische Selbstübertragung eine blockierte Entwicklung des persönlichen Selbst wieder aktivieren kann, unter der Bedingung, dass auch die zerstörerischen frühen Erlebnisse in der Übertragung aufgenommen werden. Ein gesundes persönliches Selbst erlebt sich als lebendiges, wesentliches, ganzes, wertvolles und vollständiges Individuum, ist aber gleichzeitig fähig, Erfahrungen von Tod, Mangel, Fragmentierung, Wertlosigkeit und Unvollständigkeit zu ertragen.
Traum und Schamanen
Authors: Elsensohn Susanne
Published: April 2003

Träume spielen im Schamanismus eine eminente Rolle, sie sind ein Divinationsinstrument par excellence. Versteht man die Bildsprache des Schamanismus, so ergeben sich erstaunliche Parallelen zur Jungschen Psychologie. Auch uns können Seelenteile gestohlen werden durch «Geister» (Komplexe), wie etwa der gesunde Menschenverstand, das Selbstwertgefühl oder die psychische Energie bei der Depression. Schamanen haben alle eine durchlässige Ich-Grenze, wie es auch Jung von sich selber sagte. In ihrer Ausbildung lernen sie, diesen Grenzverkehr zu handhaben, um die hilfreichen Mächte nutzen zu können und von den destruktiven nicht verschlungen zu werden. In allen schamanischen Seelensuchreisen und sonstigen Techniken kommen das Bewusstsein und das Unbewusste der Schamanen zusammen, ähnlich der aktiven Imagination. Nur mit dem Unterschied, dass Schamanen gelegentlich in ihren luziden Träumen in das System des Patienten eindringen und damit eine syntone Gegenübertragung willentlich erzeugen können. Ähnliches findet sich bei synchronistischen Phänomenen: was uns dabei einfach gelegentlich zustösst, können Schamanen offensichtlich induzieren.
Management of Lupus Nephropathy
Authors: Hebert Lee A.
Published: April 2003

This review is an evidence- and experience-based approach to the management of SLE, particularly its kidney manifestations. Specific protocols in substantial clinical detail are provided for management and monitoring, according to the severity of the SLE manifestations. The protocols are adapted from those used in a major SLE trial. The adaptations are based on subsequent extensive clinical use of these protocols. Also described is the concomitant use of cardio- and kidney-protective therapies to optimize patient outcomes.
A Model for ex vivo Renal Angiogenesis
Authors: Brodsky Sergey V. , Smith Michael , Kashgarian Michael , Goligorsky Michael S.
Published: April 2003

Attempts to study renal angiogenesis have been hampered by the lack of an appropriate model. Here we present data on a successful ex vivo culture of renal medullary explants in three-dimensional collagen 1 or Matrigel lattices and characterize the dynamics of capillary formation by sprouting endothelial cells. Initially, endothelial cells represented 71 ± 3% among the sprouting cells, but within a week growing capillaries were comprised exclusively of endothelial cells. The quantitative analysis showed that the number of sprouting capillaries progressively increased until 12 days in culture, after which capillaries underwent involution. Occasional formation of glomeruloid bodies was noted. Capillaries were characterized by a well-defined lumen, whereas glomeruloid bodies showed cellular debris occupying the luminal space. In view of the existing controversy regarding angiogenic competence in diabetic nephropathy, we applied this ex vivo culture system to Zucker diabetic rat model of diabetes mellitus. Comparative analysis of capillary sprouting in Zucker diabetic fat and lean nondiabetic control rats showed no differences in angiogenic properties of renal explants obtained at the age of 11 weeks. However, when kidneys were obtained from rats at age of 21 weeks, the capillary sprouting was significantly reduced in Zucker diabetic rats compared to age-matched lean rats. The rate of capillary involution was unaffected in Zucker diabetic rats. In conclusion, the data presented herein delineate the first successful ex vivo model of angiogenesis initiated from the renal medullary explants of adult rats and provide evidence of impaired angiogenesis in Zucker diabetic rats with the established, but not with incipient diabetes mellitus.
Clinicopathological Study of Two Subtypes of Pick’s Disease in Japan
Authors: Odawara Toshinari , Iseki Eizo , Kanai Akiko , Arai Tetsuaki , Katsuragi Toshio , Hino Hiroaki , Furukawa Yoshiko , Kato Masanori , Yamamoto Takayuki , Kosaka Kenji
Published: April 2003

