bluuebunny/crossref_metadata_2025 huggingface dataset:
Stressful Life Events and Skin Diseases: Disentangling Evidence from Myth
Authors: Picardi Angelo , Abeni Damiano
Published: April 2003

The possibility of a causal influence of emotional stress, especially of stressful life events, on the course of various skin diseases has long been postulated. Clinical wisdom and experience, as well as many anecdotal observations and uncontrolled case series, support this opinion. We reviewed the available evidence on the role of stressful life events in triggering or exacerbating skin diseases. The role of stressful events in vitiligo, lichen planus, acne, pemphigus and seborrhoeic dermatitis was either controversial or insufficiently explored. The role of stressful events in psoriasis, alopecia areata, atopic dermatitis and urticaria was apparently clearer. However, only a few studies met acceptable methodological standards for stress measurement. Also, few studies considered common potential confounding factors (e.g. age, duration of illness, familial factors), and no study controlled adequately for the influence of other crucial factors (e.g. discontinuation of treatment, seasonal effects). Adding that the large majority of studies were retrospective, it seems wise to conclude that only preliminary evidence has been published so far on the role of stressful life events in bringing on or worsening any dermatological disease. Further research is mandatory, either in the form of prospective studies or, more feasibly, of well-designed case-control studies with adequate statistical power. Future studies should also pay more attention to protective as well as vulnerability factors in stressful events. Further, it would be important to investigate other sources of psychological stress, such as chronic stress and everyday stress. Measuring stress appraisal, although difficult, would also be important.
A Twin Study of Alexithymia
Authors: Valera Eve M. , Berenbaum Howard
Published: April 2003

Background: Factors contributing to the development of alexithymia and the nature of alexithymia’s relation with trait negative and positive affectivity are unclear. In this study, a twin approach was used to examine the degree of genetic and environmental contributions to the different facets of alexithymia, and the nature of their relations to trait negative and positive affectivity. Method: Forty-five monozygotic and 32 same-sex dizygotic twin pairs completed the Toronto Alexithymia Scale-20, the Eysenck Personality Inventory, and a zygosity questionnaire. Results: Model fitting analyses indicated that familial influences contributed significantly to all three facets of alexithymia. Parameter estimates and intraclass correlations suggested, though could not confirm, that it was shared environmental factors that contributed to difficulty identifying and communicating emotions (ID and COM), but shared genetic factors that contributed to externally oriented thinking (EOT). Between-twin cross-trait twin analyses revealed strong correlations between ID and neuroticism, and between COM and extraversion, and suggested that it is shared familial influences which account for these associations. Conclusions: The results of this study indicate that: (a) the different facets of alexithymia are influenced by familial factors; (b) the previously noted associations between ID and COM and trait affectivity are not merely methodological artifacts; and (c) the associations between ID and COM and trait affectivity are influenced by familial factors. The results also suggest that ID and COM are largely influenced by shared environmental factors, but that EOT is influenced by genetic factors.
A Randomized Controlled Trial of Cognitive Therapy versus Intensive Behavior Therapy in Obsessive Compulsive Disorder
Authors: Cottraux Jean , Note Ivan , Yao Sai Nan , Lafont Sylviane , Note Brigitte , Mollard Evelyne , Bouvard Martine , Sauteraud Alain , Bourgeois Marc , Dartigues Jean-François
Published: April 2003

Background: The study was designed to compare cognitive therapy (CT) with intensive behavior therapy (BT) in obsessive-compulsive disorder (OCD) and to study their change process. Methods: Sixty-five outpatients with DSM-4 OCD were randomized into 2 groups for 16 weeks of individual treatment in 3 centers. Group 1 received 20 sessions of CT. Group 2 received a BT program of 20 h in two phases: 4 weeks of intensive treatment (16 h), and 12 weeks of maintenance sessions (4 h). No medication was prescribed. Results: Sixty-two patients were evaluated at week 4, 60 at week 16 (post-test), 53 at week 26 and 48 at week 52 (follow-up). The response rate was similar in the 2 groups. The Beck Depression Inventory (BDI) was significantly more improved by CT (p = 0.001) at week 16. The baseline BDI and Obsessive Thoughts Checklist scores predicted a therapeutic response in CT, while the baseline BDI score predicted a response in BT. At week 16, only the changes in Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and a scale measuring the interpretation of intrusive thoughts correlated in CT, while the changes in Y-BOCS, BDI, and interpretation of intrusive thoughts correlated in BT. Improvement was retained at follow-up without a between-group difference. The intent-to-treat analysis (last observation carried forward) found no between-group differences on obsessions, rituals and depression. Conclusions: CT and BT were equally effective on OCD, but at post-test CT had specific effects on depression which were stronger than those of BT. Pathways to improvement may be different in CT and BT. The outcomes are discussed in the light of an effect size analysis.
Fluoxetine and Fluvoxamine Combined with Individual Cognitive-Behaviour Therapy in Binge Eating Disorder: A One-Year Follow-Up Study
Authors: Ricca Valdo , Mannucci Edoardo , Mezzani Barbara , Moretti Sandra , Di Bernardo Milena , Bertelli Marco , Rotella Carlo M. , Faravelli Carlo
Published: April 2003

