bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of HNS-32, a Novel Antiarrhythmic Agent, on Guinea-Pig Myocardium
Authors: Noguchi Kazuo , Kase Junya , Saitoh Mariko , Masumiya Haruko , Saitoh Masaki , Nakazawa Tomoo , Tanaka Yoshio , Tanaka Hikaru , Hashimoto Keitaro , Shigenobu Koki
Published: April 2003

The electrophysiological and mechanical effects of HNS-32, a novel azulene-1-carboxamidine derivative with antiarrhythmic activity, were studied in isolated guinea-pig myocardial preparations. HNS-32 (10–6–10–4 mol/l) concentration-dependently decreased the maximum rate of rise (Vmax) of action potential in isolated papillary muscle; the potency was the same or slightly higher than that of disopyramide. At 10–4 mol/l, HNS-32 also shortened the action potential duration (APD) and depolarized the resting membrane potential; these effects were similar to those of 10–5 mol/l verapamil. HNS-32 (10–7–10–4 mol/l), as well as verapamil (10–8–10–5 mol/l) and disopyramide (10–6–10–3 mol/l), had concentration-dependent negative chronotropic and negative inotropic effects on isolated right atrial and right ventricular papillary muscle preparations, respectively. The concentration-response relationship for the positive chronotropic effect of isoproterenol was not affected by HNS-32 (10–5 mol/l). In isolated ventricular myocytes, HNS-32 (10–6–10–4 mol/l) concentration-dependently inhibited the peak amplitude of the L-type Ca2+ current. These results suggest that NHS-32 has Vmax reducing activity on myocardial tissue, which may be responsible for antiarrhythmic effect. The drug may also have additional effect on the Ca2+ channel at higher concentrations.
Voluntary Self-Administration of Both Morphine and Cocaine by Rats
Authors: Schulze K. , Dadmarz M. , Vogel W.H.
Published: April 2003

Voluntary self-administration of cocaine and/or morphine was studied in rats. Male rats were offered water bottles or bottles containing either cocaine or morphine, both cocaine and morphine (combination) or cocaine and morphine as a mixture. Alternating the three drug-containing bottles had no effect on drug choice. When offered alone, rats consumed about 12 ± 8 mg/kg/day of cocaine or 0.3 ± 0.3 mg/kg/day of morphine. When both drugs were offered in combination, they consumed a higher amount of cocaine (22 ± 7), but the same amount of morphine (0.4 ± 0.3). Availability of cocaine/morphine mixture kept morphine consumption constant (0.3 ± 0.1), but markedly decreased cocaine intake (0.3 ± 0.2). Addition of saccharin to the drug solutions only slightly increased consumption of both drugs, whereas saccharin added as a competitor or distracter to the drug solution reduced cocaine but not morphine self-administration. Animals showed wide interindividual variations but surprisingly small intraindividual variations in self-administration of cocaine or morphine under all conditions. No correlation between cocaine and morphine intake was apparent in the combination situation. Forcing animals first with cocaine had no effect on subsequent intake of cocaine or morphine presented in combination. However, forcing animals first with morphine subsequently increased morphine and reduced cocaine intake. In conclusion, morphine intake was the same if offered alone, in combination or as a mixture, whereas cocaine intake increased during a combination but decreased in the mixture situation. Cocaine pre-exposure had no effect on subsequent voluntary morphine or cocaine choice, whereas morphine pre-exposure increased subsequent voluntary morphine but decreased cocaine intake. These results suggest the possibility of two reward centers, one for each drug, the morphine center exerting a dominant influence over the cocaine center.
Effect of Alpha-Adrenoceptor Agonists and Antagonists on Imipramine-Induced Antinociception in the Rat Formalin Test
Authors: Zarrindast Mohammad-Reza , Sahebgharani Mousa
Published: April 2003

In this study, the effect of central administration of the α-adrenoceptor agents on the antinociception induced by imipramine in the formalin test has been investigated. Intraperitoneal (IP) administration of different doses of imipramine (10–80 mg/kg) and intracerebroventricular (ICV) administration of the α2-adrenoceptor agonist clonidine (0.05–0.8 µg/rat) elicited a dose-dependent antinociception in the both phases of the test. Furthermore, different doses of clonidine (0.05–0.2 µg/rat) increased the antinociception induced by imipramine (10 and 20 mg/kg). The α2-adrenoceptor antagonist yohimbine (2 µg/rat, ICV) reduced the response of a low dose imipramine (10 mg/kg, IP) plus different doses of clonidine (0.05, 0.1 and 0.2 µg/rat, ICV), but did not alter the response induced by higher doses of imipramine (20 and 40 mg/kg) alone or in combination with clonidine. Yohimbine by itself elicited no effect. The α1-adrenoceptor agonist phenylephrine (0.07–1.5 µg/rat) induced antinociception in both phases of the formalin test, but did not alter the imipramine-induced antinociception. The α1-adrenoceptor antagonist prazosin neither elicited antinociception nor altered the imipramine response. Yohimbine (2 µg/ rat, ICV) in combination with prazosin (0.5 µg/rat, ICV) caused more inhibition of the response of imipramine or imipramine plus clonidine. Therefore, it is concluded that α2-adrenoceptor mechanism may be involved in the imipramine-induced antinociception.
The Relationship between Vowel and Consonant Duration in Orkney and Shetland Dialects
Authors: van Leyden Klaske
Published: April 2003