We examined the clinical and neuropathological findings in 3 cases of Pick’s disease with Pick bodies (PiD) and 7 cases of atypical Pick’s disease without Pick bodies (aPiD). PiD and aPiD cases corresponded clinically to frontotemporal dementia and semantic dementia, respectively, based on the clinical diagnostic criteria of frontotemporal lobar degeneration. Brain CT showed that cerebral atrophy was accentuated at an early stage of the illness in the anterior portion of the frontal lobes in PiD cases and in the anterior portion of the temporal lobes in aPiD cases. Neuropathologically, PiD cases showed more circumscribed lobar atrophy than aPiD cases. Both PiD and aPiD cases revealed moderate to severe degeneration with neuronal loss and gliosis in the affected cerebral cortex and subcortical nuclei, but only aPiD cases had pyramidal tract degeneration. Immunohistochemical analyses demonstrated that tauopathy with phosphorylated tau accumulation in the Pick bodies in PiD cases, while aPiD cases showed ubiquitinopathy with ubiquitin accumulation in the intraneuronal and dendritic inclusions. These findings suggested that two subtypes of Pick’s disease in Japan can be distinguished not only neuropathologically but also clinically based on differences in pathogenesis.
A Survey on Inborn Errors of Metabolism in 323 Neonates from the State of Rio de Janeiro, Brazil
Authors: Costa de Oliveira Maria Lúcia , Simoni Ruth Ellen , Rangel de Carvalho dos Santos Cláudia Maria , Fernandes Márcia Jusan , Braga Marcela Jaqueline , Moesia de Albuquerque Renata , Lopes Ferreira Gomes Luís Nelson , Santana Correia Patrícia , Ribeiro Fernandes Alexandre , Berditchevsky Célia Ruth , Bernstein Any , de Oliveira Cesário Paulo Honório
Published: April 2003

Inborn errors of metabolism (IEM) are a relevant cause of morbidity and death among children, and neonates in particular. However, little is known about the prevalence of these disorders in Brazilian newborns. Our laboratory of IEM (LABEIM) at the Department of Biochemistry, Institute of Chemistry, Federal University of Rio de Janeiro (UFRJ), has been working on the diagnosis of IEM since 1988. Out of 3,300 patients (90% children), screened and evaluated from 1989 to 2,000 because of a high clinical suspicion of having an IEM, 323 (9.8%) were neonates. Patients came from different regions of the state of Rio de Janeiro, in which lives approximately 8.5% of the total Brazilian population. Chemical tests, various chromatographic techniques and enzyme assays were performed in urine, plasma and in some cases, cerebrospinal fluid (CSF). This study describes our laboratory and the experience with the 323 investigated neonates, among which 28 cases (8.7%) of IEM were identified and 18 (5.6%), strongly suspected. All these cases were related mainly to the metabolism of amino acids, organic acids, lysosomal enzymes and carbohydrates. Furthermore, data on population, community and health services are presented.
Perceptions of Mexican American Clients Receiving Genetic Services in South Texas
Authors: Urdaneta María Luisa , Livingston Judith , Aguilar Maricela , Suther Sandy , Enciso Vicky , Kaye Celia I.
Published: April 2003

Objectives: The objectives of this study were to assess the perceptions among medically indigent Mexican American clients in South Texas receiving genetic services, and the effects of these perceptions on the utilization of genetic services. Methods: Using a qualitative ethnographic approach, 16 caretakers of children with genetic conditions and 7 prenatal clients were interviewed. Interview data were analyzed using the NUD*IST 4 computer program. Results: Clients reported challenges with understanding and utilizing genetic services due to language and communication barriers, poverty, cultural differences, and system issues. Conclusion: Client perceptions of genetic services were influenced by experiences with other biomedical providers and traditional healers, and by anxieties precipitated by unfamiliar concepts and approaches to medical care. Recommendations are made to improve provision of genetic services.
A Novel Nonsense Mutation of the Sedlin Gene in a Family with Spondyloepiphyseal Dysplasia Tarda
Authors: Shi Yi-Ru , Lee Cheng-Chun , Hsu Yu-An , Wang Chung-Hsing , Tsai Fuu-Jen
Published: April 2003

We report a new nonsense mutation in the human sedlin (SEDL) gene in a family with X-linked spondyloepiphyseal dysplasia tarda. A substitution of cytosine for adenine at nucleotide position 329 causing a nonsense mutation (S110X) in exon 6 was identified in the affected patient in the family.
Map Error Reduction: Using Genetic and Sequence-Based Physical Maps to Order Closely Linked Markers
Authors: DeWan Andrew T. , Parrado Antonio R. , Matise Tara C. , Leal Suzanne M.
Published: April 2003

The Marshfield comprehensive genetic maps are frequently used for linkage and association studies, however, for some regions of these maps the marker order has low level of likelihood ratio support. In order to investigate the level of statistical support and the accuracy of the genetic maps compared to sequence-based physical maps, two ∼30 cM autosomal regions were selected. The first region was selected from chromosome 3 and consisted predominately of draft sequence. The second region was selected from chromosome 21 and consisted of finished sequence data. The physical order of these markers was based upon their position on Celera (CEL) and Human Genome Project-Santa Cruz (HGP-sc) sequence-based physical maps. The chromosome 3 and 21 regions contained 100 and 61 markers, respectively, on the Marshfield genetic map. The genetic and physical map order was consistent for 88.9 and 89.2% of the markers in the region on chromosome 3 and 21, respectively. Using a novel scoring criterion to assess inconsistent marker order between genetic and physical maps, it was determined that the physical order was likely the correct order for 3.3 and 7.1% of the markers in the chromosome 3 and 21 regions, respectively. To increase the accuracy of the order of markers selected for fine mapping a method is presented which combines information from genetic and sequence-based physical maps.
Age-Dependent Differences in Flurothyl-Induced c-fos and c-jun mRNA Expression in the Mouse Brain
Authors: Storey Thomas W. , Rho Jong M. , White Sylvia S. , Sankar Raman , Szot Patricia
Published: April 2003

