bluuebunny/crossref_metadata_2025 huggingface dataset:
Inhibitory Effects of Artesunate on Angiogenesis and on Expressions of Vascular Endothelial Growth Factor and VEGF Receptor KDR/flk-1
Authors: Chen Huan-Huan , Zhou Hui-Jun , Wu Guo-Dong , Lou Xiao-E.
Published: April 2004

Artesunate (ART) is a semi-synthetic derivative of artemisinin extracted from the plant Artemisia annua is a safe and effective antimalarial drug. In the present investigation, ART was found also to inhibit angiogenesis in vivo and in vitro. The anti-angiogenic effect in vivo was evaluated in nude mice by means of human ovarian cancer HO-8910 implantation and immunohistochemical stainings for microvessel (CD31), vascular endothelial growth factor (VEGF) and VEGF receptor KDR/flk-1. Tumor growth was decreased and microvessel density was reduced following drug treatment with no apparent toxicity to the animals. ART also remarkably lowered VEGF expression on tumor cells and KDR/flk-1 expression on endothelial cells as well as tumor cells. The in vitro effect of ART was tested on models of angiogenesis, namely, proliferation, migration and tube formation of human umbilical vein endothelial cells (HUVEC). The results showed that ART significantly inhibited angiogenesis in a dose-dependent form in the range of 0.5∼50 µmol/l. Additionally, the inhibitory effect of ART on HVUEC proliferation was stronger than that on Hela, JAR, HO-8910 cancer cells, NIH-3T3 fibroblast cells and human endometrial cells, indicating that ART was selectively against HUVEC. These findings and the known low toxicity of ART are clues that ART may be a promising angiogenesis inhibitor.
Evidence for a Mitochondrial Impact of Trimetazidine during Cold Ischemia and Reperfusion
Authors: Baumert Hervé , Faure Jean-Pierre , Zhang Keqiang , Petit Isabelle , Goujon Jean Michel , Dutheil Delphine , Favreau Frédéric , Barrière Michel , Tillement Jean Paul , Mauco Gérard , Papadopoulos Vassilios , Hauet Thierry
Published: April 2004

In organ transplantation, ischemia-reperfusion injury (IRI) has been implicated in delayed graft function (DGF) as well as in short- and long-term complications. Using an autotransplant pig kidney model, changes in renal function and morphology were determined after different periods of cold ischemia in kidneys preserved in the University of Wisconsin solution (UW), high-Na+ version of UW (HEH) or Celsior (CEL) a newly developed high-Na+ solution, with or without trimetazidine (TMZ). Kidney function was better preserved in CEL, UW and particularly HEH in combination with TMZ, particularly after 48 and 72 h. Mitochondria integrity was improved in TMZ-preserved groups. This study indicates that TMZ is efficiently protective against IRI even after prolonged preservation and in different preservation solutions.
Toxicity and Cell Cycle Effects of Synthetic 8-Prenylnaringenin and Derivatives in Human Cells
Authors: Tokalov Sergey V. , Henker Yvonne , Schwab Pia , Metz Peter , Gutzeit Herwig O.
Published: April 2004

The estrogenic flavanone rac-8-prenylnaringenin (8-PN) and 3 derivatives (rac-7-(O-prenyl)naringenin-4′-acetate (7-O-PN), rac-5-(O-prenyl)naringenin-4′,7-diacetate (5-O-PN), and rac-6-(1,1-dimethylallyl)naringenin (6-DMAN) were prepared by chemical synthesis and analyzed with respect to their toxicity and possible cell cycle effects in human acute myeloid leukemia (HL-60) cells. With the exception of 5-O-PN, all the other naringenins showed only weak toxic effects at concentrations below 50 µmol/l. A cell cycle analysis over several cell generations up to 4 days was carried out using the fluorescent dye carboxyfluorescein diacetate N-succinimidyl ester (CFSE) followed by propidium iodide (PI) staining at the end of the experiment. The well-studied flavonol quercetin was included in the analysis as a reference substance. All flavonoids affected cell proliferation, but the extent and the resulting changes in the proliferation pattern were specific for each substance. In contrast to the radical scavenging activity of quercetin, the tested flavanones showed no anti-oxidative properties using several different test systems. Similarly, the mitochondrial membrane potential (ΔΨm) was hardly effected by these compounds, while both menadione and quercetin strongly reduced the potential after 1 h of treatment. The reported chemical modification of interesting lead substances (like the strongly estrogenic 8-PN) presents a promising approach to modulate the properties of a relevant substance in a pharmacologically desirable way. The low toxicity and weak cytostatic properties of the tested naringenin derivatives is encouraging for further studies on known naringenin target molecules.
Modulation of Multidrug-Resistance-Associated P-Glycoprotein in Human U-87 MG and HUV-ECC Cells with Antisense Oligodeoxynucleotides to MDR1 mRNA
Authors: Rittierodt Marion , Tschernig Thomas , Harada Kunyu
Published: April 2004