In Shetland dialect, the northernmost branch of Lowland Scots, stressed monosyllables, when closed by a consonant, generally contain either a durationally short vowel followed by a durationally long consonant, or a long vowel followed by a short consonant. This feature, first described in the 1950s, can most likely be ascribed to the Scandinavian substratum of the dialect. Although several experimental investigations into the duration of Scottish vowels have been carried out recently, most of them in the light of the Scottish vowel length rule, none of them so far have looked at Shetland dialect or the relationship between the duration of the vowel and the final consonant. In the present study we will examine vowel and final consonant duration in monosyllabic words in both Shetland and Orkney dialects, as well as in Standard Scottish English and Standard Norwegian, in order to establish whether in Shetland dialect, durationally short consonants follow durationally long vowels and vice versa and if so, if this is indeed a feature peculiar to Shetland.
Voiceless Consonants and Locus Equations: A Comparison with Electropalatographic Data on Coarticulation
Authors: Tabain Marija
Published: April 2003

The appropriateness of using locus equations in a study of voiceless consonants is examined. The consonants investigated are the stops /t k/ and the fricatives /Θ s ∫/. The slope value of the locus equation, indicating degree of coarticulation in the CV syllable, is compared with electropalatographic (EPG) data on coarticulation. It is shown that, overall, there is a very poor correlation between locus equation and EPG data as regards coarticulation. It is also shown that more accurate locus equation results – in terms of their correlation with EPG data – are obtained for stop consonants when F2 onset is sampled at stop release, rather than at the onset of voicing for the vowel. Finally, results for the voiceless consonants are compared with results for their homorganic voiced counterparts. Whilst there is no significant difference between voiced and voiceless consonants in the EPG data, there is a significant difference between voiced and voiceless consonants in the locus equation data. These results suggest that locus equations cannot provide invariant cues for stop and fricative place of articulation across the voiced-voiceless distinction.
A New Classification of the Delusional Misidentification Syndromes
Authors: Rössner Veit
Published: April 2003

In recent years, a great number of very different and in part contradictory terminologies and classifications of delusional misidentification syndromes (DMS) have been published. In various case reports, several authors have also made contradictory comments on questions concerning classification, etiology and assignment to a possible entity of DMS. Further development and extension of the classifications proposed during recent years did not help to eliminate discrepancies and contradictions. The classification presented here has not shown any inconsistencies so far and it allows the classification of any DMS that has been examined recently.
Delusional Hermaphroditism: A Rare Variant of Delusional Misidentification Syndrome
Authors: Jagadheesan K. , Sandil R. , Nizamie S. Haque
Published: April 2003

Since the historical contribution of Capgras and Reboul-Lachaux, several researchers began exploring various dimensions of the fascinating phenomena of delusional misidentification syndromes. Recently, Mulholland and O’Hara have reported a new variant of delusional misidentification syndromes named ‘delusional hermaphroditism’. In this study, we report another case of this rare entity.
Obstetrical and Neonatal Outcome following Clonazepam Use during Pregnancy: A Case Series
Authors: Weinstock Lisa , Cohen Lee S. , Bailey Jennie W. , Blatman Robert , Rosenbaum Jerrold F.
Published: April 2003

Background: Given the high prevalence of panic disorder in women, treatment decisions are frequently made regarding the use of anti-panic medications during the childbearing years and during pregnancy. The objective of this case series was to evaluate obstetric and neonatal outcome associated with treatment with clonazepam during pregnancy. Methods: Subjects were 38 women with histories of panic disorder who used clonazepam during pregnancy. Information regarding the amount and duration of clonazepam use during pregnancy was obtained. Obstetrical records describing pregnancy, labor and delivery and infant Apgar scores were obtained for all subjects. Neonatal nursery records were obtained for 27 subjects. Results: Maternal outcome assessed by obstetrical records and acute neonatal outcome assessed by Apgar scores were positive. Based on neonatal records, there were no cases of orofacial anomalies, neonatal apnea, benzodiazepine withdrawal syndromes, or temperature or other autonomic dysregulation. In 2 infants born to the same mother, use of clonazepam and imipramine at the time of delivery was associated with transient neonatal distress. Conclusion: Clonazepam use during pregnancy did not appear to be directly related to any obstetric complications during pregnancy, labor, or delivery. There was no evidence of neonatal toxicity or withdrawal syndromes in babies born to mothers who took clonazepam during pregnancy. Absence of serious maternal or neonatal compromise following clonazepam use during pregnancy in these mothers and infants is somewhat reassuring. One case of hypotonia and 1 case of respiratory distress in babies who were exposed to clonazepam in combination with imipramine at the time of delivery may suggest that coadministration of benzodiazepines with other psychotropic medications may require close neonatal observation.
Prevalence and Clinical Correlates of Residual Depressive Symptoms in Bipolar II Disorder
Authors: Benazzi Franco
Published: April 2003