Numerous studies have examined the brain regional distribution of the immediate early gene (IEG), c-fos, following seizures induced by a variety of chemical or electrical provocations in the rat. Very little is known concerning the regional and temporal distribution of IEG expression following seizures in mice, and even less regarding the effects of development. In the present study, seizures of varying severities were induced in immature (postnatal day 17–18) and mature male (postnatal day 55–60) C3H mice with flurothyl, a volatile convulsant. In the immature mouse, neither c-fos nor c-jun mRNA were statistically elevated following any type of acute seizure activity. In the mature mouse, seizures of different severity resulted in differential effects on regional c-fos and c-jun mRNA expression. We conclude that the c-fos and c-jun are not reliable indicators of seizure activity in immature mice, whereas they remain indirect markers of neuronal activity in mature mice.
Healing of Duodenal Ulcers Is Not Impaired by Indomethacin or Rofecoxib, the Selective COX-2 Inhibitor, in Rats
Authors: Araki Hideo , Komoike Yusaku , Matsumoto Masahiro , Tanaka Akiko , Takeuchi Koji
Published: April 2003

Background/Aim: Studies have demonstrated an important role for endogenous PG and NO in the healing of chronic gastric ulcers. We investigated the effects of COX and NOS inhibitors on the healing of duodenal ulcers, in comparison with gastric ulcers, in rats. Methods: Gastric and duodenal ulcers were induced by serosal application of acetic acid (0.1 ml of 100% acetic acid) for 60 and 20 s, respectively. Indomethacin (a nonselective COX inhibitor) or rofecoxib (a selective COX-2 inhibitor) was given p.o. once daily for 14 days from 3 days after ulcer induction, while NG-nitro-L-arginine methyl ester (L-NAME: a nonselective NOS inhibitor) or aminoguanidine (a relatively selective iNOS inhibitor) was given s.c. twice daily during this period. Results: Both gastric and duodenal ulcers induced by acetic acid healed spontaneously within 17 days to a minimal size. Daily administration of indomethacin or rofecoxib significantly delayed the healing of gastric but not duodenal ulcers. In contrast, the healing of both gastric and duodenal ulcers was delayed by repeated administration of either L-NAME or aminoguanidine. Ulceration markedly increased the PGE2 content of the ulcerated mucosa in both the stomach and duodenum, and the increased PG biosynthetic response was inhibited by either indomethacin or rofecoxib in both tissues. The expression of both COX-2 and iNOS mRNAs was upregulated in the ulcerated mucosa of the stomach and duodenum. Conclusion: These results suggest that COX-2/PG is actively involved in the healing of gastric but not duodenal ulcers, although the mRNA for COX-2 is expressed in the duodenal mucosa after ulceration, as potently as in the gastric mucosa. In contrast, NO produced by both cNOS and iNOS plays a role in the healing of both gastric and duodenal ulcers.
Correction of Acidosis by Hemodialysis: Proposal of a Correlation with Urea Kinetics
Authors: Leite Jr. Maurilo , Leal Ethel , Cardoso Lúcio R.
Published: April 2003

Background/Aims: We examined the effect of hemodialysis (HD) on acid-base status and its relation to urea kinetics in clinically stable renal HD patients. The purpose of this study was to design a practical approach to monitoring the correction of acidosis, as it can be assisted by routine parameters of adequacy. Methods: Blood samples were drawn immediately before and after HD from 46 chronic renal patients to determine electrolytes, blood gases, serum albumin and blood urea nitrogen (BUN). Additional measurements of pH and serum bicarbonate were done in 35 patients in the periods before, immediately after and 4 h after HD. The normalized protein catabolic rate (nPCR) was calculated and correlated with the serum albumin and bicarbonate values before HD. Equilibrated KT/V (eKT/V) and urea reduction ratio (URR) were calculated and correlated with the degree of bicarbonate correction, defined as ΔHCO3–. Results: There was no correlation between nPCR and pre-HD HCO3–, while there was a significant correlation between URR and eKT/V and ΔHCO3– (p < 0.003). Conclusions: The Δbicarbonate was well correlated with URR and eKT/V, and the study suggests that in standard HD the correction of acidosis may be related to target URR and eKT/V levels.
Experimental Modulation of Cell-Cell Adhesion, Invasiveness and Differentiation in Trophoblast Cells
Authors: Hohn Hans-Peter , Denker Hans-Werner
Published: April 2003