Background: The treatment of binge eating disorder (BED) is still the object of debate. In the present study, the effectiveness of antidepressant drugs (fluoxetine – FLX – 60 mg/day, fluvoxamine – FLV –300 mg/day), cognitive-behavioural therapy (CBT) and combined treatments (CBT + FLX, CBT + FLV) has been evaluated in a randomized, clinical trial. Results at the end of the active treatment (in the 24th week) and 1-year follow-up outcomes have been evaluated. Methods: One hundred eight (44 M, 64 F) BED patients were randomly assigned to either CBT, FLX (60 mg/day), FLV (300 mg/day), CBT + FLX or CBT + FLV, for 24 weeks. At the beginning (T0), at the end (T1) of treatment and after 1 year (T2), body mass index (BMI) and eating attitude and behaviours (by EDE 12.0D) were assessed. Results: At T1, BMI and EDE scores were significantly reduced in CBT, CBT + FLX and CBT + FLV, but not in the FLX and FLV treatment groups. In the CBT + FLV group, a greater (p < 0.05) reduction of EDE total scores was observed, when compared to CBT + FLX or CBT treatment groups. At T2, BMI was significantly higher than at T1, but still significantly lower than at T0 in the CBT, CBT + FLX and CBT + FLV groups, while EDE scores remained unchanged from T1 in all treatment groups. Conclusions: CBT was more effective than FLX or FLV in the treatment of BED. The addition of FLX to CBT does not seem to provide any clear advantage, while the addition of FLV could enhance the effects of CBT on eating behaviours. Modifications of eating behaviours are maintained at the 1-year follow-up, although the lost weight was partly regained.
An Exploratory Study into the Effect of Group Psychotherapy on Cardiovascular and Immunoreactivity to Acute Stress in Breast Cancer Patients
Authors: van der Pompe Gieta , Antoni Michael H. , Duivenvoorden Hugo J. , de Graeff Alexander , Simonis R.F.A. , van der Vegt Sytze G.L. , Heijnen Cobi J.
Published: April 2003

Background: Previous studies of cancer patients investigated the effect of psychological treatment on basal endocrine and immune values. Using a randomized experiment, we explored the effect of a 13-week experiential-existential group psychotherapy (EEGP) program on the reactivity to a speech task in breast cancer patients. We explored whether changes in cardiovascular and immune reactivity to a speech task over the 3-month period correlated with changes in psychological distress and emotional expression. Methods: Patients who had been treated for early-stage breast cancer and who were diagnosed as having either positive axillary lymph nodes or distant metastases were randomly assigned to either EEGP or a waiting list control (WLC) condition. We continuously recorded heart rate (HR), diastolic (DBP) and systolic blood pressure (SBP) in response to the speech task before and after treatment. We also measured lymphocyte proliferation to pokeweed (PWM) and phytohemagglutinin (PHA), and natural killer cell activity (NKCA) as well as peripheral blood lymphocyte distributions in blood samples that were drawn before, during and after the speech task. Results: Patients in EEGP had smaller increases in natural killer (NK) cells induced by the speech task after treatment versus task-induced values observed at study entry and greater than pre-/posttreatment changes seen in patients randomized to the WLC. A similar pattern emerged with respect to NKCA over the intervention period, which was independent of the changes in NK cells. There were no differences between patients assigned to EEGP and WLC in HR, DBP and SBP responses as well as in changes in PWM- and PHA-induced lymphocyte proliferation in response to the speech task measured before and after the 3-month intervention period. Individual differences in pre-/posttreatment increases in emotional expression but not in psychological distress were significantly associated with smaller changes in the number and function of NK cells over the 3-month period. Conclusions: These findings may indicate that emotional expression during EEGP may render breast cancer patients more comfortable expressing their emotional responses to the speech challenge, which, in turn, results in smaller stress-induced changes in NK cells and function.
Dose Volume Histogram Analysis of the Gamma Knife Radiosurgery Treating Twenty-Five Metastatic Intracranial Tumors
Authors: Yang C.C.J. , Ting J. , Wu X. , Markoe A.
Published: April 2003

Treating multiple brain metastatic sites in Gamma Knife radiosurgery is not uncommon. Most metastases can be treated with few or even one single shot. Occasionally we have patients returning for retreatment for different intracranial metastatic sites at different times. Dose distribution for these metastases are prescribed locally without considering the previous dose contribution. We present a study which simultaneously calculates the dose distribution of 25 randomly placed shots distributed inside the intracranial region. The Dose Volume Histogram (DVH) is plotted to study the coverage of the tumor sites and normal tissues. We have calculated ten DVH studies and show that 50% of the brain volume receives less than 500 cGy for the maximum tumor dose of 40 Gy, and the dose gradient is extremely steep. This DVH analysis shows that the Gamma Knife radiosurgery is a good treatment modality to control the local tumors while maintaining normal brain function, even for the large number of brain metastasis treated at different times.
Short-Term Endocrinological Results after Gamma Knife Surgery of Pituitary Adenomas
Authors: Morange-Ramos I. , Régis J. , Dufour H. , Andrieu J.M. , Grisoli F. , Jaquet P. , Peragut J.C.
Published: April 2003