Background: Most patients with unipolar and bipolar I disorder have residual symptoms, despite successful treatment. The appraisal of subsyndromal symptomatology has important implications for pathophysiological models of disease and relapse prevention. Residual symptoms in bipolar II disorder were studied insufficiently. The study of residual symptoms in bipolar II disorder is important, because many depressed outpatients may suffer from it and because bipolar II disorder may be distinct from type I. The study aims were to assess the prevalence and clinical correlates of persistent residual depressive symptoms in bipolar II disorder. Methods: 138 consecutive patients with bipolar II disorder and 83 unipolar disorder outpatients, presenting for major depressive episode treatment in private practice, were interviewed with the Structured Clinical Interview for DSM-IV Axis I Disorders – Clinician’s Version. Study variables were persistent (more than 2 years) residual depressive symptoms, age, gender, age at onset, illness duration, recurrences, axis I comorbidity, severity, psychotic, melancholic and atypical features. Results: The prevalence of residual depressive symptoms was 44.9% in bipolar II disorder and 43.3% in unipolar disorder. Residual depressive symptoms in bipolar II and unipolar disorders were significantly and positively associated with illness duration and recurrences. Conclusions: Persistent residual depressive symptoms were common in bipolar II disorder. Residual unipolar and bipolar II depressive symptoms were related to duration of illness and number of recurrences. Reducing these variables could reduce and prevent residual symptoms. A mechanism of kindling (more mood episodes leading to worse outcome) could be that of leaving a larger and larger amount of residual symptoms after the acute episode has subsided.
Alexithymia and the Temperament and Character Model of Personality
Authors: Grabe H.J. , Spitzer C. , Freyberger H.J.
Published: April 2003

Objective: In our study we explored the associations between alexithymia (Toronto Alexithymia Scale 20, TAS-20) and the dimensions and subscales of Cloninger’s theoretically based and empirically validated psychobiological model of personality to further clarify the relationship between alexithymia and personality traits. Methods: Psychiatric in- and outpatients (n = 254) were investigated with the TAS-20, the Temperament and Character Inventory (TCI) and the Symptom Check List SCL-90-R to control for the severity of current psychopathology. Correlation and regression analyses were performed. Results: The regression analysis identified the TCI dimensions low self-directedness (SD), low reward dependence (RD) and to a minor degree harm avoidance (HA) as independent predictors for alexithymia. At the level of subscales, interpersonal detachment (RD3), low resourcefulness (SD3), low responsibility and blaming (SD1) and shyness with strangers (HA3) were predictors for alexithymia. The degree of explained variance of the TAS-20 scores by the TCI dimensions and subscales ranged between 43 and 45% whereas the inclusion of the general severity index into the regression models accounted for an additional 5% of the variance. Conclusions: Alexithymia is best explained by a mixture across different dimensions and subscales within Cloninger’s psychobiological model of personality. However, alexithymia is captured only partly by current concepts of personality, and additional contributing psychological and biological factors need to be identified to understand alexithymia more extensively.
Effects of Client-Centered Psychotherapy for Personality Disorders Alone and in Combination with Psychopharmacological Treatment
Authors: Teusch Ludwig , Böhme Hildegard , Finke Jobst , Gastpar Markus
Published: April 2003

Background: There is an increasing interest concerning the treatment of patients with personality disorders (PD) in data on the efficacy of psychotherapeutic strategies especially when combined with medication. Methods: The efficacy of an inpatient client-centered treatment program (CCT) was studied prospectively in 142 patients with PD and additional depressive, anxiety or eating disorders (ICD-10). Results: Significant improvements in depression, self-esteem and social adjustment were achieved up to discharge, which remained stable at the 1-year follow-up. The efficacy with regard to individual variables or the total result could not be further enhanced by a combination with psychopharmacological treatment (CCT + MED), consisting mainly of antidepressants. Within the subgroups of patients with socially deviant (F60.0–2), emotionally unstable/borderline (F60.3) and histrionic/narcissistic PD (F60.4, F60.8), CCT was significantly superior to CCT + MED in the reduction of depression (Bech-Rafaelsen Melancholia Scale ratings), whereas the response was enhanced by medication in the subgroup of patients with socially dependent ‘cluster C’ PD (F60.5–7). Conclusions: The results are discussed with regard to client-centered therapeutic concepts and to the further development of differential combination strategies.
Psychiatric Disorders and Coronary Heart Disease in Women – A Still Neglected Topic: Review of the Literature from 1971 to 2000
Authors: Bankier Bettina , Littman Andrew B.
Published: April 2003

Background: Coronary heart disease (CHD) is the leading cause of death in women aged over 40 years in the United States, for whom it conveys a worse prognosis than for men. Recently, psychosocial factors have been understood to represent significant risk factors for developing CHD, as well as having a worse outcome with established CHD. However, these factors are often overlooked, in particular comorbid psychiatric disorders and psychiatric symptoms. To summarize the current knowledge in this interdisciplinary field, the authors conducted a review of CHD in women, taking into account psychosocial aspects, in particular psychiatric disorders. Methods: Medline searches using the keywords ‘psychiatric disorder’ and ‘coronary heart disease’ and ‘women’, and ‘psychiatric disorder’ and ‘cardiac disease’ and ‘women’, were performed, covering the time span from the beginning of the Medline database until January 1, 2001. Results: Quoted items included depression, panic disorder, generalized anxiety disorder, mitral valve prolapse, chest pain, anorexia nervosa, menopause, alcohol abuse, cocaine use, sleep disorder, sexual dysfunction, hostility and type A behavior, as well as other psychosocial aspects. There is accumulating evidence of significant associations between psychosocial factors, in particular psychiatric disorders and psychiatric symptoms, and the development and recurrence of CHD in women. Conclusions: However, in summary, the topic still seems to be neglected. Future research into psychiatric disorders and psychiatric symptoms and CHD in women is strongly required, and the focus on women exclusively is underlined.
Using New Information Technology to Treat Tobacco Dependence
Authors: Etter Jean-François
Published: April 2003