The establishment of pregnancy in the human decisively depends on the competence of the early trophoblast to interact during implantation with (1) the uterine epithelium and subsequently (2) with the endometrial stroma and blood vessels. In the interaction with uterine epithelium cell-to-cell adhesion appears to be a critical element, involving initially (and astonishingly) apical cell poles of both epithelia. The subsequent invasion of the stroma includes both adhesive interactions with and degradation of extracellular matrix. How these different processes are regulated in detail remains largely unknown. While the invasiveness of the trophoblast is known to be regulated in local and temporal terms it has remained unclear so far whether trophoblast adhesiveness to cells and/or matrix is subject to a coupled regulation or whether both properties involve different, maybe sequentially effective, control mechanisms. It is also not known how the regulation of these activities is related to the differentiation pathways leading to the formation of noninvasive villous trophoblast serving endocrine as well as nutritive functions. This communication reviews experiments using normal cytotrophoblast cells isolated from first trimester or term placentae as well as malignant trophoblast (choriocarcinoma) cells treated with a panel of compounds known to modulate cell differentiation [retinoic acid, methotrexate, dibutyryl-cAMP, phorbol-(12-myristoyl-13-acetyl)-diester]. Parameters indicative of trophoblast differentiation [in particular chorionic gonadotrophin (hCG) secretion] as well as adhesion to uterine epithelial cells and invasion into extracellular matrix in vitro were monitored. While expression of differentiation parameters was increased by all drug treatments, adhesion to uterine epithelial cells in vitro was reduced. Modulation of invasiveness, however, followed a different pattern: while it was reduced in normal trophoblast cells it was even increased in choriocarcinoma cells with various substances. The response of cells with respect to production of extracellular matrix proteins or matrix-degrading proteinases showed a complex pattern that again lacked a stringent correlation with hCG production and adhesion, and in addition also with invasive behavior. These results suggest that adhesiveness of trophoblast to uterine epithelial cells and invasiveness into the uterine stroma (extracellular matrix) are subject to different control mechanisms. They support the view that trophoblast-endometrium interactions involve a cascade of various adhesion and migration processes whose cellular and molecular basis is complex but accessible to experimental investigation using a variety of available in vitro systems.
Integrins and Extracellular Matrix Proteins at the Maternal-Fetal Interface in Domestic Animals
Authors: Burghardt Robert C. , Johnson Greg A. , Jaeger Laurie A. , Ka Hakhyun , Garlow Jane E. , Spencer Thomas E. , Bazer Fuller W.
Published: April 2003

Establishment of pregnancy in mammals requires coordinated conceptus-maternal interactions involving numerous hormones, growth factors and cytokines acting via specific receptors in the uterus. Uterine secretions play an important role in establishing synchrony between development of the conceptus and uterine receptivity, as well as in conceptus remodeling, adhesion, implantation and placentation in domestic species. Studies of non-invasive implantation in domestic livestock provide valuable opportunities to investigate fundamental processes of the initial events of apposition, attachment and adhesive interactions that are shared among species. In pigs and sheep, it appears that integrins play a dominant role in these fundamental processes via interactions with extracellular matrix molecules and other ligands to transduce cellular signals in uterine epithelial cells and conceptus trophectoderm. This review considers several of the potential integrin-binding ligands involved in the complex implantation adhesion cascade in pigs and sheep along with in vitro evidence for the transduction of cytoplasmic signals that may be required to sustain fetal and maternal contributions to the formation of the epitheliochorial placenta.
Geometric Properties of the Lung Parenchyma after Postnatal Glucocorticoid Treatment in Rats
Authors: Schwyter Matthias , Burri Peter H. , Tschanz Stefan A.
Published: April 2003

While glucocorticoid (GC) administration appears to be beneficial during the acute phase of treatment of neonates at risk of developing chronic lung disease, it is still not clear whether steroid application has an adverse long-term effect on the lung maturation. Thus, the goal of the present work was to analyze GC effects on the pulmonary structure in a rat model where dosage and timing of drug administration were adapted to the therapeutic situation in human neonatology. The animals received daily a maximum of 0.1 mg dexamethasone phosphate per kiloggram body weight during the first 4 postnatal days. Investigations were performed at the light microscopic level by means of a digital image analysis system. While there were no differences in the lung architecture between experimental animals and controls on day 4, the earliest time point of observation, we found a widening of airspaces with a concomitant decrease in the alveolar surface area density, representing a loss of parenchymal complexity, on days 10 and 21 in treated rats. On days 36 and 60, however, no alterations in the pulmonary parenchyma could be detected in experimental animals. We conclude from these findings that the GC-induced initial inhibition of development (days 10 and 21) was completely reversed, so that a normal parenchymal architecture and also a normal alveolar surface area density were found in adult rats (days 36 and 60). From the results obtained using the regimen of GC administration described, mimicking more closely the steroid treatment in human neonatology, we conclude that the observed short-term adverse effects on lung development can be fully compensated until adult age.
Crossover Comparison of Efficacy and Preference for Rizatriptan 10 mg versus Ergotamine/Caffeine in Migraine
Authors: Christie Suzanne , Göbel Hartmut , Mateos Valentin , Allen Christopher , Vrijens France , Shivaprakash Malathi
Published: April 2003