We report our preliminary results after the radiosurgical treatment of 25 secreting pituitary adenomas with a mean follow-up of 20 months (range 6–36 months). Fifteen acromegalic patients showed a decrease of 65% in mean growth hormone (GH) levels after 6 months and of 77% after 12 months. Only 3 patients (20%) are considered to be in remission (mean GH and IGF1 level into the normal range). A decrease of prolactin (PRL) was noted in 46% and 64% at 6 and 12 months after radiosurgery in 4 patients with prolactinomas. There was no case of PRL normalizaion. At present 3/4 patients have individual PRL levels slightly above the normal range. A normalization of Urinary Free Cortisol (UFC) was noticed in 4/6 (66%) patients Cushing’s disease within 6–12 months. Pituitary deficiency was noticed in this series in 4/25 patients (16%) who received subtotal or total pituitary irradiation for large postoperative remnants of secreting adenomas poorly defined on magnetic resonance imaging (MRI).
Mid- and Long-Term Outcome of 166 Premature Infants Weighing Less than 1,000 g at Birth, All Small for Gestational Age
Authors: Monset-Couchard M. , de Bethmann O. , Kastler B.
Published: April 2003

This longitudinal study reported the mid- and long-term neurodevelopmental outcome of 166 premature infants born with an extremely low birth weight (<1,000 g), all small for gestational age (<10th percentile birth weight for gestational age). Nine girls were lost to follow-up before 3 years of age, and 6 children were excluded a posteriori because of specific conditions diagnosed in the 1st year of life (severe abnormalities in 5). Of the remaining 151 children, 2% had cerebral palsy, 15% had lesser motor disturbances (reduced to 2% after psychomotor training), 8% had early severe developmental delays, and added mild and moderate delays and increasing cognitive gaps amounted to 28% in the 14th year. Visual deficits increased with age up to 63% of the older children. Seven children had deafness and 13 had hearing losses after otitis media. Language delays were observed at some stage in 31% of cases, as well as behavioral disturbances in 42% (severe problems in 12%). At last evaluation, 34% of the children were normal (12% of the older ones), 51% had minor deficiencies, 18% had moderate and 3% had major disabilities. Children entered the first grade in the 7th year in only 84% of cases, which dropped to 63% at proper level in the second grade; 47% entered high school at the proper age, 7/15 obtained the ‘baccalauréat’ in the 19th/20th year. The school performance was heavily dependent on the socioeconomic and cultural level of the family.
The Role of High Frequency Oscillatory Ventilation in Very Preterm Infants
Authors: Calvert Sandra
Published: April 2003

The role of high frequency oscillatory ventilation (HFOV) for the treatment of respiratory disease in preterm infants remains uncertain. Animal work demonstrates reduced lung injury with HFOV compared to conventional ventilation (CV), and previous human trials suggest that in preterm infants HFOV reduces the incidence of chronic lung disease (CLD). However, the trials themselves have several limitations. In an attempt to conclusively establish the role of HFOV for the prevention of CLD in very preterm infants we conducted a large, UK based, multicentre trial. Preliminary results of this study suggest there are no significant differences between the two modes of ventilation regarding mortality and incidence of CLD.
High frequency of spontaneous translocations revealed by FISH in cells from patients with the cancer-prone syndromes ataxia telangiectasia and Nijmegen breakage syndrome
Authors: Stumm M. , Neubauer S. , Keindorff S. , Wegner R.-D. , Wieacker P. , Sauer R.
Published: April 2003

The application of fluorescence in situ hybridization (FISH) using whole-chromosome paints (WCPs) is proving to be a very powerful technique for revealing chromosomal instability that, for the most part, has gone undetected by conventional cytogenetic analysis. We have analyzed the frequency of translocations in lymphocytes and lymphoblastoid cell lines from ataxia telangiectasia (AT) and Nijmegen breakage syndrome (NBS) homozygotes and heterozygotes using a three-color chromosome-painting technique (WCP 1, 2, 4). With this assay we were able to detect an increased frequency of spontaneous translocations in AT homozygotes (median, 18.47 ± 10.82 translocations per 1,000 metaphase cells; 10 patients) and AT heterozygotes (median, 7.87 ± 3.15 translocations per 1,000 cells; 7 patients), in comparison to controls (median, 2.26 ± 1.75 translocations per 1,000 cells; 10 controls). Analysis of NBS homozygotes (median, 19.05 ± 11.27 translocations per 1,000 cells; 5 patients) and NBS heterozygotes (median, 6.93 ± 3.04 translocations per 1,000 cells; 6 patients) also showed an increased frequency of translocations in these patients compared to controls. The presence of such hitherto undetected chromosomal aberrations corroborate previous findings of spontaneous chromosomal instability in AT and NBS patients, as manifested by an increased rate of open breaks and rearrangements involving chromosomes 7 and 14. Moreover, we show that the degree of genomic instability in AT and NBS patients is even higher than previously established and that some AT and NBS heterozygotes evidence spontaneous chromosomal instability as well. These increased levels of nonspecific translocations could be an important risk factor for the development of malignancies in homozygotes and heterozygotes for ATM or NBS1 gene mutations.
Classifying by colors: FISH-based genome analysis
Authors: Fauth C. , Speicher M.R.
Published: April 2003

In recent years a fascinating evolution of different multicolor fluorescence in situ hybridization (FISH) technologies could be witnessed. The various approaches to cohybridize multiple DNA probes in different colors opened new avenues for FISH-based automated karyotyping or the simultaneous analysis of multiple defined regions within the genome. These developments had a remarkable impact on microscopy design and the usage of highly sensitive area imagers. In addition, they led to the introduction of new fluorochromes with appropriate filter combinations, refinements of hybridization protocols, novel probe sets, and innovative software for automated chromosome analysis. This paper attempts to summarize the various multicolor approaches and discusses the application of the individual technologies.
Alteration of chromosome numbers by generation of minichromosomes – Is there a lower limit of chromosome size for stable segregation?
Authors: Schubert I.
Published: April 2003