Objective: Glioblastoma is the highest dedifferentiated form of astrocytic brain tumors, and it is refractory to chemotherapy in most cases. To improve the clinical outcome of such tumors, new therapeutic strategies are needed. While malignancy is mainly associated with a nonfunctional apoptotic pathway, the lack of chemotherapeutic success correlates with overexpression of the multidrug resistance 1 (MDR1) gene product P-glycoprotein (P-gp). Previous investigations have shown that not only glioblastoma cells but also endothelial cells are important in the response to chemotherapy. The aim of the present investigations was to reduce the expression of P-gp in the human glioblastoma cell line U-87 MG and in the human endothelial cell line HUV-ECC. Methods: Therefore, these cells were treated with antisense oligodeoxynucleotides (asn-ODN) directed against the P-gp mRNA in order to increase the intracellular retention of doxorubicin (DOX) which had been given previously. Results: Flow cytometry revealed about 4-fold increased intracellular retention of DOX in both asn-ODN-treated cell lines as compared to asn-ODN non-treated cell lines. Conclusion: These results suggest that asn-ODN-mediated inhibition of P-gp expression is an efficient way to increase intracellular retention of DOX.
Frequent Loss of RUNX3 Expression by Promoter Hypermethylation in Gastric Carcinoma
Authors: Oshimo Yasuhiro , Oue Naohide , Mitani Yoshitsugu , Nakayama Hirofumi , Kitadai Yasuhiko , Yoshida Kazuhiro , Ito Yoshiaki , Chayama Kazuaki , Yasui Wataru
Published: April 2004

The RUNX3 gene is a member of the Runt domain family of transcription factors that are master regulators of gene expression in major developmental pathways. Recently, lack of RUNX3 function was found to be associated with genesis and progression of gastric carcinoma. We studied methylation of CpG islands in the RUNX3 gene by methylation-specific PCR in 80 gastric carcinoma specimens, 45 corresponding non-neoplastic mucosae, and 7 gastric carcinoma cell lines. We also measured levels of RUNX3 mRNA in 50 of the gastric carcinoma cases by quantitative RT-PCR and in the gastric carcinoma cell lines by RT-PCR. Hypermethylation of the RUNX3 promoter was found in 57 (71%) of 80 gastric carcinomas, and promoter hypermethylation of RUNX3 occurred more frequently in intestinal and diffuse-adherent type tumors than in diffuse-scattered type tumors (p = 0.046). Reduced RUNX3 expression was associated with promoter hypermethylation (p = 0. 036), however, there was no correlation between RUNX3 mRNA expression levels and T grade, N grade, tumor stage, or histological type. In corresponding non-neoplastic mucosae, hypermethylation of the RUNX3 promoter was found in 38 (84%) of 45 specimens. Among seven gastric carcinoma cell lines, three cell lines (MKN-28, MKN-74, TMK-1) with diminished expression of RUNX3 had promoter methylation and three cell lines (MKN-1, MKN-7, MKN-45) with RUNX3 expression showed no promoter methylation. Our results overall suggest that transcriptional inactivation of RUNX3 by promoter hypermethylation may participate in the stomach carcinogenesis.
The Cardiff Acne Disability Index: Cultural and Linguistic Validation in French
Authors: Dreno Brigitte , Finlay Andrew Y. , Nocera Thérèse , Verrière François , Taïeb Charles , Myon Eric
Published: April 2004

Background: The Cardiff Acne Disability Index (CADI) evaluates the impact of acne on the patient’s life. Objective: The objective of the present study was to translate the CADI into French and to validate the French version. Method: The CADI was translated into French following international methodological recommendations (translation, quality control, back-translation and pilot test). Results: Compatibility difficulties between the cultural background of UK and France were identified and resolved by the translation process, which should guarantee that specific words and phrases reflect the cultures in the respective countries. A pilot test in volunteers demonstrated the clarity and understandability of the questions across social classes and ages. A preliminary test-retest comparison of the final scale showed sufficient reliability, with a correlation coefficient of 0.90 for the total CADI score of the French version. Moreover, the good internal consistency of the scale was demonstrated with a Cronbach α of 0.87. Conclusion: The CADI, a valuable tool for assessing the impact of acne on a patient’s life, can now be used in French.
Familial Lassueur-Graham-Little-Piccardi Syndrome
Authors: Viglizzo Gianmaria , Verrini Anna , Rongioletti Franco
Published: April 2004