Smoking cessation programs that can be disseminated at a large scale and at a low cost are needed to decrease smoking-related mortality and morbidity. Research showed that several computer-based smoking cessation programs are effective, in particular when they are combined with pharmacotherapy. When available on the Internet, these programs can reach thousands of smokers at a low cost per participant. Some of these programs are designed to complement smoking cessation counseling given by physicians to their patients who smoke. They can be a useful adjunct to medical advice and should be prescribed in association with pharmacotherapy.
Gamma Knife Treatment of Acoustic Neurinoma
Authors: Kwon Y. , Kim J.H. , Lee D.J. , Kim C.J. , Lee J.K. , Kwun B.D.
Published: April 2003

The results of treatment of acoustic neurinomas using Gamma Knife radiosurgery (GKR) during a 6-year period in our center were reviewed. Since May 7, 1990, we treated 88 cases of acoustic neurinoma with GKR. During a 52-month mean follow-up period, MRI was obtained in 63 patients. Reduction in tumor size occurred in 34 (54%) cases, and another 27 (42.8%) tumors showed no change. The tumor control rate was thus 95%. Tumor size increased in 3 (4.8%) cases, but one case is still in early follow-up. Two cases were operated after GKR. Histological examination of the tumors removed at surgery 8 months after GKR were obtained. The examinations showed enlargement of nucleoli and cytoplasm and proliferation of endothelial cells due to delayed radiation changes. Post-GKR facial neuropathy was noted in 7 (8.8%) patients, of which 4 recovered during the follow-up period. The tumor volume, margin dose, number of isocenters and marginal isodose did not have any statistically significant relationship with the development of facial neuropathy. Transient trigeminal neuropathy were noted in 3 patients. Hearing was preserved in 2 of 3 hearing patients. In conclusion, our GKR results for acoustic neurinomas were very similar to the previously reported series, which makes GKR for acoustic tumors an excellent treatment modality for small- to medium-sized tumors with or without microsurgical tumor removal.
Magnitude of Microelectrode Refinement in Pallidotomy and Thalamotomy1
Authors: Milligan Brian D. , Wilkinson Steve , Overman John , Kirschman David L. , Koller William C. , Pahwa Rajesh , Lyons Kelly E. , Batnitzky Solomon , Gordon Michael A.
Published: April 2003

The relative accuracy of starting point algorithms in microelectrode-guided stereotactic pallidotomy and thalamotomy was evaluated using postoperative magnetic resonance imaging (MRI) data. Multiplanar reformations were performed to align postoperative MRI in anterior-posterior, dorsal-ventral and mediolateral planes. Three-dimensional distance and direction from the pallidal and thalamic stereotactic starting points to the respective radiofrequency lesions were measured. Similar magnitude of microelectrode refinement in pallidotomy and thalamotomy suggested similar accuracy of algorithms used to set the stereotactic starting point. Fewer microelectrode-recording tracts were required to identify optimal lesioning sites in thalamotomy compared to pallidotomy. Lesions were consistently localized anterior and superior to the starting point and a refined starting point algorithm may reduce the number of microelectrode recording tracts.
Tactile Discrimination Task Not Disturbed by Thalamic Stimulation
Authors: Abbassian A.H. , Shahzadi S. , Afraz S.R. , Fazl A. , Moradi F.
Published: April 2003

The major pathway of human somatosensation passes through the ventrocaudal nucleus (Vc) of the thalamus. We tested the effect of direct electrical stimulation of the Vc on tactile discrimination in 5 Parkinson patients undergoing stereotactic thalamotomy. Raised gratings with lines 3, 4, or 6 mm apart were used. Patients had to actively touch test patterns placed in the hand contralateral to the thalamus under operation and compare it with a reference 3-mm grating held continuously in their other hand. Their performance was best for 6-mm, followed by 3-mm and then by 4-mm patterns regardless of electrical stimulation. Under Vc stimulation, patients recognized the 4-mm gratings slightly better. This can be explained either by the nature of thalamocortical interaction, which makes it resistant to external noise, or by the involvement of other pathways that circumvent the effect of thalamic stimulation.
Functional Recovery after Combined Cerebral and Cerebellar Hemispherectomy in the Rat
Authors: Marino Jr. Raul , Machado André G.G. , Timo-Iaria César
Published: April 2003

The cerebellum seems to be one of the structures responsible for early neurological improvement after cerebral hemispherectomy and its consequent deficits. Considered as an accessory brain, the cerebellum may constitute a neurobiological substrate for the recovery of such extensive cortical and subcortical lesions. It may compensate for the injury by structural remodeling and plasticity. The authors observed that, indeed, rats submitted to contralateral hemicerebellectomy before cerebral hemispherectomy do not recover as well as those submitted to hemicerebellectomy 2 weeks after cerebral hemispherectomy.
Leuprorelin 1-Month Depot as Neoadjuvant Therapy for Prostate Cancer
Authors: Prezioso Domenico , Lotti Tullio , Montironi Rodolfo , Polito Mario , on behalf of Takeda NHT Italian Group
Published: April 2003

In the last few years, the role of neoadjuvant hormonal treatment (NHT) prior to radical prostatectomy has been largely debated and investigated in randomized multicenter trials as well as in large single-institution studies. We have initiated a prospective randomized comparative trial with parallel groups in patients with clinically limited disease to contribute to the clarification of the possible role of NHT; to evaluate the efficacy of NHT with leuprolide plus cyproterone acetate in ‘maintaining’ the stage of the disease; to reduce the percentage of pathological overstaging, and mainly to accurately assess the pathological modifications induced by NHT. The present paper is an interim report of the results.
Alpha-Fetoprotein-Producing Gastric Cancer Mimicking Extragonadal Testicular Cancer
Authors: Becker T. , Hegele A. , Varga Z. , Schwetlick I. , Heidenreich A. , Hofmann R.
Published: April 2003

