bluuebunny/crossref_metadata_2025 huggingface dataset:
Aqueous Humor Dynamics in Anesthetized Rats Infused with Intracameral Apraclonidine
Authors: Searles RobinV. , Shikher Vladimir , Balaban Carey D. , Severs WalterB.
Published: April 2003

We studied the acute effects of the ocular hypotensive drug, apraclonidine (AP), on intraocular pressure (IOP) and aqueous humor dynamics of anesthetized rats during infusion-induced ocular hypertension. Two infusions were made into the anterior chamber of the eye: one was constant at a rate of 0.05 µl/min, the other was cyclic, at a rate of 0.25 µl/min, with the pump on for 4 min, then off for 4 min. Data were processed by complex demodulation and analysis of a second-order transfer function. This permitted separate calculations of resistive components (Ao), i.e., trabecular meshwork and uveoscleral outflows, and residual pressure (RP) estimating nonresistive components, i.e., aqueous synthesis and episcleral venous pressure. A balanced salt solution (BSS) and AP (0.0005%) were tested. AP markedly delayed the within-group rise in IOP: 20 min for BSS vs. 60 min for AP (p < 0.001). IOP of AP rats was less than control for 100 min (p < 0.05). The infusions raised Ao in both groups (p < 0.05). AP initially had a transient inhibitory effect (p < 0.05). Infusions raised RP in both groups. AP had a strong inhibitory effect for the first 8 cycles (p < 0.05). These data document that the acute effects of AP in this in vivo rat model of ocular hypertension were to delay increases in IOP, mainly by reducing nonresistive components of aqueous humor dynamics. Transient inhibition of resistive mechanisms also occurred.
Effect of Mometasone Furoate by Topical Application on Allergic Rhinitis Model in Rats
Authors: Sugimoto Yukio , Ishizawa Keisuke , Saitou Kouichi , Suzuki Genzo , Tarumi Tadatsugu , Nakahara Hiroto , Kirino Yasushi , Kamei Chiaki
Published: April 2003

The effects of mometasone furoate on experimental allergic rhinitis in rats were studied in comparison with that of fluticasone propionate. Topical application of both drugs inhibited dose-dependently the increase of nasal symptoms (sneezing and nasal rubbing) after antigen challenge to the nasal cavity of actively sensitized rats. Mometasone furoate and fluticasone propionate at concentrations of 0.01 or 0.1% significantly inhibited both nasal rubbing and sneezing 1 h after topical application of both drugs. The relative potencies of mometasone furoate in nasal rubbing and sneezing compared to fluticasone propionate were 5.01 and 6.87, respectively. Mometasone furoate (0.02%) and fluticasone propionate (0.1%) significantly inhibited the increase of antigen-induced nasal rubbing even 6 h after topical application, indicating that both drugs have a long-lasting effect.
The Effect of Speaking Style on a Locus Equation Characterization of Stop Place of Articulation
Authors: Sussman H.M. , Dalston E. , Gumbert S.
Published: April 2003

Locus equations were employed to assess the phonetic stability and distinctiveness of stop place categories in reduced speech. Twenty-two speakers produced stop consonant + vowel utterances in citation and spontaneous speech. Coarticulatory increases in hypoarticulated speech were documented only for /dV/ and [gV] productions in front vowel contexts. Coarticulatory extents for /bV/ and [gV] in back vowel contexts remained stable across style changes. Discriminant analyses showed equivalent levels of correct classification across speaking styles. CV reduction was quantified by use of Euclidean distances separating stop place categories. Despite sensitivity of locus equation parameters to articulatory differences encountered in informal speech, stop place categories still maintained a clear separability when plotted in a higher-order slope × y-intercept acoustic space.
Voice Onset Time in Speech to Infants and Adults
Authors: Sundberg Ulla , Lacerda Francisco
Published: April 2003

Investigations of the phonetics of infant-directed speech (IDS) have mainly focused on prosodic aspects, showing extreme values or overspecifications in comparison to adult-directed speech (ADS). On the other hand, studies of segmental properties, especially consonantal ones, are very rare. The lack of knowledge of phonetic characteristics of the infant’s speech input is problematic, considering that the infant’s perceptual development seems to be attuned towards properties in the ambient language, as suggested by infant perception experiments. In the present study voice onset time (VOT) was measured in Swedish mothers’ IDS and in their ADS. VOT was significantly shorter in IDS than in ADS in both voiced and voiceless stops. The impact of stress was very clear in both IDS and ADS, showing significantly longer VOT in stressed positions as compared to the unstressed. The results are discussed in a framework assuming a differential weighting system of different phonetic aspects such as prosodic, consonantal and vocalic, as a function of infant development.
The Source-Filter Frame of Prominence
Authors: Fant Gunnar , Kruckenberg Anita , Liljencrants Johan
Published: April 2003

One aim of our study is to discuss some of the relations of prosodic parameters to the speech production process, e.g. how speech intensity is related to the vocal tract filter and the voice source and the underlying aerodynamics. A specific problem of phonetic interest is the role of subglottal pressure and fundamental frequency as intensity determinants and their covariation in speech. Our speech analysis displays, incorporating perceptually scaled syllable prominence, are suitable for multilevel studies of speech parameters. A new intensity parameter, SPLH, related to sonority is introduced. In combination with the standard sound pressure level it provides information on the voice source spectral slope. In Swedish, high long stressed vowels approach a semi-closed target, and thus a sonority minimum, which suggests a motor component in prominence perception.
Modeling and Perception of ‘Gesture Reduction’
Authors: Carré René , Divenyi Pierre L.
Published: April 2003