Lassueur-Graham-Little-Piccardi syndrome (LGLPS) is a rare lichenoid dermatosis characterized by progressive cicatricial alopecia of the scalp, loss of pubic and axillary hairs and keratosis pilaris. The syndrome is considered a form of follicular lichen planus (LP). Although the familial occurrence of LP is a well-described phenomenon, no familial case of LGLPS has ever been reported. We describe the occurrence of LGLPS in a mother and her daughter. HLA typing revealed HLA-DR1 in both patients. Topical tacrolimus was of partial benefit in the daughter.
Successful Treatment of Cutaneous Langerhans Cell Histiocytosis with Thalidomide
Authors: Sander C.S. , Kaatz M. , Elsner P.
Published: April 2004

Langerhans cell histiocytosis (LCH) represents a group of rare histiocytic syndromes characterized by tissue infiltration with dendritic cells. The management of LCH is difficult as these disorders respond inconsistently to immunosuppressive and chemotherapeutic strategies. Thalidomide (N-phtalimidoglutarimide), initially used as a tranquilizer, has recently been used in the management of several inflammatory skin diseases. We describe the case of a 38-year-old male with mucocutaneous LCH. A treatment course with 6 cycles of 2-chlorodeoxyadenosin (cladribine) was initiated. This was well tolerated but withdrawn after 6 months to prevent secondary malignancy. A partial remission was seen. Subsequently, a treatment course with thalidomide 200 mg daily was started. This therapy resulted in a significant improvement of the mucocutaneous lesions within 4 weeks and complete healing was achieved after 3 months. Treatment was then successfully continued with daily doses of 100 mg to prevent relapse. In conclusion, thalidomide monotherapy represents an effective, safe and well-tolerated treatment option that should be considered as first-line therapy for mucocutaneous LCH.
Purpuric Generalized Lichen nitidus: An Unusual Eruption Simulating Pigmented Purpuric Dermatosis
Authors: Yáñez Sonsoles , Val-Bernal J. Fernando
Published: April 2004

Background: Generalized haemorrhagic lichen nitidus is rare. To our knowledge, this form of presentation has only been reported once. Objective: To describe a new case of generalized haemorrhagic lichen nitidus simulating a pigmented purpuric dermatosis. Methods and Results: We document a 24-year-old man who presented with an 8-month history of a progressive non-pruritic, red-brown papular eruption on the dorsa of the feet, ankles and distal third of the legs. A diagnosis of Schamberg’s progressive pigmentary dermatosis was made, and no treatment was prescribed. Two months later, the lesions had extended to the abdomen, groins, forearms, elbows and wrists. Biopsy of the skin of the right foot revealed lesions typical of lichen nitidus with subepidermal extravasation of red cells and capillary wall hyalinization. Macrophages and T lymphocytes were abundant in the infiltrate. Conclusion: Purpuric generalized lichen nitidus should be included in the differential diagnosis of pigmented purpuric dermatoses.
Neonatal Resuscitation by Laryngeal Mask Airway after Elective Cesarean Section
Authors: Zanardo Vincenzo , Simbi Alphonse Kibwe , Savio Valentina , Micaglio Massimo , Trevisanuto Daniele
Published: April 2004