A case of α-fetoprotein-producing gastric hepatoid adenocarcinoma mimicking an extragonadal testicular cancer in a 28-year-old man is presented. This rare kind of tumor should be included in differential diagnosis in young patients without evidence of primary testicular malignancies.
Unusual Cause of Hematuria
Authors: Deka P.M. , Rajeev T.P.
Published: April 2003

The leech is an invertebrate which has the habit of entering the anatomical orifices of man and animals. During the process of sucking blood it releases an anticoagulant and causes continuous bleeding from the bite site. A leech as a cause of gross hematuria is unusual. We present a case of a leech in the bladder as a cause of gross hematuria.
Bone Metaplasia in a Case of Bilateral Renal Cell Carcinoma
Authors: Bielsa O. , Lloreta J. , Arango O. , Serrano S. , Gelabert-Mas A.
Published: April 2003

We present a case of synchronous, bilateral renal cell carcinoma with osseous metaplasia. In renal cell carcinoma, bone can originate through two different processes: osseous differentiation or osseous metaplasia. The case we report here represents the second process. We discuss pathological differential diagnosis and prognosis of the infrequent tumor.
Comparison of Cytology and Nuclear Matrix Protein 22 for the Detection and Follow-Up of Bladder Cancer
Authors: Lahme Sven , Bichler Karl-Horst , Feil Gerhard , Krause Steffen
Published: April 2003

Objectives: This study was designed to determine the clinical usefulness of the nuclear matrix protein 22 (NMP 22) test for the detection of bladder cancer in comparison to urine cytology. Methods: 84 patients suffering from bladder cancer or suspected bladder cancer, 25 patients with benign urological lesions and 60 healthy controls participated in a prospective study. Freshly voided spot urine samples were taken for cytological examination and determination of NMP 22 levels by enzyme-linked immunoassay. Results: The sensitivity of the NMP 22 test according to the tumor grading was (results of cytology in brackets): G1 25.0% (20.0%); G2 68.2% (59.1%), and G3 100.0% (66.7); overall sensitivity was 62.5% (45.0%). The sensitivity for superficial bladder cancer was 46.7% (36.7%) and for invasive bladder cancer 90.0% (70.0%). The specificity was 65.9% (88.9%). Conclusions: NMP 22 is a reliable tool for detecting invasive bladder cancer. Results for the frequently occurring low grade superficial bladder cancer are as poor as those obtained with cytology. In addition benign lesions such as urolithiasis or urinary tract infection lead to false-positive results. Therefore cystoscopy has to be performed when trying to detect and follow-up bladder cancer.
Regional Variations in Thiol Distribution Pattern and Superoxide Dismutase Activity of the Male Reproductive Tract of the Rat Modulate the Transport of Spermatozoa through the Epididymis and Vas deferens
Authors: Chatterjee Suvro , Laloraya Malini , Kumar G. Pradeep
Published: April 2003

Background: Contractile activity of the muscular coat of the epididymis wall is considered the major driving force for the propulsion of sperm through the male reproductive tract. Methods: Region-specific changes in the status of membrane thiols and the free radical scavening potential of the male reproductive tract of the rat were observed. Results: The present study shows that the local biochemical milieu has some influence on the transport of spermatozoa through the male reproductive tract. The vas deferens showed a higher level of superoxide dismutase activity and a low profile of thiol exposure. Conclusion: We conclude that the strong scavenging potential and the lesser thiol exposure of the vas create an apparently inert vas lumen which facilitates the transit of spermatozoa through the vas.
Five-Year Prognosis after Radical Prostatectomy in a Patient with Localized Prostate Cancer and Incidental Non-Hodgkin’s Lymphoma
Authors: Drinis Sophia , Finkelstein Michael P. , Tortorelis Dean G. , Konno Sensuke , Choudhury Muhammad S.
Published: April 2003

We present a white male patient with an initial prostate-specific antigen level of 69 ng/ml, referred for urological evaluation. He was found to be free of prostatitis but diagnosed for prostate adenocarcinoma without any indications of metastatic disease. Lymphadenectomy then revealed lymphadenopathy of low-grade non-Hodgkin’s lymphoma. Five-year follow-up after radical retropubic prostatectomy (RRP) showed no evidence of metastatic or local prostate cancer recurrence. In addition, no radiation or chemotherapy was required for his lymphoma. Although RRP is a viable option in this unique case, the outcome thus far suggests that it should be considered a primary therapeutic modality.
Predictive Value of Radiological Criteria for Disintegration Rates of Extracorporeal Shock Wave Lithotripsy
Authors: Aeberli Daniel , Müller Samuel , Schmutz Rolf , Schmid Hans-Peter
Published: April 2003