The phenomenon of vowel reduction is investigated by modeling ‘gesture reduction’ with the use of the Distinctive Region Model (DRM). First, a definition is proposed for the term gesture, i.e. an acoustically efficient command aimed at deforming, in the time domain, the area function of the vocal tract. Second, tests are reported on the perception of vowel-to-vowel transitions obtained with reduced gestures. These tests show that a dual representation of formant transitions is required to explain the reduction phenomenon: the trajectory in the F1–F2 plane and the time course of the formant changes. The results also suggest that time-domain integration of the trajectories constitutes an integral part of the auditory processing of transitions. Perceptual results are also discussed in terms of the acoustic traces of DRM gestures.
Searching for an Auditory Description of Vowel Categories
Authors: Diehl Randy L.
Published: April 2003

This paper examines three auditory hypotheses concerning the location of category boundaries among vowel sounds. The first hypothesis claims that category boundaries tend to occur in a region corresponding to a 3-Bark separation between adjacent spectral peaks. According to the second hypothesis, vowel category boundaries are determined by the combined effects of the Bark distances between adjacent spectral peaks but that the weight of each of these effects is inversely related to the individual sizes of the Bark distances. In a series of perceptual experiments, each of these hypotheses was found to account for some category boundaries in American English but not others. The third hypothesis, which has received preliminary support from studies in our laboratory and elsewhere, claims that listeners partition the vowel space of individual talkers along lines corresponding to relatively simple linear functions of formant values when scaled in auditorily motivated units of frequency such as Bark.
Deriving Speech from Nonspeech: A View from Ontogeny
Authors: MacNeilage Peter F. , Davis Barbara L.
Published: April 2003

A comparison of babbling and early speech, word patterns of languages, and, in one instance, a protolanguage corpus, reveals three basic movement patterns: (1) a ‘Frame’ provided by the cycles of mandibular oscillation underlying the basic mouth close-open alternation of speech; this Frame appears in relatively ‘pure’ form in the tendency for labial consonants to co-occur with central vowels; (2) two other intracyclical consonant-vowel (CV) co-occurrence patterns sharing the alternation: coronal consonants with front vowels and dorsal consonants with back vowels; (3) an intercyclical tendency towards a labial consonant-vowel-coronal consonant (LC) sequence preference for word initiation. The first two patterns were derived from oral movement capabilities which predated speech. The Frame (1) may have evolved from ingestive cyclicities (e.g. chewing). The intracyclical consonant-vowel (CV) co-occurrence patterns involving tongue position constraints common to consonants and vowels (2) may result from the basic biomechanical property of inertia. The third pattern (LC) was a self-organizational result of pressures for interfacing cognition with action – a result which must have numerous analogs in other domains of movement organization.
Japanese Mora-Timing: A Review
Authors: Warner Natasha , Arai Takayuki
Published: April 2003

Japanese is often called a ‘mora-timed’ language, and contrasted with ‘stress- timed’ or ‘syllable-timed’ languages. The definition of what constitutes mora-timing has undergone several revisions, and a wide variety of experimental evidence both for and against mora-timing has been presented. This article reviews the hypotheses, the means of testing them, and the results of nearly 40 years of experimental work on mora-timing in Japanese, and suggests directions for future work in this area.
Acoustic Vowel Reduction in Creek: Effects of Distinctive Length and Position in the Word
Authors: Johnson Keith , Martin Jack
Published: April 2003

Eight speakers (4 male and 4 female) of the Muskogee dialect of Creek pronounced a set of words illustrating the vowels and diphthongs of Creek. These recordings were analyzed acoustically and data on vowel duration and vowel formant frequencies are presented in this paper. The ratio of the durations of dictinctively long and short vowels was 1.8. This ratio showed a sex difference, being larger for female speakers than it was for male speakers. Final lengthening was also observed: both distinctively long and short vowels were longer in word-final position than in word-initial position. The vowel formant data showed two additive, orthogonal phonetic vowel reduction processes: short vowel centralization and positional reduction. Short vowel centralization has been found in many languages. Distinctively long vowels in Creek tended to be more peripheral in the acoustic vowel space than were the distinctively short vowels. Positional reduction is also evident in these data: vowels in word-final position were reduced relative to vowels in word-initial position. Short vowel centralization was preserved in both positions in the word. Positional reduction has been documented in several languages, and these results from Creek lend support to the hypothesis that it is a general property of speech production. The results of this acoustic-phonetic study, the first such study of Creek, are discussed in light of cross-linguistic phonetic trends.
Concomitant Fibrous Dysplasia and Aneurysmal Bone Cyst of the Skull Base
Authors: Haddad Georges F. , Hambali Fadi , Mufarrij Amjad , Nassar Anis , Haddad Fuad S.
Published: April 2003

The combination of fibrous dysplasia and aneurysmal bone cyst of the skull base is extremely rare yet it should be recognized, lest the rapid growth of the lesion and the radiological picture lead to the wrong diagnosis of a malignant process. We report on a 6½-year-old patient who suffered from concomitant fibrous dysplasia and aneurysmal bone cyst of the skull base. He is still disease-free 4 years postoperatively. The treatment of choice remains early surgical removal of the maximal amount of involved bone that can safely be achieved. There is no role for radiotherapy in the treatment of these lesions. A review of the literature is included.
Primary Hypothyroidism Mimicking aPituitary Macroadenoma
Authors: Ehirim Princewill U. , Kerr Douglas S. , Cohen Alan R.
Published: April 2003