The aim of this case-control study was to determine whether unplanned resuscitation using a laryngeal mask airway (LMA) is suitable for neonates delivered by elective cesarean section, a procedure known to carry a risk of inadequate physiological response to birth with a consequent adverse respiratory outcome. During a 3-year period, from January 1998 to December 2000, all newborns delivered by elective cesarean section at term were compared with the next infant born vaginally in the same maternity unit (level III center). The two groups were matched for gestational age >37 weeks. The requirement for resuscitation with positive-pressure ventilation (PPV) using either the LMA or an endotracheal tube (ETT), together with the occurrence of an adverse neonatal outcome, was recorded and analyzed in the cesarean section and vaginal delivery groups. During this time 1,284 at-term elective cesarean sections were performed. 3% (n = 43) of the cesarean section deliveries and 1.4% (n = 18) of the vaginal controls required PPV resuscitation by LMA or ETT, a significant difference (OR 1.26; 95% CI 2.38–5.1; p < 0.01). Of the cesarean section group requiring resuscitation, 30 neonates were managed with the LMA and 13 with the ETT, while in the control vaginal delivery group the numbers were 13 and 5, respectively. LMA use accounted of about 70% of the overall PPV resuscitations and was associated with a successful outcome in 42 of 43 cases. One case was unsuccessfully managed with the LMA, and the ETT subsequently used was effective. Moreover, the probability for the LMA-resuscitated newborns of both cesarean and vaginal groups to have a <5 Apgar score at 1 and 5 min, neonatal intensive care unit admission, and respiratory insufficiency requiring oxygen and intermittent mandatory ventilation was statistically lower than for the ETT group (p < 0.01). In conclusion, infants born by elective cesarean section at term are at increased risk of requiring PPV resuscitation as compared with those born by vaginal delivery. We have shown that about 70% of the neonates who required PPV resuscitation after elective cesarean section and vaginal delivery were arbitrarily treated with LMA by the attending anesthesiologist, without adverse negative respiratory outcome.
Clinical, Cytogenetic and Molecular Investigation in a Fetus with Wolf-Hirschhorn Syndrome with Paternally Derived 4p Deletion
Authors: Dietze Ilona , Fritz Barbara , Huhle Dagmar , Simoens Wouter , Piecha Ernestine , Rehder Helga
Published: April 2004

Wolf-Hirschhorn (4p-) syndrome (WHS), caused by partial deletion of the short arm of chromosome 4, has been extensively described in children and young adults. Knowledge on fetuses with WHS is still limited due to the small number of published cases. We report on a fetus with prenatally diagnosed severe intrauterine growth retardation, reduced thoracal diameter, clubfeet deformity and midface hypoplasia including slight microretrognathia indicative for fetal karyotyping. Chromosome analysis after amniocentesis revealed a de novo terminal deletion of chromosome 4p [karyotype: 46,XX,del(4) (p16)] which was confirmed by FISH. Analyses of a set of polymorphic markers mapping in 4pter->4p15.3 showed absence of paternal haplotypes. These observations corroborate the preferential paternal origin of the de novo 4p deletion in WHS patients. Furthermore, the distal breakpoint could be narrowed to band 4p16.1. At autopsy, the fetus showed typical craniofacial dysmorphic signs of WHS, severe IUGR and delayed bone age. This report suggests the possibility of recognising the particular phenotype of WHS in utero by prenatal ultrasound and emphasises the importance of karyotyping fetuses with severe IUGR, especially when the amount of amniotic fluid is normal.
Second and Third Medical Termination of Pregnancy with Misoprostol without Mifepristone
Authors: Langer Bruno R. , Peter Christine , Firtion Céline , David Eric , Haberstich Renaud
Published: April 2004

Background: Advances in prenatal diagnosis make it possible to detect many fetal pathologies for which a termination of pregnancy (TOP) is possible in France. In pregnancies which go beyond 3 months, the use of prostaglandins combined with mifepristone has simplified this procedure. Since mifepristone must be taken 48 h before using prostaglandins, we have used only misoprostol intravaginally. Methods: Our report deals with a continuous series of terminated pregnancies in the second and third trimesters. The time period in question is January 1, 1996 through July 31, 2001. When this treatment was used within the first 30 weeks of gestation, four tablets (800 µg) of misoprostol were administered intravaginally. When there were no contractions, two additional tablets (400 µg) of misoprostol were given orally every 3 h, not exceeding 3 times. Beyond 30 weeks of amenorrhoea, because of the risk of uterine rupture, the initial dose was lower: 1/4 tablet (50 µg) of misoprostol intravaginally was increased to 100 µg (1/2 tablet) every 3 h until expulsion. Results: In the second and third trimesters, 55 pregnancies were terminated medically; only 1 case was not successful. In the other 54 cases, the average time interval between administering misoprostol intravaginally and expulsion was 12.7 ± 8 h. Side effects included nausea or vomiting for 12 patients (22%) and hyperthermia for 11 patients (20%). Thirty-three patients (60%) had no side effects at all. In 10 cases (18%), the fetus and the placenta were removed in one movement. In 11 cases (20%), the placenta had to be removed by artificial means. In 7 cases (13%), a curettage with a curette foam was done. In the long run perspective, only 1 patient needed a curettage to remove placental residue. Conclusion: Treatment by misoprostol without mifepristone during the second and third trimesters makes it possible to terminate a pregnancy easily and quickly without significant complications.
Epidural versus General Anesthesia for Twin-Twin Transfusion Syndrome Requiring Fetal Surgery
Authors: Myers Laura B. , Watcha Mehernoor F.
Published: April 2004