Objective: To evaluate routinely applicable criteria to predict fragmentation of renal calculi by extracorporeal shock wave lithotripsy (ESWL). Patients and Methods: Two hundred and two consecutive patients (121 men, 81 women), median age 48 (range 19–81) years, were treated with the original Dornier HM-3 lithotriptor at a single stone center. Inclusion criteria were: solitary stones, 10–30 mm in greatest diameter, located in renal pelvis or calyces. Based on plain radiographs, the calculi were classified according to their size, form, location, density (compared to the 12th rib), structure and surface. Furthermore, age of the patient, gender and body mass index were also considered for evaluation. Disintegration was documented on day 1 after ESWL by plain X-ray. A multivariate regression analysis was applied to all preoperative parameters, based on the dual variable stone free versus residual fragments. Results: The overall disintegration rate was 95.5%; 42 patients (20.8%) were completely stone free, and 151 patients (74.7%) had clinically insignificant residual fragments (5 mm or smaller). 14.9% of men and 29.6% of women were stone free (p = 0.01). All other parameters did not reach statistical significance. Conclusions: The disintegration rate of the HM-3 is excellent for kidney stones; women did significantly better than men. However, because of this high disintegration rate, a much larger series would be necessary to define possible differences between preinterventional parameters, if there were any at all.
PSA and Second-Line Therapy of Hormone Refractory Prostate Carcinoma
Authors: Serretta V. , Rizzo I. , Contino G. , Pavone C. , Pomara G. , Melloni D. , Pavone-Macaluso M.
Published: April 2003

The aim of the present study was to correlate PSA response with subjective response (bone pain and performance status), in patients treated for hormone refractory carcinoma of the prostate. Twenty-four patients were introduced into the study. Median PSA was 198 ng/ml. Symptom score, performance status and PSA were monitored monthly for 3 months and then 3-monthly. Sixteen patients (66%) showed a PSA response (median value 10 ng/ml). In 8 patients (33%) PSA was <4 ng/ml. Eight patients (33%) only had a subjective response. However, 75% of the patients with a PSA value <4 ng/ml had a subjective improvement. On the other hand, subjective response was 25% only in patients in whom PSA value decreased to <50% of the initial value but >4 ng/ml. In conclusion, PSA response is not always related to subjective improvement and does not always implicate a beneficial effect of the therapy for the patient.
The Applicability of Using Straight Ureteral Stents for the Treatment of Ureteral Stones in Presumably Non-Compliant Patients
Authors: Mydlo Jack H. , Streater Scott
Published: April 2003

There have been many reports describing the complications of retained ureteral stents following stone treatment. We wanted to evaluate the practicality of definitive treatment of poorly compliant patients who present with ureteral stones using a straight stent connected to a urethral catheter alone and compared these to patients treated with double-J stents alone. We treated 23 patients (12 in group I and 11 patients in group II) who had a ureteral stone of 6 mm or less, with an indwelling straight stent and a double-J stent, respectively, while on oral antibiotics. We followed these patients 1 week later with an abdominal X-ray prior to removing the stent. Eleven patients in group I and 9 patients in group II passed their stones spontaneously. Three patients required surgical intervention with a ureterscope and laser lithotripsy. There were no cases of infection or pyelonephritis. Although each of the straight-stent-treated patients returned to our clinic for follow-up, only 5 of the 11 double-J stent patients returned for follow-up. The remaining 6 patients had to be contacted to remind them that they still had an internal stent. Although technologic advances now allow many urologists to definitively treat ureteral stones, some urologists may lack the proper equipment and/or assistance to treat the stone at the time of presentation, or may deal with non-compliant patients. Therefore, in these certain circumstances, treatment of small ureteral stones in non-compliant patients using a straight stent connected to a leg bag, as either definitive or initial treatment, may be of practical use and avoid the risk of retained double-J ureteral stents.
Handicap of Walking by a Huge Paratesticular Liposarcoma
Authors: Augustin H. , Schips L. , Vilits P. , Zigeuner R. , Petritsch H.P. , Uggowitzer M. , Hubmer G.
Published: April 2003

We describe the case of a 71-year-old male with a huge left-sided paratesticular tumour, whose walking was increasingly handicapped by this vast mass. Two palliative excisions of tumour tissue were performed. Histology revealed a poorly differentiated paratesticular liposarcoma. The patient achieved satisfying mobility for several months before he died of cachexia.
Molecular Interactions in Pulmonary Surfactant Films
Authors: Pérez-Gil Jesús
Published: April 2003

Pulmonary surfactant is a lipid-protein complex which has the essential physiological role of stabilizing the respiratory surface of lungs against collapse. To achieve this function, surfactant forms films at the air-liquid interface that reduce dramatically the surface tension of the thin aqueous layer lining the alveoli. Natural surfactant has optimised two important properties. Once secreted to the alveolar spaces, surfactant adsorbs rapidly to the interface. There, surfactant films reduce surface tension close to 0 mN/m when compressed during expiration. The design and production of efficient artificial surfactants for respiratory therapeutics is critically dependent on the knowledge of the molecular mechanisms governing efficient interfacial adsorption and optimal surface activity, in the context of respiratory cycling. The present review summarizes the data available today on the behaviour of the different molecular components of pulmonary surfactant at air-liquid interfaces. A working model is proposed of how surfactant films could modulate the respiratory dynamics.
Two Ecological Approaches to Cognition
Authors: Yonas Albert
Published: April 2003

This book is a Festschrift made up of chapters that reflect the talks presented at a conference held at Emory University in November 1996 to celebrate the career of Dick Neisser. This commentary is not really a review of the book that came out of that conference; a review would be difficult to write. The chapters are of high quality but are not focused on a single problem or theoretical question. Rather, they demonstrate Dick Neisser’s skill at attracting talented students, his gifts as a mentor, and his value as a colleague.
The 2000 United Kingdom Haemophilia Centre Doctors’ Organisation (UKHCDO) Inhibitor Guidelines
Authors: Hay C.R.M.
Published: April 2003