Pituitary macroadenomas occur infrequently in children and can present with visual dysfunction or endocrinopathy. Occasionally, primary end-organ failure can cause reactive enlargement of the pituitary gland that may be clinically and radiographically indistinguishable from pituitary macroadenoma. The authors describe an example of reactive pituitary hyperplasia from primary hypothyroidism that mimicked a pituitary macroadenoma in a child. Recognition of this entity, which responds to medical therapy, is important because it can spare patients unnecessary surgery.
Chemotherapy in Recurrent Ependymoma
Authors: Siffert Joao , Allen Jeffrey C.
Published: April 2003

Surgical resection with or without radiation therapy confers long-term remission in approximately half of the patients newly diagnosed with ependymoma. Chemotherapy has a limited role in the management of ependymoma. In newly diagnosed infants, chemotherapy is utilized as an attempt to defer radiation. The use of chemotherapy in older children has provided no conclusive benefit. The largest experience with chemotherapy in ependymoma has been in children with recurrent disease. In this section, we will analyze the principal institutional and cooperative group phase I, phase II, and phase III clinical trials utilizing single-agent and multiagent chemotherapy in patients with recurrent ependymoma. In addition, future directions relating to novel medical oncologic therapies will also be discussed.
Familial Intracranial Arteriovenous Malformations
Authors: Amin-Hanjani Sepideh , Robertson Richard , Arginteanu Marc S. , Scott R. Michael
Published: April 2003

Familial intracranial arteriovenous malformations (AVMs) are rare. We describe a father and son both presenting in childhood with cerebral AVMs. Both patients underwent successful surgical extirpation of the AVM. Familial AVMs present at a young age and tend to be multiple, as was the case in one of our patients. Imaging of asymptomatic family members may detect previously undiagnosed AVMs, and we recommend screening of the relatives of patients with a strong family history of such lesions.
Fusiform P1 Segment Artery Aneurysm in a Pediatric Patient: Technical Case Report
Authors: Gewirtz Robert J. , Broderick Richard W. , Baumann Rob ert J. , Stevens Julia L.
Published: April 2003

We present an unusual aneurysm in a pediatric patient. Due to the fusiform nature of the aneurysm and the small size of the patient, a unique surgical solution was applied. One year of clinical follow-up is also provided.
Visually Evoked Potentials in 52 Children Requiring Operative Repair of Craniosynostosis
Authors: Mursch Kay , Brockmann Knut , Lang Johannes K. , Markakis Evangelos , Behnke-Mursch Julianne
Published: April 2003

We evaluated the prevalence of pathological visually evoked potentials (VEP) before the apppearance of papilledema or other signs of elevated intracranial pressure in children suffering from craniosynostosis. In 52 children (19 girls, 33 boys, median age 7.6 months, mean age 7.6 months, range from 3 to 34 months) preoperative VEP were analyzed. In 13 patients, pathological VEP were observed. In all children, both eyes were involved. Only 1 child suffered from papillar anomalies. Latency was pathological in 12 children, whereas the amplitude was suppressed in only 2 children. In all children with preoperative pathological VEP, postoperative controls (n = 4) were improved or normal. Thus, VEP may be the first test for neuronal damage in craniosynostosis.
Growing Skull Fracture of the Orbital Roof
Authors: Koç R.Kemal , Kurtsoy Ali , Öktem İ.Suat , Akdemir Hidayet
Published: April 2003

Growing skull fractures are rare complications of head trauma and very rarely arise in the skull base. The clinical and radiological finding and treatment of a growing fracture of the orbital roof in a 5-year-old boy are reported, and the relevant literature is reviewed. The clinical picture was eyelid swelling. Computed tomography (CT) scan was excellent for demonstrating the bony defect in the orbital roof. Frontobasal brain injury seems to play an important role in the pathogenesis of the fracture growth. Growing skull fracture of the orbital roof should be considered in the differential diagnosis in cases of persistent ocular symptoms. Craniotomy with excision of gliotic brain and granulation tissue, dural repair and cranioplasty is the treatment of choice.
The Chiari II Malformation: Lesions Discovered within the Fourth Ventricle
Authors: Piatt Jr. Joseph H. , D’Agostino Anthony
Published: April 2003

Structural lesions associated with the Chiari II malformation have been identified within the fourth ventricle in 8 patients. During the 42-month period encompassing the operations of the 7 patients treated surgically, only 9 other patients were explored without the discovery of some associated structural lesion. The patients ranged in age from 2 to 26 years. The following lesions were identified: glial or arachnoidal cysts (3 patients), glial or choroidal nodules (3 patients) and subependymoma (2 patients). These lesions were all situated in the roof of the fourth ventricle adjacent to or interspersed with the choroid plexus. Only the cystic lesions were identified by preoperative imaging. In only 1 case did the associated lesion, a 2-cm cyst, seem to contribute to the patient’s clinical presentation. Structural lesions of the fourth ventricle associated with the Chiari II malformation are common in patients who are submitted to decompression. These lesions may be dysplasias of developmental origin, or they may be reactive lesions related to chronic compression and ischemia. They do not necessarily required biopsy or excision.
Infantile Cerebral Aneurysms with Visual Pathway Compression
Authors: Huna-Baron Ruth , Lesser Robert L. , Warren Floyd A. , Muszynski Cheryl A. , Kupersmith Mark J.
Published: April 2003