Practical applications of minichromosomes, generated by de novo composition or by truncation of natural chromosomes, rely on stable transmission of these chromosomes. Functional centromeres, telomeres and replication origins are recognized as prerequisites for minichromosome stability. However, it is not yet clear whether, and if yes, to what degree the chromatin content has a qualitative or quantitative impact on stable chromosome transmission. A small translocation chromosome, which arose after X-irradiation of a reconstructed field bean karyotype, comprised ∼5% of the haploid metaphase complement and was found to consist of three pieces of duplicated chromatin and a wild-type centromere. This chromosome was stably transmitted through all meristematic and pollen grain mitoses but was frequently lost during meiosis (66% loss in hemizygous and 33% in homozygous condition). This minichromosome was only a little smaller than stably segregating translocation chromosomes (comprising ∼6% of the genome) of a euploid field bean karyotype. The duplications specific for this minichromosome did not influence meiotic segregation when associated with non-duplicated chromatin of other chromosomes. In comparison with minichromosomes of other species, the possibility of a lower size limit for a stable chromosome transmission must therefore be considered which might be based, for instance, on insufficient lateral support of centromeres or on insufficient bivalent stability due to the incapability of chiasma formation.
Worlds of Experience After School
Authors: Pope Edwards Carolyn
Published: April 2003

In the children’s classic, The Phantom Tollbooth, by Norton Juster [1961], a little boy named Milo is stirred out of a chronic state of boredom, lethargy, and nonengagement by a magical trip that begins when he receives a mysterious gift box bearing the label, ‘For Milo, who has plenty of time’. The book begins with Milo alone, with no company but his unhappy thoughts, facing another tedious afternoon. Then he notices the gift box, follows the instructions, and drives off through the gate of the mysterious Tollbooth, to begin an after-school adventure that changes his feelings toward himself and the world around him. Exploring a land with places named Dictionopolis, Digitopolis, Foothills of Confusion, and the Doldrums, Milo discovers the fascination of words and numbers and begins to forget that ‘the world, which was so large, could sometimes feel so small and empty’. At the end of the trip, Milo realizes that right outside his own window there are woods and gardens to get to know, music to play, conversations to hear, books to take him anywhere. He decides he would like to take another trip, but doesn’t know when he will have the time. ‘There’s just so much to do right here’, he says, in the closing sentence of the book.
Isolation of Endogenous Anticoagulant N-Sulfated Glycosaminoglycans in Human Plasma from Healthy Subjects
Authors: Ruggiero Marco , Melli Michele , Parma Bruna , Bianchini Pietro , Vannucchi Simonetta
Published: April 2003

Endogenous N-sulfated glycosaminoglycans (GAGs) comigrating with standard heparin and sensitive to nitrous acid treatment were isolated from plasma of healthy donors. The amount of these compounds was 7–10 µg/ml, and activated partial thromboplastin time, anti-Xa and anti-IIa activities were similar to those of standard heparin of high molecular mass. Analysis with gradient PAGE of the putative endogenous heparin showed a mean molecular mass of 12 kD. These N-sulfated GAGs could be isolated only after removal of binding peptides that impaired purification by ion-exchange chromatography. We used SDS-PAGE as a tool to separate peptides from endogenous GAGs. N-sulfated GAGs exited the gel before peptides when the electrophoresis was overrun. Endogenous GAGs could be recovered by ion-exchange chromatography of the SDS-PAGE buffer, ‘free’ from associating peptides. These results strongly support the hypothesis that endogenous heparin is associated in vitro with a variety of proteins and that this association could be responsible for modification of both heparin and protein activities.
Evidence for the Use of Activated Prothrombin Complex Concentrates (aPCCs) in the Treatment of Patients with Haemophilia and Inhibitors
Authors: Wilde J.T.
Published: April 2003

FEIBATM and Autoplex®T have been used to control bleeding in patients with factor VIII or IX inhibitors for over 25 years. The major components of FEIBATM are thought to be activated factor X and prothrombin, whereas the main active components in Autoplex®T are thought to be activated factors IX and VII. Both products have been found to effectively control approximately 80% of bleeds involving joints and soft tissues. Published experience of their use in surgery is limited. Thrombotic complications have been reported with high dose FEIBATM therapy and have led to maximum dosage guidelines for this product.
Metabolic Acidosis and Protein Catabolism: Mechanisms and Clinical Implications
Authors: Bailey James L.
Published: April 2003

Metabolic acidosis increases protein degradation resulting in muscle wasting and a negative nitrogen balance. The branched-chain amino acids serve as useful markers of these changes and their catabolism is increased in acidosis, particularly for the spontaneous acidosis associated with renal failure. As a result, the neutral nitrogen balance is compromised and malnutrition results. Glucocorticoids mediate these changes through the recently discovered ATP-dependent ubiquitin-proteasome pathway. Therapy necessitates correction of the underlying acidosis either through adjustment of the alkalinity of the dialysate for the patient on dialysis or through dietary protein restriction and sodium bicarbonate supplements for the predialysis patient.
Factors Contributing to Catabolism in End-Stage Renal Disease Patients
Authors: Bergström Jonas , Wang Tao , Lindholm Bengt
Published: April 2003