The UKHCDO inhibitor guidelines address the diagnosis and management of patients with haemophilia A, haemophilia B and acquired haemophilia. Recommendations are based on best current practice as reflected in the published evidence base. Many current treatment strategies are based on uncontrolled observations highlighting the need for well designed controlled studies.
High Cost Patients and the Consortium Approach
Authors: Schonfield Susan , Reid Keith
Published: April 2003

The Pan-Thames Haemophilia Consortium was established to provide coherent regional planning of haemophilia services. The Expert Advisory Group is a clinical reference point for the consortium and was established to consider specifically elective high cost treatment programmes. An audit of the first year of consortium activity demonstrated that patients receiving high cost therapy represented 1.6% of the patient population and received 16% of the entire treatment budget. The Pan-Thames Consortium provides focused commissioning expertise and a model for national commissioning of haemophilia services.
Ovarian Hormones Do Not Attenuate Methamphetamine-Induced Dopaminergic Neurotoxicity in Mice Gonadectomized at 4 Weeks Postpartum
Authors: Yu Lung , Kuo Yumin , Cherng Chianfang G. , Chen Hsiang-Hua , Hsu Chia-Hung
Published: April 2003

The present study was undertaken to assess the ability of ovarian hormones to alter methamphetamine (MA)-induced dopaminergic toxicity in male and female mice gonadectomized at 4 and 6 weeks of age. None of the following three treatments, estradiol benzoate (EB, 3 × 0.47 µg), progesterone (Prog, 3 × 0.47 µg), or EB (2 × 0.47 µg) followed by Prog (0.47 µg), affected the dopamine (DA)-depleting effects of MA in male and female mice gonadectomized when they were 4 weeks old. However, in contrast to the findings that male mice are more sensitive to MA-induced DA depletion than female mice, no sexual differences in the sensitivity to MA treatment were observed in mice gonadectomized at this age. Moreover, three daily doses of EB (0.47 µg) and EB (0.47 µg) combined with 4-hydroxytamoxifen (4OHT, 6 µg) effectively attenuated striatal DA depletion produced by MA in female mice ovariectomized at 6 weeks of age. Three daily doses of Prog (0.47 µg) and EB (0.47 µg) combined with 4OHT (6 µg) significantly attenuated MA-induced striatal DA depletion in male mice gonadectomized at 6 weeks of age. Taken together, the modulating effects of ovarian hormones on MA-induced DA depletion in mouse striatum could be sex- and age-dependent. 4OHT did not block the protecting effects of EB on MA-induced DA depletion in female and male mice, suggesting that the estrogen receptor may not be involved in the protective effects of EB on attenuating MA-induced DA toxicity.
Impact of Chronic Renal Failure on Nitrogen Metabolism
Authors: Maroni Bradley J.
Published: April 2003

Evidence indicates that both nephrotic and nonnephrotic chronic renal failure (CRF) patients can activate normal compensatory responses when dietary protein intake is restricted and that their protein and energy requirements are similar to normal subjects. When properly implemented, low-protein diets are safe and the benefits include the amelioration of uremic symptoms and some of their metabolic complications and possibly a reduction in the rate of progression of renal failure. To ensure dietary adequacy and compliance, patients should be monitored when treated with low-protein diets. Recent evidence that the protein intake of patients with progressive CRF declines when they consume unrestricted diets should not be considered as an argument against the use of low-protein diets. Rather, it is a persuasive argument in favor of restricting dietary protein intake to minimize the complications of renal failure.
Nutritional Status and Survival in End-Stage Renal Disease Patients
Authors: Owen William F.
Published: April 2003

Several reports have emphasized that putative laboratory surrogates of nutrition, such as serum albumin, creatinine, and cholesterol concentrations are statistically more powerful independent predictors of odds riks of death for dialysis patients than is the delivered dose of dialysis. In view of the relative simplicity with which these blood tests can be obtained, their lack of expense, and simplicity in interpretation, the dialysis community has greatly escalated their importance as performance measures for the processes of patient care, arguably without full consideration of their meaning. If malnutrition in dialysis patients is a powerful predictor of death risk, and is amenable to corrective interventions that result in a reduction in the odds risk of death, then the zeal with which these laboratory tests have been embraced is appropriate. However, the assumption that a statistical correlation between laboratory surrogates of malnutrition, or other measures of inadequate nutrition, such as body mass index or a subjective global assessment, indicate a direct causal relationship between nutritional intake, nutritional status, and outcome may be incorrect. Such apparent linkages may be a consequence of the statistical model selected alone, i.e., another unappreciated medical condition may be the proximate cause of death in addition to resulting in malnutrition. The mechanism(s) by which malnutrition may adversely impact the survival of end-stage renal disease (ESRD) patients is unclear. The impact of milder degrees of malnutrition on patient survival, their proximate effect on survival, and the reality of their independent effect on patient survival are also inadequately defined. Clearly, there is a statistical link between the putative laboratory surrogates of nutrition and patient survival. Regardless of the pathobiology of such a causal link, it is valid to enquire if an intervention that results in a positive change in nutritional parameters enhances patient survival. These issues surrounding nutritional status and survival in patients with ESRD are reviewed here in detail. The conclusion of this critique is that additional studies are needed to determine if malnutrition is truly an independent and responsive predictor of outcome for ESRD patients.
TGF-β Knockout and Dominant-Negative Receptor Transgenic Mice
Authors: Letterio John J. , Böttinger Erwin P.
Published: April 2003