Intracranial aneurysms are rare in infancy. The commonest presentation is intracranial hemorrhage, but signs of mass effect are more frequent than in adults. We report 2 infants with cerebral aneurysms, one presenting with macrocephaly and another with strabismus. Both had visual loss and optic disc pallor; MRI revealed a suprasellar mass and anterior visual pathway compression. In both cases, the preoperative diagnosis was craniopharyngioma. It is essential to recognize that, although exceedingly uncommon, cerebral aneurysms do occur in infants and have features that differ from those in adults.
Lycanthropy: New Evidence of Its Origin
Authors: Moselhy Hamdy F.
Published: April 2003

Two cases of lycanthropy will be described. Its possible aetiology and psychopathology will be discussed. In the first case there is clear evidence of an organic origin of the syndrome which is reported for the first time.
Repeated Pulmonary Infection by Nocardia asteroides Complex in a Patient with Bronchiectasis
Authors: Cremades M.J. , Menéndez R. , Santos M. , Gobernado M.
Published: April 2003

A rare case of pulmonary nocardiosis was presented in a nonimmunocompromised patient who had chronic airway obstruction and bronchiectasis without corticoid treatment. The microbial diagnosis was established after isolating Nocardia in bronchial aspirate and sputum samples. An in vitro study showed sensitivity only to imipenem, netilmicine, amikacin and ofloxacin. The evolution was chronic, with multiple clinical recurrences in spite of prolonged antibiotic treatment. Finally, the eradication of Nocardia was achieved with the combination of imipenem and amikacin.
Established Acute Respiratory Distress Syndrome: Benefit of Corticosteroid Rescue Therapy
Authors: Keel J.B.P. , Hauser M. , Stocker R. , Baumann P.C. , Speich R.
Published: April 2003

The mortality of the acute respiratory distress syndrome (ARDS) is still very high. There is some evidence based on case series suggesting that corticosteroids may be beneficial in the chronic fibroproliferative state of the disease. In a retrospective study we analysed the data of 31 non-trauma ARDS patients who had been on mechanical ventilation for at least 7 days. Thirteen cases received corticosteroids at a dosage equivalent to 100–250 mg methylprednisolone at the discretion of the attending physician in charge. Apart from corticosteroid administration, supportive care was identical in the treated and non-treated patient subgroups. Both groups were comparable regarding the relevant demographic, clinical and physiologic data, Apache-II score, radiological score, lung injury score and multiple organ failure score. Mortality in the treatment group was 38% (5/13) as opposed to 67% (12/18) in the untreated group (p = 0.117). There was a significant improvement in the PaO2/FIO2 ratio from a median of –26 to +5 mm Hg measured in a 48-hour period before and after corticosteroid treatment (p = 0.039). The response to corticosteroid therapy could not be predicted on the basis of clinical or physiologic data. Five patients responded within 48 h, and 3 showed a delayed response after 5–6 days. There were no significant complications attributable to corticosteroid treatment. Conclusions: Although the data of this first comparative study were retrospective, they suggest a beneficial effect of corticosteroid treatment in patients with established fibroproliferative ARDS. A prospective clinical trial, however, is highly warranted in order to fully elucidate the true effect of this therapeutic approach under controlled conditions.
Elevated Serum Sialyl Lewis X-i Antigen Levels in Non-Small Cell Lung Cancer with Lung Metastasis
Authors: Satoh Hiroaki , Ishikawa Hiroichi , Kamma Hiroshi , Yamashita Yuko T. , Takahashi Hideto , Ohtsuka Morio , Hasegawa Shizuo
Published: April 2003

To evaluate the relationship between serum levels of sialyl Lewis X-i antigen and lung metastasis in patients with non-small cell lung cancer (NSCLC), we measured the serum level of the antigen in 299 patients with untreated locally advanced or metastatic NSCLC. Before treatment, serum levels of sialyl Lewis X-i antigen were significantly higher in patients with lung metastasis than in those without lung metastatis (p = 0.0001). Of 201 patients without lung metastasis at the time of primary diagnosis, 121 patients died between July 1987 and December 1995. Serum levels of sialyl Lewis X-i antigen in 21 patients who developed lung metastasis during the period were significantly higher than those in 100 patients who did not develop lung metastasis (p = 0.0171). Our results suggested that sialyl Lewis X-i antigen might be a good indicator for the presence or development of lung metastasis, and it might provide clinical information about the management of patients with NSCLC.
Eight-Year Follow-Up Study of a Patient with Central Alveolar Hypoventilation Treated with Diaphragm Pacing
Authors: Yasuma Fumihiko , Sakamoto Michiyo , Okada Tamotsu , Abe Kazunari
Published: April 2003

We had treated a 17-year-old girl with central alveolar hypoventilation with diaphragm pacing at home for the past 8 years. Nocturnal diaphragm pacing with an open tracheostomy was effective in maintaining an adequate ventilation after 4 months of undergoing training of the diaphragm on the pacemaker implantation. However, the diaphragm pacemaker failed to maintain it mostly in the presence of respiratory tract infection, when she was treated with intermittent positive-pressure ventilation. Pulse oximetry was used at home for monitoring the adequacy of respiratory support. We conclude that the respiratory assistance by the diaphragm pacemaker or the use of a mechanical ventilator as a backup was highly useful for the home care of a patient with central alveolar hypoventilation.
The ‘Fragmented’ Scintigraphic Lung Pattern in Pulmonary Lymphangitic Carcinomatosis Secondary to Breast Cancer
Authors: Vattimo Angelo G. , Burroni Luca , Bertelli Paolo , Vella Alessandra , Volterrani Duccio
Published: April 2003