Objectives: This paper describes our experiences with epidural and general anesthesia for selective fetoscopic laser photocoagulation (SFLP) of placental vascular anastomoses in patients with severe twin-twin transfusion syndrome (TTTS). Methods: Retrospective review of 29 anesthetic and surgical operative records of 28 women undergoing SFLP at The Children’s Hospital of Philadelphia from July 1996 to June 2001. Results: Patients with anterior placentas were more likely to receive a general anesthetic. Patients receiving an epidural anesthetic received significantly more intravenous (i.v.) crystalloid but less i.v. fentanyl than those receiving a general or combined technique. Conclusions: The advantages of general anesthesia include increased ability of the patient to tolerate extreme positions and the surgical manipulation of the uterus (required in the technically more difficult cases), greater uterine relaxation, decreased use of i.v. fluids, but increased fentanyl requirements. Epidural anesthesia avoids the risks of failed tracheal intubation in pregnant women but may not reduce fetal responses to surgical stimuli unless the mother receives supplemental intravenous drugs. However, this may increase the risk of respiratory depression. The choice of anesthetic technique for SFLP in patients with severe TTTS must be made after careful consideration of maternal and fetal factors.
The Closure of Iatrogenic Membrane Defects after Amniocentesis and Endoscopic Intrauterine Procedures
Authors: Young Bruce K. , Roman Ashley S. , MacKenzie Andrew P. , Stephenson Courtney D. , Minior Victoria , Rebarber Andrei , Timor-Tritsch Ilan
Published: April 2004

Objective: To describe a new technique for wound closure after endoscopic intrauterine procedures which prevents amniotic fluid leakage after the procedure. Study Design: This is an observational study which reviews a new technique under an IRB-approved protocol. The rationale for this study was the increasing frequency of intrauterine endoscopic procedures. The most common complication of these procedures is persistent leakage of amniotic fluid from puncture sites, which can result in preterm labor and preterm delivery. Thus, these procedures carry a high morbidity rate that may overcome the benefit of the intervention. We have employed a new technique, which has successfully prevented amniotic fluid leakage following the procedure. The instruments used for the endoscopic procedures were no larger than 3.5 mm for all cases. A sealant of platelets was rapidly injected followed by injection of fibrin glue and powdered collagen slurry at each puncture site. Sonography for modified AFI, clinical examination for nitrazine and ferning, and pad count were performed after each procedure at three intervals: immediately after the procedure, 24 h and 48 h. Results: Eight patients undergoing an endoscopic intrauterine procedure (either cord ligation for twin-twin transfusion syndrome or sealing of ruptured membranes after amniocentesis) were included. All patients were treated between 18 and 24 weeks of gestation. Sonography, clinical examination and pad count revealed no evidence of amniotic fluid leakage either intra-abdominally or vaginally in any of the patients. There was 1 patient who ruptured membranes 12 h after the procedure due to severe vomiting. Another patient elected to terminate the pregnancy 48 h after the procedure without evidence of leakage. The remaining patients continued for 8 weeks or more without fluid leakage. Conclusion: The technique described, immediate sealing of puncture wounds following endoscopic intrauterine procedures, is effective in preventing amniotic fluid loss after the procedure.
Limited Prognostic Value of a Staging System for Twin-to-Twin Transfusion Syndrome
Authors: Luks François I. , Carr Stephen R. , Plevyak Michael , Craigo Sabrina D. , Athanassiou Achilles , Ralston Steven J. , Tracy Jr. Thomas F.
Published: April 2004

Objective: Severe twin-to-twin transfusion syndrome (TTTS) is usually classified according to a staging system (I–V) based on ultrasonographic findings of polyhydramnios in the recipient, oligohydramnios in the donor, the presence or absence of the donor’s bladder, Doppler waveform changes and (impending) hydrops. Stage correlates with the severity of disease, and it is assumed that, without intervention, severe TTTS will evolve in succession from stage I to stage V (fetal demise). However, this progression has not been validated in longitudinal studies. Herein, we report on the natural progression of severe TTTS in a cohort of patients from a regional Fetal Treatment Program. Methods: Eighteen patients with severe TTTS, diagnosed between 15 and 25 weeks of gestation, were managed over a 28-month period. Data were collected until delivery, endoscopic surgical intervention or dual fetal demise. Patients were evaluated at least once a week. Stage, estimated fetal weight, percent recipient/donor body weight discordance and survival were recorded. Results: The present study represents a total follow-up of 108 patient-weeks. Of 90 week-to-week evaluations, 65 showed no change in stage; 11 showed downstaging (by more than 1 stage in 3, or 27%), and 13 showed upstaging (by more than 1 stage in 8, or 62%). Nine patients (all stage II or above) underwent endoscopic laser ablation. Overall survival was 67%, and survival of at least 1 twin occurred in 78% of pregnancies. Weight discordance between the donor and recipient did not predict outcome. Conclusion: The current staging system for severe TTTS may not be helpful in predicting the direction, degree or speed of progression of the condition. Indications for intervention should remain stage-related, and not based on projected progression.
Diminished Expression of Sodium Transporters in the Ureteral Obstructed Kidney in Rats
Authors: Kim Soo Wan , Lee JongUn , Jung Kwon , Ma Seong Kwon , Oh YoonWha , Kim Wan-Young , Choi Ki Chul , Kim Jin
Published: April 2004