Rizatriptan 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 double- blind crossover outpatient study assessed the preference for 1 rizatriptan 10 mg tablet to 2 ergotamine 1 mg/caffeine 100 mg tablets in 439 patients treating a single migraine attack with each therapy. Of patients expressing a preference (89.1%), more than twice as many preferred rizatriptan to ergotamine/caffeine (69.9 vs. 30.1%, p ≤ 0.001). Faster relief of headache was the most important reason for preference, cited by 67.3% of patients preferring rizatriptan and 54.2% of patients who preferred ergotamine/caffeine. The co-primary endpoint of being pain free at 2 h was also in favor of rizatriptan. Forty-nine percent of patients were pain free 2 h after rizatriptan, compared with 24.3% treated with ergotamine/caffeine (p ≤ 0.001), rizatriptan being superior within 1 h of treatment. Headache relief at 2 h was 75.9% for rizatriptan and 47.3% for ergotamine/caffeine (p ≤ 0.001), with rizatriptan being superior to ergotamine/caffeine within 30 min of dosing. Almost 36% of patients taking rizatriptan were pain free at 2 h and had no recurrence or need for additional medication within 24 h, compared to 20% of patients on ergotamine/caffeine (p ≤ 0.001). Rizatriptan was also superior to ergotamine/caffeine in the proportions of patients with no nausea, vomiting, phonophobia or photophobia and for patients with normal function 2 h after drug intake (p ≤ 0.001). More patients were (completely, very or somewhat) satisfied 2 h after treatment with rizatriptan (69.8%) than at 2 h after treatment with ergotamine/caffeine (38.6%, p ≤ 0.001). Recurrence rates were 31.4% with rizatriptan and 15.3% with ergotamine/caffeine. Both active treatments were well tolerated. The most common adverse events (incidence ≧5% in one group) after rizatriptan and ergotamine/caffeine, respectively, were dizziness (6.7 and 5.3%), nausea (4.2 and 8.5%) and somnolence (5.5 and 2.3%).
Dopamine Agonists Induce Episodes of Irresistible Daytime Sleepiness
Authors: Schlesinger Ilana , Ravin Paula D.
Published: April 2003

We assessed the prevalence and risk factors for irresistible daytime sleepiness (IDS) in a cohort of patients with Parkinson’s disease (PD) treated with dopamine agonists. Seventy consecutive PD patients on dopamine agonists were interviewed. IDS was experienced by 24 patients (34.3%). Fifty percent of the pramipexole patients, 15.4% of the pergolide patients, 23.1% of the ropinirole patients and the 2 patients on bromocriptine experienced IDS. Patients who experienced IDS were younger (p = 0.009). Nineteen patients had IDS while driving, 3 sustained a motor vehicle crash. Daytime somnolence (p = 0.05) and early arousals (p = 0.001) were risk factors and daytime napping (p = 0.007) and benzodiazepines (p = 0.006) were protective. Improvement was achieved by changing the dosing schedule, the amount of agonist per dose, discontinuing the agonist or accommodating the sleepiness. We conclude that dopamine agonists are commonly implicated in IDS.
Assessment of the Intestinal Permeability following Postoperative Chemotherapy for Human Malignant Disease
Authors: Inutsuka S. , Takesue F. , Yasuda M. , Honda M. , Nagahama S. , Kusumoto H. , Nozoe T. , Korenaga D.
Published: April 2003

Purpose: Administration of anticancer drugs may damage gastrointestinal epithelium, thereby increasing the permeability of the gastrointestinal mucosa. We estimated the usefulness of oral lactulose and mannitol (L/M) test for assessment the extent of mucosal damage following postoperative chemotherapy for human malignant disease. Methods: The permeability index (PI): the urinary recovery ratio of excreted L to M was measured before and after chemotherapy in 31 patients with gastrointestinal cancers who underwent surgical resection. These findings were compared with data on 12 patients with breast cancer. The effect of chemotherapy was evaluated by the ratio of increase in PI, which was designed as post-chemotherapy value on day 7 divided by pre-chemotherapy value. Results: The mean PIs before chemotherapy in patients who underwent gastrectomy or colectomy were significantly higher than the value in those treated with mastectomy (p < 0.05). In the gastrointestinal cancer patients, the mean PIs significantly increased after chemotherapy compared with the pre-chemotherapeutic value (p < 0.01), however no significant difference was seen in breast cancer patients. When the ratios of increase in PI were calculated among gastric cancer patients, the total gastrectomy group showed a significantly higher increase in PI compared with the partial gastrectomy group (p < 0.05). Conclusions: Since the oral L/M absorption test is useful for assessing the degree of mucosal damage and measurement of intestinal permeability, this analysis should be recommended to determine the optimum timing and the adequate dosage of the anticancer drug administration.
Changes in Gene Expression of ARPE-19 Cells in Response to Vitreous Treatment
Authors: Fan Wei , Zheng Jing Juan , Peiper Stephen C. , McLaughlin Barbara J.
Published: April 2003