Pulmonary lymphangitic carcinomatosis (PLC) is an unusual presentation of diffuse infiltrative lung disease. In this report we present two cases secondary to breast cancer; the diagnosis was made by means of transbronchial lung biopsy or postmortem examination. The goal of this study was to analyze the scintigraphic pattern of pulmonary perfusion performed with technetium-99m macroaggregated albumin (99mTc-MAA) in the hope of achieving improved recognition of PLC and its subsequent diagnosis. Upon admission, both patients underwent routine clinical exams followed by chest X-rays. The second patient also underwent CT examination, and both were ultimately examined using pulmonary perfusion scintigraphy with 99mTc-MAA. In the various exams performed, the most reliable and easily identified diagnostic finding turned out to be a characteristic ‘fragmented’ lung pattern revealed with the perfusion lung scan. Unfortunately, in both cases the patients’ conditions rapidly worsened and death occurred shortly following scintigraphy. We were able to conclude that the recognition of the mentioned fragmented scintigraphic lung pattern may be useful in suspected PLC, whereas the nonspecific clinical presentation of this pathology makes diagnosis extremely difficult, with the most significant results being achieved through a comparison of scintigraphic and high resolution CT data.
The Lung in the Immunocompromised Patient
Authors: Tamm Michael
Published: April 2003

Pulmonary infections decisively contribute to morbidity and mortality in immunocompromised patients. Bacterial, mycobacterial and infections with Pneumocystis carinii have been reviewed in an article in the last issue of Respiration. In this review, viral and fungal pulmonary infections are discussed in HIV-positive patients and in patients treated with high-dose chemotherapy, stem cell or solid-organ transplantation.
Effect of Immunomodulators on Bleomycin-Induced Lung Injury
Authors: Kremer S. , Breuer R. , Lossos I.S. , Berkman N. , Christensen T.G. , Connor M.W. , Goldstein R.H. , Or R.
Published: April 2003

Background: The role of lymphocytes and their subpopulations in lung fibrosis is as yet unclear. Objective: To define the role of immunomodulation in bleomycin-induced inflammatory fibrotic lung injury, by testing the effect of two known Th1 inhibitors: linomide and pentoxifylline. Methods: C57BL/6 mice were treated by a single intratracheal instillation of 0.06 mg bleomycin in 0.01 ml saline or saline alone. Treatment groups included: (1) intratracheal bleomycin and daily treatment with linomide or pentoxifylline; (2) intratracheal bleomycin and daily water; (3) intratracheal saline and daily linomide or pentoxifylline; (4) intratracheal saline and daily water. Linomide and pentoxifylline were available per os in the drinking water from 1 day prior to intratracheal instillation. Animals were studied 14 days after intratracheal instillation. Lung injury was evaluated by total and differential cell count in bronchoalveolar lavage fluid, by a semiquantitative morphological index of lung injury and a quantitative image analysis of cellularity, fibrosis fraction and alveolar wall area fraction, and by biochemical analysis of lung hydroxyproline content. Results: Linomide or pentoxifylline did not cause any lung injury in saline-treated control mice. Overt signs of lung injury were apparent in bleomycin-treated mice. These changes were not affected by daily treatment with linomide or pentoxifylline, which were given in the highest tolerable dose. Conclusion: This study does not support the use of linomide or pentoxifylline to prevent or ameliorate lung fibrosis and may suggest that drug-induced differentiation of T lymphocytes into Th1/th2 subpopulations does not affect the evolution of bleomycin-induced lung injury.
Effects of Mometasone Furoate on Human Keratinocytes and Fibroblasts in vitro
Authors: Wach F. , Bosserhoff A. , Kurzidym U. , Nowok K. , Landthaler M. , Hein R.
Published: April 2003

The long-term treatment of inflammatory skin diseases with topical glucocorticoids is limited by their side effects such as skin atrophy, delayed wound healing and striae distensae. Mometasone furoate (MF) is a newly synthesized glucocorticoid with the advantage of increasing efficacy and reducing the number of adverse effects. The aim of our study was to compare the effects of MF and conventional fluorinated corticosteroids on a human keratinocyte cell line (HaCat) and human skin fibroblasts in vitro. Monolayer cultures of these cell lines were exposed to different concentrations of the active compounds for 5 days to analyze the influence on morphology and proliferation. Chemotaxis of HaCat cells and fibroblasts was studied in blind-well Boyden chambers using collagen type I and fibroblast-conditioned medium as a chemoattractant. Additionally, fibroblasts were used to investigate the contraction of collagen gels since lattice contraction appears to model the contraction of skin wounds. All glucocorticoids tested influenced fibroblast and keratinocyte proliferation in a dose-dependent manner, yet the effect was clearly more marked with fluorinated corticosteroids than with MF. Similar effects were obtained using the chemotaxis assay. At low concentrations (10–9 M) MF exerted almost no influence, while the conventional fluorinated substances inhibited direct migration significantly. Contraction of collagen gels was inhibited completely by betamethasone valerate at high concentrations (10–5– 10–3 M), but only partially inhibited by MF at its highest concentration (10–3 M). Although MF reveals high anti-inflammatory activity similar to that known for conventional fluorinated derivatives of corticosteroids, the study shows that MF has less effect in the tested in vitro systems. Therefore, it remains to be seen whether these data might indicate the possibility of a dissociation between the inflammatory activity and the inhibition of the biosynthetic capacities of fibroblasts and keratinocytes by modification of the steroidal structure of corticosteroids.
Direct and Non-Direct Measurement Techniques for Analysis of Skin Surface Topography
Authors: Fischer Tobias W. , Wigger-Alberti Walter , Elsner Peter
Published: April 2003