Background/Aims: Whether the postobstructive natriuresis and diuresis is related with an altered regulation of sodium transporters in the kidney was examined. Methods: Male Sprague-Dawley rats underwent either bilateral (BUO) or unilateral obstruction (UUO) of the proximal ureters for 24 h. The expression of Na,K-ATPase, type-3 sodium-hydrogen exchanger (NHE3), type-1 bumetanide-sensitive sodium cotransporter (BSC1), and thiazide-sensitive sodium cotransporter (TSC) proteins was determined in the obstructed kidney by Western blot analysis and immunohistochemistry. Catalytic activity of Na,K-ATPase was also determined. Results: The expression of α1 and β1 subunit proteins and the catalytic activity of Na,K-ATPase were significantly decreased in the obstructed kidney in BUO. The expressions of NHE3, BSC1 and TSC proteins were also significantly decreased. Immunohistochemistry confirmed the downregulation of these sodium transporters in the obstructed kidney. In UUO, the expression of sodium transporters was similarly decreased in the obstructed kidney. Conclusion: The postobstructive natriuresis and diuresis may in part be accounted for by a reduced abundance of sodium transporters in the kidney.
Gene Regulation of Renal-Osmotic Stress-Induced Na-Cl Organic Solute Cotransporter
Authors: Baba Tomoko , Nonoguchi Hiroshi , Itoh Kazuko , Nakayama Yushi , Kohda Yukimasa , Inoue Takeaki , Tomita Kimio
Published: April 2004

Background: Na- and Cl-dependent organic solute cotransporters participate in transporting neurotransmitters in the brain and organic osmolytes in the kidney. Methods: We examined the intranephron localization and regulation of the renal osmotic-stress-induced Na-Cl organic solute cotransporter (ROSIT) mRNA expression using microdissected nephron segments from control and dehydrated rats and RT-PCR. To further know the mechanisms of gene regulation of ROSIT, microdissected proximal straight tubules (PST) were incubated in isotonic (290 mosm/kg H2O) or hyperosmotic (490– 1,090 mosm/kg H2O) solution. Results: ROSIT mRNA was expressed predominantly in PST and to a lesser extent in cortical thick ascending limbs and cortical collecting ducts in control rats, and dehydration caused an increase in the expression in whole nephron segments. ROSIT mRNA in PST was decreased with time by incubation in isotonic solution. Incubation of PST in hypertonic solution by adding NaCl increased mRNA expression as early as 15 min (1.5- and 3-fold at 15 and 30 min, respectively). This stimulating effect of NaCl was largest at 890 mosm/kg H2O. Hypertonicity by mannitol or myoinositol also increased ROSIT mRNA expression. In contrast, hyperosmolality by urea reduced ROSIT mRNA expression. GAPDH mRNA expression, an internal standard, did not change by incubation in NaCl or mannitol solution. Conclusion: In summary, ROSIT mRNA expression was most abundant in PST in control and it was stimulated in whole nephron segments by dehydration. ROSIT mRNA expression in PST was stimulated by hypertonicity but not by urea. These data suggest that ROSIT may participate in the transport of amino acid under control conditions and organic osmolytes in dehydration.
Bartter’s and Gitelman’s Syndromes: From Gene to Clinic
Authors: Naesens Maarten , Steels Paul , Verberckmoes René , Vanrenterghem Yves , Kuypers Dirk
Published: April 2004