End-stage renal disease (ESRD) patients, whether they are treated with hemodialysis or continuous ambulatory peritoneal dialysis, frequently suffer from protein-energy malnutrition, which is associated with increased morbidity and mortality. The protein requirements in dialysis patients are increased compared to those of healthy individuals and nondialyzed patients with chronic renal failure. The intake of protein and energy is frequently reduced because of the underlying disease, comorbidity, psychosocial factors, and uremic anorexia (underdialysis). There are several factors in ESRD patients that may enhance protein catabolism and increase protein requirements, such as low energy intake, amino acid abnormalities, metabolic acidosis, endocrine abnormalities (insulin resistance, hyperglucagonemia, hyperparathyroidism, insensitivity to growth hormone and insulin-like growth factor-1, cardiac failure, infection and inflammation, anemia, and physical inactivity. The dialytic procedures per se may enhance protein catabolism due to dialytic losses of protein and amino acids and, in hemodialysis, an inflammatory response to blood-dialyzer interaction. The relative importance of the various factors which cause anorexia and stimulate protein catabolism is still not well understood.
Localization of TGF-β and Its Receptors in the Kidney
Authors: Ando Takashi , Okuda Seiya , Yanagida Taihei , Fujishima Masatoshi
Published: April 2003

This paper reviews the expression and localization of proteins of the TGF-β system in the kidney, i.e. TGF-β isoforms, latent TGF-β binding protein, and receptors. There is heterogeneity of TGF-β isoforms, binding proteins and receptors. TGF-βs are more evenly distributed among different segments of the nephron than TGF-β receptors, and are expressed by almost all cell types in the kidney. The spatial distribution of TGF-β and its signaling receptor may help to better understand the biologic function of TGF-β in the kidney.
Intermittent Calcitriol Therapy and Growth in Children with Chronic Renal Failure
Authors: Kuizon Beatriz D. , Salusky Isidro B.
Published: April 2003

Intermittent calcitriol (1,25D) therapy has been used for the management of secondary hyperparathyroidism in children with chronic renal failure; however, the development of adynamic bone has been demonstrated in up to 40% of pediatric patients after 12 months of intermittent 1,25D therapy. To assess its effect on linear growth, we compared growth and biochemical data from 16 prepubertal patients with biopsy-proven secondary hyperparathyroidism during 12 months of intermittent 1,25D therapy and the preceding year of daily 1,25D therapy. While Z-scores for height remained stable during daily therapy, values decreased from –1.8 ± 0.32 to –2.0 ± 0.33, p < 0.01, during intermittent 1,25D therapy; the largest reductions were seen in those who developed adynamic bone. Reductions in growth may be due to the direct inhibitory effects of large intermittent doses of calcitriol on chondrocyte activity.
Physiologic Actions and Molecular Expression of the Renin-Angiotensin System in the Diabetic Rat
Authors: Anderson Sharon
Published: April 2003

Clinical, experimental, biochemical, and molecular biologic studies all invoke an important role for the renin-angiotensin system (RAS) in the pathogenesis of diabetic complications. Studies of pharmacologic interruption of the RAS with angiotensin-converting enzyme (ACE) inhibition have implicated this hormonal system in the progression of diabetic nephropathy, both experimentally and clinically. Preliminary evidence also suggests a beneficial effect of angiotensin II (Ang II) receptor antagonists. The relative roles of the systemic vs. intrarenal RAS in the pathogenesis of diabetic nephropathy have recently been evaluated. Though plasma renin is generally low, it is not yet clear whether RAS component processing is normal in diabetes; there may be subtle changes in Ang II metabolism which sustain relatively higher plasma Ang II levels. Furthermore, the intrarenal RAS may not be suppressed. Renal renin levels tend to be disproportionately elevated, as compared to plasma renin values. Renal Ang II levels are normal, and renal mRNAs for RAS components have been variable, though not suppressed. In general, lack of RAS suppression (despite plasma volume and increased exchangeable sodium) may indicate inappropriate activity of the RAS in diabetes. Indeed, disproportionate activity of the intrarenal RAS may be a proximate cause of the observed suppression of the systemic RAS. RAS-mediated injury may occur via stimulation of a number of sclerosing mediators, and there is evidence that hyperglycemia acts synergistically with Ang II to promote cellular injury. Together, these recent investigations lend further support to the notion that the RAS plays an important role in diabetic nephropathy, and are beginning to shed light on the mechanisms of progressive renal injury.
Cardiovascular Mortality and Morbidity in Dialysis Patients
Authors: Eknoyan Garabed
Published: April 2003

Dialysis patients constitute a high-risk group for cardiovascular disease, which accounts for 40% of deaths in these patients. After stratification for age, race and gender, cardiovascular mortality is several orders of magnitude (10–20 times) higher in dialysis patients than in the general population. A clustering of risk factors renders dialysis patients especially susceptible to cardiovascular disease. Their morbidity and mortality can be favorably altered by interventional measures which systematically address and modify each individual risk factor. It is necessary to institute intervention during the course of progressive renal failure, well before the onset of end-stage renal disease and the initiation of dialysis.
Regulation of the Renal Na-HCO3 Cotransporter X. Role of Nitric Oxide and Intracellular Calcium
Authors: Ruiz Ofelia S. , Qiu Yi-Yong , Cardoso Lucio R. , Arruda J.A.L.
Published: April 2003