Estimation of skin smoothness is of ever-increasing interest especially in the field of cosmetic research. There are some established methods for assessing skin smoothness, e.g. optical and mechanical profilometry, but the presentation of recently developed new methods reflects the demand for alternatives which are more precise and practical. For fundamental research on ultrastructure of the stratum corneum surface scanning electron microscopy is a suitable method. A direct method is the surface evaluation of living skin, which is based on an optical system in a CCD camera measuring four parameters of roughness, scaling, smoothing and wrinkling. A similar but non-direct method is optical profilometry using skin replicas. Laser profilometry produces a variety of data which can be analysed using complex mathematical functions. A promising new method is transparency profilometry (skin visiometer) using a very thin skin print which allows parallel light to pass through and is analysed immediately after production. The different methods can be used for characterization of the skin microrelief in dermatoses or for dynamic measurements of time-dependent changes in skin surface topography after application of cosmetic or medical products.
Phylogeny of Tamm-Horsfall Protein
Authors: Badgett Allen , Kumar Satish
Published: April 2003

The Tamm-Horsfall protein (THP, uromodulin) is urine’s most abundant protein. The phylogenetic distribution of the gene for THP was examined in all the major vertebrate classes. Genomic DNA was obtaind from each vertebrate class and hybridized with a rat THP cDNA probe in a DNA hybridization assay. In separate experiments, a polymerase chain reaction assay was used to amplify segments of the THP gene using primers from a consensus sequence for THP among multiple mammalian species. Both methods revealed that the THP gene was present in all the vertebrate classes. These data demonstrate the evolutionary conservation of the THP gene among vertebrates and suggest a role for this protein that is common to the kidney of all vertebrates.
Experience with Transurethral Incision of Ureteroceles
Authors: Dahm P. , King L.R.
Published: April 2003

Objectives: The value of primary transurethral ureterocele incision was investigated in the treatment of ureteroceles in infants and children. Methods: The charts and radiographic studies of 13 patients between the ages of 2 weeks and 8 years who underwent transurethral incision of 14 ureteroceles as primary surgical therapy at our institution were reviewed. Results: 57% of the ureteroceles were intravesical and 43% extravesical. 64.3% were associated with the upper pole of a duplicated system. All 14 ureteroceles were associated with a functional renal moiety. Endoscopic incision achieved ureterocele decompression in 13 of 14 ureteroceles (93%). Preexisting hydronephrosis improved or resolved in 10 of 14 cases (71.4%). Renal function after decompression was not shown to be significantly altered or improved. 5 of 13 patients (38%) required definite surgical reconstruction for recurrent urinary tract infections, upper pole vesicoureteral reflux, hydronephrosis and lower pole vesicoureteral reflux within a mean follow-up period of 14 months. Conclusion: Transurethral incision has a limited role in the treatment of ureteroceles in children. In many or even most cases it cannot be expected to constitute long-term definite treatment for ureteroceles. It is mainly indicated in patients with urosepsis, prolapsing ureteroceles with functional bladder neck obstruction or massive reflux into other renal segments. In these settings it reliably achieves decompression and allows effective treatment of infection. The function of the previously obstructed renal segment can be reevaluated at later point in time to assess whether it should be saved. The delay permits interim growth that is likely to make bladder reconstruction easier.
Semiquantitative Evaluation of Testicular Histology after Testicular Torsion: Protective Effect of External Cooling
Authors: Sarica Kemal , Bakir Kemal
Published: April 2003

To evaluate the protective effect of external cooling on testicular histology and tubular diameter, an experimental study was performed on rat testes that underwent a torsion procedure for a defined period of time (4 h). In a second group of animals external cooling for 90 min was performed during the torsion procedure. Evaluation of both the semiquantitative testicular histology and tubular diameter demonstrated a relatively well-preserved histology and tubular diameter. However, significant changes were noted in testes that underwent the torsion procedure without any protective measure. Our results indicate the protective effects of hypothermia in ischemic testes undergoing torsion with regard to both histologic and tubular alterations.
Cushing’s Syndrome in Prostate Cancer
Authors: Haukaas Svein Andreas , Halvorsen Ole Johan , Nygaard Svein Jacob Tjoflaat , Paus Elisabeth
Published: April 2003

We report a case with an initial diagnosis of adenocarcinoma of the prostate in whom Cushing’s syndrome developed. The disease did not respond to estrogen treatment and the patient died of severe septicemia. Histopathologic examination of the autopsy specimens revealed a small cell carcinoma intermingled with a moderately differentiated adenocarcinoma in the prostate and widespread metastases of small cell carcinoma. Immunoreactivity for neuroendocrine differentiation was found only in the small cell carcinoma. Determination of different tumor markers in plasma samples showed markedly elevated levels of prostate-specific antigen as well as carcinoembryonic antigen prior to treatment, with no significant changes after treatment. The concentration of the neuroendocrine marker chromogranin A was initially within the normal range, but increased during estrogen treatment, whilst neuron-specific enolase was moderately elevated throughout the observation period.
Cutaneous Metastases in Renal Cell Carcinoma
Authors: Dorairajan L.N. , Hemal A.K. , Aron M. , Rajeev T.P. , Nair M. , Seth A. , Dogra P.N. , Gupta N.P.
Published: April 2003