Bartter’s and Gitelman’s syndromes are characterized by hypokalemia, normal to low blood pressure and hypochloremic metabolic alkalosis. Recently, investigators have been able to demonstrate mutations of six genes encoding several renal tubular transporters and ion channels that can be held responsible for Bartter’s and Gitelman’s syndromes. Neonatal Bartter’s syndrome is caused by mutations of NKCC2 or ROMK, classic Bartter’s syndrome by mutations of ClC-Kb, Bartter’s syndrome associated with sensorineural deafness is due to mutations of BSND, Gitelman’s syndrome to mutations of NCCT and Bartter’s syndrome associated with autosomal dominant hypocalcemia is linked to mutations of CASR. We review the pathophysiology of these syndromes in relation to their clinical presentation.
Burn Septicaemia in Kuwait: Associated Demographic and Clinical Factors
Authors: Bang Rameshwar L. , Sharma Prem N. , Sanyal Suhas C. , Bang Sarla , Ebrahim Mohammed K.
Published: April 2004

Objective: To study the demographic and clinical factors associated with burn septicaemia patients in Kuwait. Materials and Methods: All burn in-patients, who developed septicaemia at the Burns Unit, Al-Babtain Centre for Burns and Plastic Surgery, Kuwait, during a 9-year period (June 1992 to May 2001) were included in the study. The data were recorded for age, sex, nationality, cause and percentage of burns, inhalation injury, resuscitation, number of episodes, septicaemia on post-burn day, the microorganisms responsible in each episode, treatment and outcome for statistical analysis. Using SPSS (PC version 11.0) software, a probability level of p < 0.05 was considered significant. Results: Of the 2,082 patients treated in the Burns Unit, 166 [8%; 99 (60%) males and 67 (40%) females] with a mean age of 26 years (range 1–70) had septicaemia. Significantly higher (p < 0.001) cases were recorded among Kuwaiti children (≤14 years) and non-Kuwaitis (25–59 years) than other corresponding age groups. The total body surface area burned ranged from 2 to 95% (mean 42%) and the main cause of burn was flame (77.1%). Inhalation injury was diagnosed in 39 (23.5%) patients. A total of 253 septicaemic episodes occurred in all patients. The majority, 123 (74.1%), had a single episode and the remaining 43 (25.6%) had multiple (2–10) episodes. One hundred and fifty-five (61.3%) episodes were due to gram-positive organisms, mainly methicillin-resistant Staphylococcus aureus, and 32 (12.7%) were polymicrobial. One hundred and twenty-four (74.7%) patients had wound excision and skin grafting procedures and their survival was significantly higher (OR = 4.3; 95% CI: 1.98–9.31) than non-surgically treated patients. Thirty-nine (23.5%) patients died mainly due to multi-organ failure. Conclusion: The findings indicate that the patients with extensive flame burns were prone to developing septicaemia due mainly to gram-positive bacteria. The surgical excision of eschar and wound covering improved the outcome of the patients while prophylactic antibiotic treatment had no role in the incidence and outcome of the burn patients.
A Survey of 150 Video-Assisted Thoracoscopic Procedures in Kuwait
Authors: Ayed Adel K. , Al-Shawaf Emad
Published: April 2004

Objective: To review our experience of indications, technique, and complications as they relate to video-assisted thoracoscopic surgery (VATS) in the diagnosis and management of intrathoracic diseases. Subjects and Methods: One hundred and fifty consecutive VATS procedures, which were performed over a 3-year period, were retrospectively evaluated. Indications included recurrent or persistent primary spontaneous pneumothorax (n = 73 patients), lung biopsies for diagnosis of diffuse lung disease (n = 33), pleural biopsies (n = 18), wedge resections of pulmonary nodules (n = 8), bilateral thoracic sympathectomy (n = 6), decortication (n = 5), mediastinal tumor biopsies (n = 5), excision of bullous emphysema (n = 1), and removal of a foreign body from the pleural cavity (n = 1). An alternative method of manipulating thoracoscopic instruments without using a trocar is described. Results: Of the 150 VATS procedures, 127 (85%) were successfully performed, 6 (4%) were converted to thoracotomy and 17 (11%) had complications. The most common complication was prolonged air leak, which occurred in 9 patients. The average postoperative hospital stay was 4 days (range: 2–17). Diagnostic procedures were considered successful in 32 out of 33 lung biopsies and in all 18 patients with pleural diseases, 8 lung nodules, or 5 mediastinal tumor biopsies. The other 86 therapeutic VATS procedures were effective in 82 (95%) patients. Four (5%) patients had a recurrence of the pneumothorax after VATS. Conclusion: Thoracoscopy and the use of a nontrocar technique is a safe and effective method for the diagnosis and treatment of intrathoracic diseases.
Polymyositis and Hepatitis Concurrent with Breast Cancer
Authors: Yamac Deniz , Gunel Nazan , Goker Berna , Coskun Ugur , Erdem Ozlem , Akyol Gulen , Ozenirler Seren
Published: April 2004