Purposes: The purpose of this study is to determine the changes in gene expression by a human retinal pigment epithelium (RPE) cell line (ARPE-19) in response to vitreous treatment, which induces RPE proliferation and phenotypic changes in vitro that mimic the repair response observed in vivo during proliferative vitreoretinopathy. Methods: ARPE-19 cells were grown for more than 4 weeks and their gene expression studied in: (1) subconfluent cultures treated with 50% human vitreous for 72 h; (2) subconfluent cultures without vitreous treatment, and (3) a confluent, nondividing monolayer. Total RNA was extracted from RPE cells and differential gene expression between each condition was determined using gene arrays (Clontech, Palo Alto, Calif., USA). Semiquantitative RT-PCR was used to confirm the upregulation of 4 genes related to vitreous treatment. In addition, the secretion of 1 of these upregulated gene products, monocyte chemotactic protein 1 (MCP-1), was confirmed by ELISA. Results: A greater than threefold increase in the expression of mRNA for cell cycle regulators, intracellular transducers, cell adhesion proteins, growth factors and chemokines was observed following vitreous treatment of the RPE cell line and a corresponding decrease in the expression of genes related to apoptosis. RT-PCR confirmed the increased gene expression of MCP-1, intercellular adhesion molecule-1, vascular cell adhesion protein 1 precursor and vascular endothelial growth factor in vitreous-treated cells. Immunoassays further showed an increased MCP-1 secretion by vitreous-treated RPE. Conclusions: These findings suggest that in this in vitro vitreous treatment model, ARPE-19 cells participate in a mock repair response by upregulating genes encoding for proteins associated with inflammation and wound healing.
Command Hallucinations: Who Obeys and Who Resists When?
Authors: Erkwoh R. , Willmes K. , Eming-Erdmann A. , Kunert H.J.
Published: April 2003

The impact of auditory command hallucinations on the behaviour of schizophrenic patients sometimes appears to be unpredictable. In order to tackle this problem, the psychopathological characteristics of command hallucinations in 31 schizophrenic patients were assessed using a 24-item questionnaire. Using binary data and relative risk analysis methods, predictors were determined for obeying or resisting command hallucinations. Characteristics of voices and the attitude toward the voices appear equally important for prediction. A set of three psychopathological characteristics comprising a voice known to the patient, emotional involvement during the hallucinations, and seeing the voice as real provides significant predictivity of behaviour following command hallucinations. These results are interesting for clinical and forensic psychiatrists.
Radon: A Possible Risk Factor in Multiple Sclerosis
Authors: Bølviken B. , Celius E.G. , Nilsen R. , Strand T.
Published: April 2003

Ecological studies in Norway, using a method for spatially moving bivariate correlation analysis, show that south of 65 degrees N, there are significant positive correlations (p < 0.01) for rates of multiple sclerosis (MS) versus contents of radon (Rn) in indoor air, and significant negative correlations for MS rates versus fallout of magnesium (Mg) and amounts of precipitation. Based on these data, we propose the hypothesis that the content of Rn in inhaled air is a risk factor in MS. The release of harmful Rn levels to the air may be influenced by (1) the levels of exchangeable Mg in soil, which may affect the soil content of the Rn precursor radium (Ra), and (2) the amounts of precipitation through its effects on soil moisture, which is one of the factors controlling Rn emanation from the soil. This hypothesis agrees with several of the known epidemiological characteristics of MS.
Incidence of Parkinson’s Disease in Estonia
Authors: Taba Pille , Asser Toomas
Published: April 2003

The incidence of Parkinson’s disease (PD) was studied over a 9-year period (1990–1998) in Tartu county, Estonia, with a mean population of 156,417. Based on 264 patients, the average crude incidence rate of PD was 18.8 per 100,000 person-years. The age-adjusted incidence was 16.8/100,000; 18.3 for the urban group and 14.0 for the rural group; 16.6 for men and 17.1 for women. The age-specific incidence was 1.0/100,000 in the age range 30–39 years, reached a maximum of 117.2/100,000 in the age range 70–79 years and declined in the elderly. The incidence of PD was comparable with that found in developed countries, except for a slightly higher (not significant) incidence rate in the urban compared with the rural population in Estonia.
Association between Atrial Septal Aneurysm and Patent Foramen ovale in Young Patients with Recent Stroke and Normal Carotid Arteries
Authors: Mattioli Anna Vittoria , Bonetti Lorenzo , Aquilina Michele , Oldani Antonio , Longhini Carlo , Mattioli Giorgio
Published: April 2003