Cholinergic agents increase the activity of the renal Na-HCO3 cotransporter and have been shown to stimulate the production of nitric oxide (NO) in other cells. To study the role of NO in mediating the effect of carbachol on Na-HCO3 cotransporter, we measured the activity of the cotransporter in rabbit proximal tubule cells treated with carbachol (10–4 M) or the NO inhibitor, L-NAME (10–3M), or carbachol+L-NAME. The activity of NaHCO3 cotransporter was measured by recovery of intracellular pH (pHi) in cells loaded with pH-sensitive dye, BCECF. In control cells, carbachol significantly increased Na-HCO3 cotransporter activity while L-NAME did not affect the activity of the cotransporter but completely blocked the enhancement induced by carbachol. Carbachol increased NO production by proximal tubule cells. We also studied the effect of the NO donor, SNAP (10–3M), on the cotransporter incubated for 1 h in cultured proximal tubule cells. SNAP caused a similar enhancement in the activity of the cotransporter sug- gesting that a different NO donor is capable of enhancing the activity of the cotransporter to the same extent as that observed with carbachol. Because the effect of NO is thought to involve cGMP, we examined the effect of 8-Br-cGMP (10–3 M) on the cotransporter. 8-Br-cGMP caused stimulation of the Na-HCO3 cotransporter activity although to a lesser degree than carbachol. We have previously shown that carbachol increases cytosolic calcium but the role of intracellular calcium (Cai) per se on the cotransporter has not been studied. We therefore studied the role of Cai on the activity of Na-HCO3 cotransporter in rabbit proximal tubule cells by utilizing the calcium ionophore, ionomycin, the microsomal Ca-ATPase inhibitor, thapsigargin, and the calcium chelator, BAPTA. Ionomycin, 5 µM, caused a significant stimulation of Na-HCO3 cotransporter which was prevented by BAPTA. The microsomal Ca-ATPase inhibitor, thapsigargin, also increased the cotransporter activity. As expected both ionomycin and thapsigargin caused a significant increase in Cai. Calyculin A, an inhibitor of protein phosphatase 2A prevented the stimulation of the cotransporter by calcium (in pH units/min: control 1.8±0.13; Ca 2.22±0.07; p<0.05; Ca+calyculin A 1.9±0.09, p<0.025) suggesting that calcium acting through kinases/phosphatases, plays a role in the phosphorylation of the cotransporter. These results demonstrate that NO and Cai modulate the activity of the cotransporter.
Differences in Calcium Metabolism between Black and White Men and Women
Authors: Bikle Daniel D. , Ettinger Bruce , Sidney Stephen , Tekawa Irene S. , Tolan Kimberly
Published: April 2003

To determine whether environmental factors influence racial differences in calcium metabolism, the authors evaluated the influence of three factors (season, length of sunlight exposure, and diet) on calciotropic hormones, renal calcium excretion, and markers of bone turnover in an ambulatory population aged 25–36 years. Included were 109 black men, 114 white men, 95 black women, and 84 white women. Compared with white subjects, black subjects of both genders showed lower levels of serum 25-hydroxyvitamin D (25-OHD) and higher levels of serum 1,25-dihydroxyvitamin D [1,25(OH)2D]. The mean winter levels of 25-OHD were 19 to 29% lower than the summer levels in all groups. The urinary calcium excretion was 26% lower in black men than in white men and was 36% lower in black women than in white women. The parathyroid hormone levels were 29% higher in black women than in white women, but no statistically significant racial differences in parathyroid hormone levels were seen in men. Bone turnover markers (serum osteocalcin, bone-specific alkaline phosphatase, urinary pyridinoline cross-link excretion) did not show consistent racial differences. Racial and gender differences in calcium excretion did not significantly correlate with differences in lifestyle or with levels of the calciotropic hormones. Environmental factors such as diet and sunlight exposure do not appear to influence racial differences in the levels of the calciotropic hormones or renal calcium excretion.
Homocysteine and Chronic Renal Failure
Authors: Perna Alessandra , Castaldo Pasquale , De Santo Natale , Galletti Patrizia , Ingrosso Diego
Published: April 2003

Homocysteine, a sulfur amino acid, is an important methionine derivative, which has been implicated in the pathogenesis of atherothrombosis. Although only observational, epidemiological studies are available at present, the evidence of an association between hyperhomocysteinemia and increased cardiovascular risk is quite strong and this is confirmed also in a population of chronic renal failure patients. From a biochemical standpoint at least three mechanisms have been so far summoned in order to explain homocysteine toxicity including: oxidation, hypomethylation, and acylation. Proteins are believed to play a crucial role as homocysteine molecular targets. Interference with the functions of several of such macromolecules has been so far described being mediated by any of the above mechanisms. Vitamins may positively influence homocysteine metabolism, thus facilitating the metabolic clearance of this compound. Therefore they are presently considered as potential means for reducing plasma levels of this amino acid and preventing vascular occlusions in hyperhomocysteinemic patients. These compounds, with special regard to folate, are eligible for interventional clinical trials, from which the definitive answer on the role of homocysteine in atherothrombosis is expected.
Effects of Neuropeptide Y on Appetite
Authors: Kokot Franciszek , Ficek Rafat
Published: April 2003