Use of homologous recombination and transgenic technologies have provided mouse models to study the physiological roles of the three mammalian TGF-β isoforms, and their regulation in the context of the intact animal. Mice harboring null mutations for TGF-β isoforms demonstrate that each exerts discrete nonoverlapping functions during development. TGF-β1 null mice reveal a crucial role for this cytokine in modulation of the immune system, with evidence for altered development, activation and function of various immune cell populations. New approaches to tissue- and cell-restricted disruption of TGF-β signaling pathways in transgenic mice carrying dominant-negative mutant TGF-β receptors will be discussed.
Fat-Soluble Vitamins in Patients with Acute Renal Failure
Authors: Druml Wilfred , Schwarzenhofer Maria , Apsner Robert , Hörl Walter H.
Published: April 2003

Objective: Systematic investigations on the status of fat-soluble vitamins in patients with acute renal failure (ARF) are lacking and hence no recommendations for vitamin supply can be defined for these subjects. Thus we compared the status of fat-soluble vitamins, of transport molecules and some vitamin-dependent proteins in patients with ARF and healthy controls. Setting: Nephrology unit of a university hospital. Patients and Methods: Eight patients with ARF requiring hemodialysis therapy were investigated and 28 healthy volunteers served as controls. Plasma concentrations of retinol (vitamin A) and retinol-binding protein (RBP), 25-OH and 1,25-(OH)2 vitamin D3, of parathyroid hormone (PTH), of α-tocopherol (vitamin E) and of phylloquinone (vitamin K), osteocalcin and noncarboxylated osteocalcin, respectively, were measured and plasma lipoprotein fractions (as vitamin transport vehicle) were evaluated. Results: Vitamin A levels were decreased (p < 0.001), but RBP levels were normal in ARF patients. Vitamin D3 metabolites 25-OH and 1,25-(OH)2 vitamin D3 plasma levels were profoundly depressed, and PTH was elevated (p < 0.001). Vitamin E plasma concentration was reduced (p < 0.001) but this cannot be accounted for by decreased LDL cholesterol or triglyceride levels. In contrast, vitamin K plasma level was rather elevated in ARF patients with a broad range of individual values. Blood coagulation was normal but total and carboxylated osteocalcin were decreased. No correlation of vitamin K concentrations and any of the plasma lipoprotein fractions could be identified. Conclusion: With the exception of vitamin K, profound deficiencies of fat-soluble vitamins develop in patients with ARF. Current recommendations for vitamin supplementation are inadequate and should be re-evaluated for these patients.
Childhood Insulin-Dependent Diabetes mellitus: Initial Presentation and Management in the Nineties
Authors: Limbach Thomas , Truttmann Anita C. , Mullis Primus-E. , Bianchetti Mario G.
Published: April 2003

Diabetes mellitus with onset during childhood usually presents as overt ketoacidemia. Pediatricians now inquire specifically about diabetes mellitus in children with nonspecific signs of illness and perform urinary dipstick testing. The present study was therefore performed to assess the possible influence of this strategy on the initial presentation and management of diabetes mellitus. The charts of 61 consecutive children with newly diagnosed diabetes mellitus (positive glucosuria and ketonuria and capillary glucose >14 mmol/l), who had been admitted between 1991 and 1996 at the Department of Pediatrics, University of Bern, Switzerland, were therefore reviewed. Twenty-six out of the 61 patients were nonacidemic (blood pH 7.36 or more). Children with and without acidemia did not differ with respect to age, history of polydipsia and polyuria, plasma glucose and circulating glycated hemoglobin A1c. The degree of dehydration and the amount of fluid required for its correction and the total insulin dosage were more prominent in the group of patients with acidemia. The study demonstrates that childhood diabetes mellitus is nowadays often recognized as nonacidemic hyperglycemia and that in these patients a reduced initial fluid repair and total insulin dosage is recommended.
Lipid Metabolism in Primary Cultured Hepatocytes from Daunomycin-Nephrotic Rats
Authors: Gomikawa Shuzou , Takamitu Yoshihiro
Published: April 2003

We investigated the lipid metabolism in primary cultured hepatocytes to elucidate the causes of hyperlipidemia, increased cholesteryl esters, and decreased triglyceride levels in the livers of daunomycin-nephrotic rats. The incorporation of 14C-palmitate into phospholipids and triglycerides in primary cultured hepatocytes and medium was similar in daunomycin-nephrotic and control rats. The incorporation of 14C-acetate into phospholipids, triglycerides, cholesterol, cholesteryl esters, and total fatty acids in primary cultured hepatocytes was increased in daunomycin-nephrotic rats. The radioactivity of phospholipids, triglycerides, cholesterol, cholesteryl esters, and very-low-density lipoprotein lipids in medium was increased in the hepatocytes of daunomycin-nephrotic rats using 14C-acetate as a precursor. The increased cholesterogenesis and the increased secretion of triglycerides synthesized from acetate by hepatocytes may be due to an increased cholesteryl ester content and a decreased triglyceride content in the livers of daunomycin-nephrotic rats. The increased secretion of lipids synthesized from acetate by hepatocytes may be due to increased accumulation of lipids in serum and very-low-density lipoprotein in daunomycin-nephrotic rats.