Background: Atrial septal aneurysm (ASA) has been considered a potential source of cardiogenic embolism for many years. The ASA Multicenter Italian (ASA-MI) Study evaluated the prevalence and characteristics of ASA in patients with stroke and normal carotid arteries compared with control patients without stroke. The purpose of the present study was to evaluate the frequency of ASA and the association with patent foramen ovale (PFO) in the subgroup of younger patients (aged less than 55 years) included in the ASA-MI Study. Methods: The ASA-MI Study included 606 patients, enrolled between November 1990 and December 1996: 245 patients with a previous cerebral embolic attack and normal carotid study and a control group of 316 patients. They all underwent transthoracic and transesophageal echocardiography. The subgroup of younger patients aged less than 55 years included 90 patients (61 men and 29 women of mean age 49 ± 5 years) (group AY). This group was evaluated and compared with an age- and sex-matched control population (61 men; of mean age 48 ± 6 years) (group BY). Results: The prevalence of ASA was 48.8% (95% confidence interval 40–61) in group AY and 22.2% in the group BY (95% confidence interval 18–33) (χ2 = 5.968; p = 0.01). Morphological features were similar in the 2 groups of patients. ASA involved the entire septum in 52% of patients of group AY, and in 47.2% of group BY. The prevalence of PFO was 58.8% (95% confidence interval 43–62) in group AY and 28.8% in group BY (95% confidence interval 17–35) (χ2 = 5.811; p = 0.01). A strong association was found between ASA and PFO. Of the 90 younger patients with stroke, 39 of 44 (88.6%) with ASA also had PFO, compared with 14 of 46 (30.4%) without ASA (χ2 = 7.370; p = 0.007). Conclusion: We found that ASA and PFO were independent predictive factors for stroke in younger patients with stroke and normal carotid arteries and that the association between ASA and PFO bore an increased odds risk.
Chlamydia pneumoniae in Elderly Patients with Stroke (C-PEPS): A Case-Control Study on the Seroprevalence of Chlamydia pneumoniae in Elderly Patients with Acute Cerebrovascular Disease
Authors: Ngeh Joseph , Gupta Sandeep , Goodbourn Colin , Panayiotou Barnabas , McElligott Geraldine
Published: April 2003

Background and Purpose: Multiple studies have suggested an association between Chlamydia pneumoniae infection and atherosclerotic vascular disease. We investigated whether serological markers of C. pneumoniae infection were associated with acute stroke or transient ischaemic attack (TIA), exclusively in elderly patients. Methods: One-hundred white patients aged over 65 years admitted with acute stroke or TIA, and 87 control patients admitted with acute non-cardiopulmonary, non-infective disorders were recruited prospectively. Using an enzyme-linked immunosorbent assay kit, the presence of C. pneumoniae immunoglobulins IgA, IgG, IgM in patients’ sera was determined. Results: The seroprevalence of C. pneumoniae-specific IgA, IgG, IgM were 63, 71, and 14% in the stroke/TIA group (median age = 80), and 62, 65, and 17% in the control group (median age = 80), respectively. Using a logistic regression statistical model, adjusting for age and sex, history of hypertension, smoking, diabetes, ischaemic heart disease (IHD), ischaemic electrocardiogram (ECG), the odds ratios (ORs) of having a stroke/TIA in relation to C. pneumoniae-specific IgA, IgG, IgM were 1.04, 1.24, 0.79 (p = NS). Further analysis identified 43 acute stroke/TIA cases and 44 controls without history of IHD or ischaemic ECG or both. After adjusting for history of hypertension, smoking, diabetes, age and sex, the ORs in this subgroup were 1.40 for IgA [95% confidence interval (CI) 0.53–3.65; p = 0.49], 2.41 for IgG (95% CI 0.90–6.46; p = 0.08) and 1.55 for IgM (95% CI 0.45–5.40; p = 0.49). Conclusions: Although a high seroprevalence of C. pneumoniae in elderly patients was confirmed, no significant association between serological markers of C. pneumoniae infection and acute cerebrovascular events was found. There was, however, a weak trend towards increased ORs for acute cerebrovascular disease in a subgroup of C. pneumoniae seropositive elderly patients without any history of IHD or ischaemic ECG.
Heparin Treatment in Cerebral Sinus and Venous Thrombosis: Patients at Risk of Fatal Outcome
Authors: Mehraein S. , Schmidtke K. , Villringer A. , Valdueza J.M. , Masuhr F.
Published: April 2003

We performed a retrospective analysis of 79 patients with cerebral sinus venous thrombosis, who were treated with a fixed regimen of dose-adjusted intravenous heparin, to determine predictors of a fatal course. The parameters investigated were the state of consciousness and the presence of intracranial haemorrhage (ICH) at the start of heparin treatment, involvement of the internal venous system, mean delay from initial symptom to stupor or coma and from initial symptom to hospital admission, focal neurological deficits, mean intracranial circulation time (ICT) on conventional angiography, and age and sex distribution. Mortality rate was 10% in this series (8/79). There was a strong link between the outcome and the level of vigilance: 53% of the patients with stupor or coma at the start of the heparin therapy died (8/15), whereas all of the 64 patients with no more than mildly impaired vigilance survived (p < 0.00001). Furthermore, mean age and mean ICT were significantly higher in the group of patients who died. There was a statistical trend (p = 0.056) for ICH to be more frequent in cases with fatal outcome, but there was reason to assume that ICH represented an epiphenomenon of a severe course rather than an independent predictor. Other investigated parameters were not linked with a fatal outcome.
Aging and Stroke Rehabilitation
Authors: Paolucci Stefano , Antonucci Gabriella , Troisi Elio , Bragoni Maura , Coiro Paola , De Angelis Domenico , Pratesi Luca , Venturiero Vincenzo , Grasso Maria Grazia
Published: April 2003