Cutaneous metastasis from renal cell carcinoma is believed to be rare. We present our experience with 10 (3.3%) cases seen in the last 12 years among 306 cases of renal adenocarcinoma treated at our center. There were 9 males and 1 female. Age ranged from 30 to 65 years (average 45 years). 5 patients had skin metastases at the time of presentation (stage IV). In one of them the skin nodule, rather than urologic symptoms, was the presenting complaint. 5 patients presented with skin metastasis during follow-up after nephrectomy. The average time to skin metastasis was 51 months for patients in stage I and 13 months in stage IIIb. The scalp was the most common site of metastasis followed by chest and abdomen. 90% of patients had secondaries in at least one other site, most commonly in lungs (4 cases) and bones (5 cases). 4 patients were treated with interferon-α 6 MIU, subcutaneously, three times a week for varying periods from 3 to 4 months but there was no response. In conclusion, cutaneous secondaries from RCC, though uncommon, are not very rare. A few patients may present with a skin mass before detection of the renal tumor. Patients with low-stage disease at presentation may also develop cutaneous secondaries, therefore a prolonged follow-up is required. The commonest site for cutaneous metastasis from RCC is the scalp and face. Most patients had at least one other site of systemic metastasis, hence they were not candidates for curative therapy. Interferon therapy was not helpful. Mean survival after detection of cutaneous metastasis was 7 months.
Treatment of a Delayed Zipper Injury
Authors: Mydlo Jack H.
Published: April 2003

Penile zipper injuries have been reported occurring usually in the pediatric population, and occasionally in adults. Usually, the zipper can be dislodged with mineral oil or by breaking the median bar. When these attempts fail, a small elliptical incision may be used to remove the zipper and any devitalized tissue.
α-Thalassemia in the United Arab Emirates
Authors: El-Kalla Salah , Baysal Erol
Published: April 2003

A neonatal screening survey of α-thalassemia (α-thal) among the United Arab Emirates (UAE) nationals was conducted on 418 consecutive cord blood samples. Our findings demonstrate that 49% of the cases studied were found with an α-globin gene defect. The gene frequency of the –α3.7 was 0.2847 and that of the –α4.2 was 0.0072. Four nondeletional α-thal mutations were found; αPA-1, αPA-2, Hb CS and α-5nt del with gene frequencies of 0.0036, 0.0012, 0.0024, and 0.0072, respectively. We also report here the genotype-phenotype correlation in 22 patients with Hb H disease or Hb H-like syndrome. Of these, 6 were homozygous for the αPA-1 mutation, 2 were homozygous for Hb CS, and 14 were compound heterozygous for either αPA-1, Hb CS, α-5nt del or ––MED-I, with the –α3.7. The data reported here demonstrate that a considerable heterogeneity of α-thal mutations occurs in the UAE and that the incidence of α-thal in the indigenous population is one of the highest in the world. Our clinical data suggest that Hb H disease in the UAE has, in general, a mild to moderate phenotypic presentation.
Respiratory Distress due to Tracheal Aspergillosis in a Severely Immunocompromised Patient
Authors: Lévy V. , Burgel P.R. , Rabbat A. , Cornet M. , Molina T. , Zittoun R.
Published: April 2003

A 23-year-old man, intensively treated for acute lymphoblastic leukaemia in relapse and with documented pulmonary aspergillosis, was admitted to the intensive care unit for acute respiratory failure. The diagnosis of invasive tracheal aspergillosis was made by bronchoscopy and biopsy. The lesions consisted of extensive necrotizing bronchitis with transmural and peribronchial extension associated with tracheal and bronchial obstruction due to the presence of pseudomembranes almost entirely composed of fungal hyphae. Despite treatment with amphotericin B and itraconazole, mechanical ventilation and bronchoscopy, the patient died 3 weeks later of massive bleeding.
Hepatitis C Virus and Immunoglobulin Gene Rearrangements: An Early Step in Lymphomagenesis?
Authors: Santini G.F. , Crovatto M. , Giannini F. , Bortolin M.T. , Mazzaro C. , Invernizzi F.
Published: April 2003

A clonal expansion of peripheral blood mononuclear cells committed to IgM cryoprecipitating rheumatoid factor production has been demonstrated in hepatitis C virus (HCV)-associated mixed cryoglobulinemia (MC). To determine the role of HCV in B cell gene rearrangements we studied a series of 57 HCV-infected patients with and without MC. Clonal Ig gene rearrangements of both RNA and DNA were detected in 10 of the 13 patients with type II MC, 1 patient had gene rearrangement of the DNA only, and 2 had polyclonal patterns. 2 of the 17 patients with type III MC showed clonal rearrangement of both RNA and DNA, in 6 only the DNA was rearranged clonally and in 9 the patterns were completly normal. 14 of 27 patients with cryocrit <1% or without cryoglobulins had clonal DNA rearrangements without any in the RNA. These results suggest that clonal lesions in the DNA are related to HCV infection and that these changes antedate the appearance of mixed cryoglobulinemia.
Response to Plasma Exchange and Steroids as Combined Therapy for Patients with Thrombotic Thrombocytopenic Purpura
Authors: de la Rubia Javier , López Aurelio , Arriaga Francisco , Cid Ana Rosa , Vicente Ana Isabel , Marty Maria Luisa , Sanz Miguel A.
Published: April 2003