Neuropeptide Y (NPY) is a polypeptide containing 36 amino acids. Circulating NPY originates predominantly from the sympatho-adrenomedullary nervous system. It has a vasoconstrictive and mitogenic effect on blood vessels and seems to be involved in blood pressure regulation and angiogenesis. NPY is a potent orexigenic agent and is presumed to play a leading role in the regulation of eating behavior. Stimulation of the NPY-ergic arcuate – paraventricular nucleus (ARC–PVN) pathway by exercise, fasting, energy loss (glucosuria) is followed by increased appetite and food intake and increased parasympathetic activity, but suppression of sympathetic activity and energy expenditure. The end result of this process is an increase of energy stores. Activity of the NPY-ergic ARC–PVN pathway is suppressed by leptin – a polypeptide produced by adipocytes. Although functioning of an NPY–leptin feedback was found in rodents, it seems likely that also in man the NPY–leptin axis is involved in the regulation of food intake and energy expenditure.
Influence of Water and Sodium Diuresis and Furosemide on Urinary Excretion of Vitamin B6, Oxalic Acid and Vitamin C in Chronic Renal Failure
Authors: Mydlík Miroslav , Derzsiová Katarína , Žemberová Eva
Published: April 2003

Urinary excretion of vitamin B6, oxalic acid and vitamin C was investigated in 15 healthy subjects during maximal water diuresis and in the group of 12 patients in polyuric stage of chronic renal failure without dialysis treatment receiving a diet containing high sodium chloride (15g/day). Urinary excretions of the same parameters were investigated in another group of 15 patients in polyuric stage of chronic renal failure without dialysis treatment after i.v. administration of 20 mg furosemide. Urinary excretion of vitamin B6, oxalic acid and vitamin C significantly increased during maximal water diuresis while during high intake of sodium chloride the urinary excretions of these substances were not affected. The results suggest that urinary excretion of vitamin B6, oxalic acid and vitamin C depends on the urinary excretion of water. Intravenous administration of 20 mg furosemide led to an increase of urinary excretion of vitamin B6, oxalic acid and vitamin C in patients with chronic renal failure. The increased urinary excretion of vitamin B6 and vitamin C is a new negative side effect of furosemide and increased urinary excretion of oxalic acid is a new positive side effect in patients with chronic renal failure.
Preventive Effects of an Oral Sorbent on Nephropathy in Rats
Authors: Aoyama Isao , Miyazaki Takashi , Niwa Toshimitsu
Published: April 2003

Circulating uremic substances are thought to be involved in the progression of chronic renal failure (CRF). An oral adsorbent AST-120 (Kremezin) is effective in removing circulating uremic toxins from the gastrointestinal tract, and retards the progression of CRF. AST-120 is widely used as an approved drug in Japan for the treatment of undialyzed uremic patients to delay the progression of CRF. AST-120 attenuates the progression of glomerular sclerosis and interstitial fibrosis in a variety of experimental rat models of CRF. However, the mechanism by which AST-120 delays the progression of CRF had not been clear. We have demonstrated that indoxyl sulfate, a dietary protein metabolite, is a circulating uremic toxin stimulating glomerular sclerosis and interstitial fibrosis, and that AST-120 decreases the serum and urine levels of indoxyl sulfate by adsorbing its precursor, indole, in the intestine. The administration of indoxyl sulfate to uremic rats stimulated the expression of transforming growth factor (TGF)-β1, tissue inhibitor of metalloproteinase (TIMP)-1 and pro-α1(I)collagen in the kidneys. Further, the administration of AST-120 to uremic rats reduced the extent of glomerular sclerosis and interstitial fibrosis as well as the renal expression of TGF-β1 and TIMP-1, by reducing the serum and urine levels of indoxyl sulfate. We propose the protein metabolite hypothesis that endogenous protein metabolites such as indoxyl sulfate play an important role in the progression of CRF, and that AST-120 is effective in retarding the progression of CRF by removing these protein metabolites through intestinal absorption.
A Comparative Approach towards the Understanding of Adult Neurogenesis
Authors: Zupanc Günther K.H.
Published: April 2003

In all vertebrate species examined thus far the production of new neurons in the central nervous system takes place not only during embryogenesis but also in adult life. However, although in mammals this so-called adult neurogenesis appears to be limited to a very few brain regions, in non-mammalian vertebrates new neurons are generated continuously in many regions of the adult central nervous system. This difference makes it particularly interesting to examine adult neurogenesis from a comparative point of view. Such an approach is likely not only to yield new insights into the evolution and function(s) of this phenomenon, but also to facilitate identification of central sites that, although quiescent in vivo, have retained their intrinsic potential to produce new cells during adulthood in mammals.
Development of a Sexually Dimorphic Neuromuscular System Involved in Green Anole Courtship Behavior
Authors: O’Bryant Erin L. , Wade Juli
Published: April 2003