The aim of this study was to assess the specific influence of age on basal functional status and rehabilitation results. We conducted a case-comparison study on 150 stroke inpatients. They were enrolled in homogeneous subgroups, matched for severity of stroke (measured by Canadian Neurological Scale – CNS) and onset admission interval (within 3 days) and divided into five subgroups according toage: ≤50; 51–64; 65–74; 75–84; and ≧85 years. Even when severity of stroke was the same, increasing age was associated with greater disability in activities of daily living (ADL) and mobility, minor results of rehabilitation treatment and shorter length of stay. Patients ≧85 years were nearly ten times as likely to show a low response in ADL (OR = 9.28, 95% CI = 2.89–29.76) and nearly six times in mobility (OR = 6.13, 95% CI = 2.18–17.25) than younger patients. However, rehabilitation treatment was efficacious also in patients ≧85 years, with effectiveness of treatment 27.96% on ADL and 18.64% on mobility. On one hand our results confirm the unfavorable influence of age on functional outcome and on the other that inpatient rehabilitation is substantially effective also for very old patients, although less than for younger ones.
Functional Outcome, Rehabilitation Use and Length of Hospital Stay for Stroke Patients in South Madrid
Authors: Jiménez Muro Milagros , de Pedro-Cuesta Jesus , Almazán Javier , von Koch Lena , Widén Holmqvist Lotta
Published: April 2003

Background: Health status and use of resources by stroke patients in Spain are unknown. Methods: A total of 103 acute stroke patients resident in south Madrid, population 665,168, were seen in 1996 at a general hospital and three primary care centres and evaluated at 5–10 days, 3 and 6 months after stroke. Health outcomes and patterns of rehabilitation and hospital use by patient groups were studied using multivariate logistic regression. Results: The group receiving rehabilitation exhibited higher levels of impairment, disability and handicap at each time point, these differences decreasing with time, except in the distribution of walking ability which was unimodal in that group. Younger age, poor walking ability and motor capacity, pain on the paretic side and living with a spouse predicted use of rehabilitation; low level of education predicted a long hospital stay. Conclusion: Rehabilitation for stroke in south Madrid was sparse and used mainly by young, severely affected patients.
Radioprotectants: Current Status and New Directions
Authors: Grdina David J. , Murley Jeffrey S. , Kataoka Yasushi
Published: April 2003

The ability to prevent radiotherapy-induced toxicity without affecting antitumor efficacy has the potential to enhance the therapeutic benefit for cancer patients without increasing their risk of serious adverse effects. Among the currently available cytoprotective agents capable of protecting normal tissue against damage caused by either chemo- or radiotherapy, only amifostine has been shown in clinical trials to reduce radiation-induced toxicity. Most notably, it reduces the incidence of xerostomia, which is a clinically significant long-term toxicity arising in patients undergoing irradiation of head and neck cancers. In vitro studies with the active metabolite of amifostine (WR-1065) have shown it to prevent both radiation-induced cell death and radiation-induced mutagenesis. The potential of this agent to prevent secondary tumors, as well as other radiation-induced toxicities is now the focus of ongoing research. Among other novel approaches to radioprotection being explored are methods to increase levels of the antioxidant mitochondrial enzyme manganese superoxide dismutase (MnSOD). In addition, the use of epoetin alfa, alone or in combination with cytoprotectants (e.g., amifostine), to treat radiation-induced anemia is also being investigated. The objective of developing newer cytoprotective therapies is to improve the therapeutic ratio by reducing the acute and chronic toxicities associated with more intensive and more effective anticancer therapies.
Raising Hemoglobin: An Opportunity for Increasing Survival?
Authors: Thomas Gillian M.
Published: April 2003

Although the association between low hemoglobin levels and poorer outcomes in radiation oncology has long been recognized, anemia is often overlooked and untreated. However, a growing body of clinical evidence now indicates that low hemoglobin levels during radiation treatment are associated with decreased response and survival following radiotherapy. For example, a large Canadian retrospective study in patients receiving radical radiotherapy for cervical cancer showed that the 5-year survival rate was 19% higher in those whose hemoglobin during radiation treatment was =12 g/dl compared to those with levels <12 g/dl. The data suggest that clinical trials need to be performed to determine whether increasing hemoglobin levels leads to improved local control and survival. The mechanism by which low hemoglobin levels could cause poorer outcomes is not well understood and needs further elucidation. It is postulated that lower hemoglobin levels resulting in decreased oxygen carrying capacity may lead to increased tumor hypoxia, radiation resistance and increased tumor angiogenesis. The interrelationship of low hemoglobin levels, hypoxia, tumor angiogenesis and survival is explored in this article.