We describe our experience in the management of 11 consecutive patients with thrombotic thrombocytopenic purpura (TTP) treated with a combined therapy of plasma exchange (PE) and steroids. Nine patients (82%) achieved complete remission (CR) after a median of 6 rounds of PE (range 2–22). There were 3 early relapses managed in the same way as the initial episode. One patient relapsed 23 months after diagnosis achieving CR with standard therapy; another patient suffered several relapses, and splenectomy was performed after the last one. Three patients died, 2 of them with resistant disease 9 and 38 days after diagnosis, and the remaining one died due to AIDS-related complications while he was in CR. Eight patients are alive in CR with a median follow-up of 38 months (range 8–74). The combination of PE and steroids is a well-tolerated and effective treatment of TTP, but improvements in therapy are needed to manage refractory patients.
Epsilon-Aminocaproic Acid Inhibits the Activity of Factor VIII Inhibitors in Patients with Severe Haemophilia A in vivo and in vitro
Authors: Ghosh Kanjaksha , Shetty Shrimati , Pathare Anil , Mohanty Dipika
Published: April 2003

Haemophilia patients with inhibitors pose a formidable challenge for patient management. This is particularly problematic in developing countries, where porcine factor VIII, FEIBA, factor VIIa or immunoadsorption column are generally unavailable or unaffordable. Under these circumstances, any effective modality of affordable treatment is welcome. We investigated, both in vivo and in vitro, the effect of ε-aminocaproic acid (EACA) on the inhibitory activity of factor VIII inhibitor. It was found that in vitro EACA (final concentration 1.25–5 mg/ml) substantially inhibited the activity of the inhibitors, while the same concentration of EACA had no effect on other immunological reactions like red cell agglutination and immunofluorescence. The inhibitory action of EACA on factor VIII inhibitor was also confirmed in an improvised antigen-binding ELISA system. Further, the inhibitory activity of EACA was confirmed in 2 patients, in whom the inhibitory activity persisted for 15 min following infusion of EACA (100 mg/kg over 10 min). EACA was found to be even more effective in local wound application in patients of haemophilia A with inhibitors. EACA at the concentration cited did not act as an inhibitor of factor VIII inhibitor through occupancy of lysine binding sites. The inhibitory activity of EACA on factor VIII inhibitor was equally seen with recombinant factor VIII also; hence this action cannot be explained by its antifibrinolytic activity.
Red Blood Cell Osmotic Fragility in Chronically Hemodialyzed Patients
Authors: Wu San-Giang , Jeng Fu-Rong , Wei Shu-Yi , Su Chin-Zung , Chung Tieh-Chi , Chang Wen-Jou , Chang Hsueh-Wen
Published: April 2003

Chronic renal failure induces anemia and a short erythrocyte life span. Red blood cell (RBC) osmotic fragility is the resistance of RBC hemolysis to osmotic changes that is used to evaluate RBC friability. To find the cause of shortened red cell survival in uremic patients, we evaluated the RBC osmotic fragility in 57 chronic hemodialyzed patients. Each patient had received 12 h of dialysis per week continuously prior to being enrolled in the study. Nineteen healthy volunteers served as a control group. Biochemistry, hemoglobin, electrolyte, osmolarity, β2-microglobulin, and intact parathyroid hormone were examined before and after the dialysis session. To evaluate the osmotic fragility of RBC, blood samples were collected in heparinized test tubes. Fifty microliters of the RBC of each individual was then incubated in solutions containing a series of various concentrations of NaCl ranging from 0 to 0.6%. The concentration of NaCl at which 50% of RBCs were lysed was considered the median osmotic fragility (MOF). The results showed that the MOF was significantly greater in hemodialyzed patients before dialysis than in the control group (0.41 ± 0.03 vs. 0.39 ± 0.02%). The osmotic resistance to hemolysis was also recorded after dialysis (MOF 0.38 ± 0.03%). Correlation analysis showed that the MOF was significantly correlated with urea nitrogen, serum osmolarity, and intact parathyroid hormone level. In addition, the osmotic fragility was higher in patients who had a predialysis intact parathyroid hormone level >100 pg/dl. In conclusion, hemodialysis can improve the osmotic fragility. The mechanism underlying this improvement may be the removal of low molecular weight uremic toxins, resulting in normalization of serum osmolarity. Our results indicate that parathyroid hormone is probably a major factor influencing RBC osmotic fragility in chronic renal failure.
Secondary Hyperparathyroidism, Decreased Hepatic Triglyceride Lipase, Elevated Intermediate Density Lipoprotein and Atherosclerosis in Hemodialysis Patients
Authors: Shoji Tetsuo , Nishizawa Yoshiki , Kawagishi Takahiko , Emoto Masonori , Morii Hirotoshi
Published: April 2003

Cardiovascular mortality is higher in dialysis patients than the nonuremic population. This has been taken to indicate that dialysis patients have accelerated atherosclerosis [1]. We have recently revealed that atherosclerosis in hemodialysis patients is advanced morphologically, showing a greater intima media thickness in the carotid and femoral arteries in dialysis patients than healthy control subjects by high-resolution B mode ultrasonography [2]. Lipoprotein abnormality is one of the major risk factors for atherosclerosis in the general population, and recent studies [3–6] reemphasize the importance of triglyceride-rich lipoproteins such as partially lipolyzed very low density lipoprotein (VLDL) and intermediate density lipoprotein (IDL). These lipoprotein classes are significantly elevated in patients with chronic renal failure [7–9].