During courtship and aggression, adult male green anoles (Anolis carolinensis) extend a large red throat fan called a dewlap. Adult females have a very small dewlap; they rarely use it during agonistic encounters and never during courtship. The motoneurons, nerve, muscle fibers, neuromuscular junctions, and cartilage pieces responsible for dewlap extension are all larger in adult males than females, parallel to the behavioral dimorphisms. However, the general developmental pattern of these structures, and when they become sexually dimorphic, was largely unknown. In the present study, we examined the length of the 2nd ceratobranchial cartilages (which unfold the dewlap), muscle fiber size, nerve cross-sectional area, and motoneuron soma size, as well as measures of body size (snout-vent length and body weight) at post-hatching days 1, 30, 60, 75, and 90. All measures other than motoneuron soma size increased over time. However, only cartilage length and muscle fiber size became sexually dimorphic in the first three months after hatching. The cartilage was greater in males than females by d60, and muscle fiber size differentiated by d75. The results indicate that peripheral structures involved in dewlap extension differentiate prior to those in the brain and thus, because males and females in this age range are identical in size, dewlap (cartilage) size could be a relatively specific factor contributing to the sexual differentiation of the rest of the neuromuscular system.
Changes in Lactate and Other Ions in Plaque and Saliva after a Fluoride Rinse and Subsequent Sucrose Administration
Authors: Vogel G.L. , Zhang Z. , Chow L.C. , Schumacher G.E.
Published: April 2003

The purpose of this study was to examine plaque and saliva composition after a fluoride rinse and subsequent sucrose application. Fifteen subjects accumulated plaque for 48 h, and then rinsed with a fluoride rinse based on 228 µg/g (ppm) Na2SiF6 and some received no rinse. After 60 min, upper and lower buccal molar plaque samples and 1-min saliva samples were collected. The subjects then rinsed with 10% g/g sucrose solution, and 7 and 15 min later, a second and a third set of samples were collected. Plaque fluid and clarified saliva were then recovered from these samples by centrifugation, and the remaining plaque acid extracted. The plaque fluid, centrifuged saliva, and plaque extract samples were then analyzed using micro techniques for pH, free calcium, phosphate, organic acids (plaque fluid and saliva only) and fluoride. Considering both the fluoride rinse and no-rinse groups, the most notable compositional changes in saliva 7 min after the sucrose rinse were pH –0.40 unit, free calcium 0.42 mM, lactate 5.2 mM, phosphate –1.3 mM, and fluoride 2.8 µM; while in plaque fluid, the corresponding changes were pH –1.59 unit, free calcium 1.5 mM, lactate 35 mM, phosphate –1.6 mM and fluoride –26 µM. After sucrose rinsing, undersaturation was found with respect to dicalcium phosphate dihydrate in saliva and plaque fluid and with respect to tooth enamel in some plaque fluid samples. Plaque fluid composition appeared to be strongly influenced by salivary clearance, diffusive loss of ions into the water phase of the rinse, and lower jaw pooling of the sucrose and fluoride components of the rinses. After the experimental rinse, the fluoride concentration in plaque fluid [86 ± 22 mM (upper molar site), 162 ± 150 mM (lower molar site)], saliva (26 ± 18 mM), and whole plaque [99 ± 97 µg/g (upper molar site), 197 ± 412 µg/g (lower molar site)] was comparable to the values in previous studies using this rinse. These very high plaque fluid fluoride concentrations, compared with the ‘no-rinse’ samples, induced an approximately 0.3-unit increase in the plaque fluid pH 7 min after the sucrose rinse, a small decrease (approximately 20%) in lactate production and a modest increase in enamel saturation. Although these changes were all statistically significant, no correlation was found between the decrease in lactate concentration and plaque fluid fluoride, pH or whole plaque fluoride.
«Goodbye, Anima»?
Authors: Langendorf Uwe
Published: April 2003

Leider besteht für diesen Artikel keine Zusammenfassung. Als Einstieg stellen wir den Textanfang zur Verfügung Ich begrüsse es sehr, dass Jungs Konzept von Anima und Animus nun kon-trovers diskutiert wird und danke den Beteiligten (Anne Springer, Claus Braun und Joachim Wilke in der Analytische Psychologie 31/1/2000 und 32/1/2001) für ihre anregenden Argumente. Ich selbst spüre seit einigen Jahren ein zunehmendes Unbehagen, mit dem Begriffspaar Anima/Animus umzugehen. Jungs Konzept erscheint mir schillernd und kaum greifbar, aber eben deswegen auch unangreifbar, weil dieses «Schillern» genau dem Wesen des Bezeichneten entsprechen soll. Das kann man eigentlich nicht diskutieren. Letztlich kann es nur heissen: «Love it or leave it.» Dennoch will ich meine Kritik in einigen Punkten zusammenfassen:
Speech Perception and Language Criteria for Paediatric Cochlear Implant Candidature
Authors: Blamey Peter , Sarant Julia
Published: April 2003

Existing criteria for cochlear implantation of children with impaired hearing aim to select children who will eventually achieve better speech perception scores with an implant than with a hearing aid. It is difficult to predict the eventual outcomes with hearing aid and implant because speech perception scores typically increase with age, and because the distribution of scores for implant and hearing aid users overlap considerably at all ages. This paper shows how speech perception scores can be combined with spoken language measures to arrive at an objective criterion for implant selection. The method also allows estimation of the likely increase in speech perception score within a few months of implantation and estimation of the probability that the child will perform better with the implant than the hearing aid. The criteria were based on data from 135 evaluations of 50 children using cochlear implants with monosyllabic words, open-set sentences, the Clinical Evaluation of Language Fundamentals, and the Peabody Picture Vocabulary Test. Data from 114 evaluations of 43 children using hearing aids were used to illustrate the sensitivity of the criteria.