Objective: To present a rare case of breast cancer associated with both inflammatory muscle disease and liver disease as a paraneoplastic syndrome. Clinical Presentation and Intervention: A woman with breast cancer presented with elevated liver enzymes and progressive proximal muscle weakness. Liver biopsy was consistent with hepatitis and muscle biopsy revealed myositis. The start of corticosteroid therapy was followed by relief of the myopathic symptoms and regression of hepatitis histopathologically. Conclusion: A case of polymyositis and hepatitis associated with breast cancer and their flare-up with recurrence of malignancy is presented. In this case, the temporal relation with malignancy following its concurrent remission and relapse suggests a paraneoplastic mechanism.
Recognition of Apertures in Overhead Transparent Barriers by Leopard Frogs
Authors: Saltzman Heath , Zacharatos Mario , Gruberg Edward R.
Published: April 2004

Anurans have independent systems for detecting moving stimuli and stationary opaque objects. We have discovered that leopard frogs will also orient to, and spontaneously and accurately jump through, circular apertures in overhead transparent covers. When given a choice between one large aperture of 3.8 cm diameter, and three apertures of smaller but equal diameter (2.5 cm diameter, 1.9 cm diameter, or 1.3 cm diameter) they choose the larger diameter aperture at a frequency (64, 87 and 97%, respectively) that is statistically greater than chance. In only 1 of 255 attempts was there a jump to the overhead cover that was not directed at an aperture. Atectal frogs are still able to detect and jump accurately through transparent apertures. Frogs cannot distinguish between two apertures of equal diameter if one aperture is covered with clear plastic with high light transmissibility (92% of transmissibility of air). However, if the plastic covering of the aperture has a residue which reduces light through the cover from 92 to 87% of the transmissibility of air, frogs will jump to the uncovered aperture at a frequency that is statistically greater than chance. Our results show that leopard frogs have an extremely well developed ability to detect overhead apertures just as they can vertical obstacles. They are able to jump towards such openings with a small margin of error independent of the tectal visual system.
Retinal Morphology and Electrophysiology of Two Caprimulgiformes Birds: The Cave-Living and Nocturnal Oilbird (Steatornis caripensis), and the Crepuscularly and Nocturnally Foraging Common Pauraque (Nyctidromus albicollis)
Authors: Rojas L.M. , Ramírez Y. , McNeil R. , Mitchell M. , Marín G.
Published: April 2004

Oilbirds (Steatornis caripensis) breed in the total darkness of caves and forage at night on fruits. Common pauraques (Nyctidromus albicollis) are crepuscular and nocturnal foragers on flying insects. We examined if their retinal structure and function can be correlated with their types and periods of activity. Electroretinograms (ERGs) were obtained from anesthetized birds in photopic and scotopic conditions to a wide range of light intensities, following which the retinas were processed for histological analysis. Retinal sensitivity is higher in oilbirds than in common pauraques. Under scotopic conditions with maximum flash luminance, the average (± 95% CI) b-wave amplitude of oilbirds is double that of common pauraques (500.4 ± 49.8 and 245.4 ± 40.9 µV, respectively) but, under photopic conditions, the results are the reverse (common pauraque: 69.4 ± 18.1; oilbird: 23.0 ± 4.4 µV). On the other hand, the retina of both species is highly rod-dominated, but rods are highly more numerous in oilbirds than in common pauraques (rods:cones ratio: 123:1 and 5:1, respectively). In oilbirds, rods are largely thinner and their outer segments are 1.0 µm in diameter and 18.6 µm in length. They are distributed over various levels in the photoreceptor layers, an arrangement known for deep-sea fishes, but so far unknown for birds. In common pauraques, rods are patchily distributed and their outer segments are 4.0 µm in diameter and 53 µm in length. The oilbirds rod thinness allows more rods per area unit, and thus to catch more photons per area unit under darkness, while the low cone number suggests that the species has poor daytime vision, which concurs with the species cavernicolous daytime habits. The lower rod number of common pauraques, compared to oilbirds, appears counterbalanced by their patchiness and longer and thicker outer segments to provide high retinal sensitivity. In addition, common pauraques also have a tapetum. These features, combined with a higher proportion of cones, show that common pauraques are well equipped for crepuscular and nocturnal foraging on flying insects in an open environment.
Dimension of Typus melancholicus on Kasahara’s Inventory for the Melancholic Type Personality
Authors: Ueki Hirofumi , Holzapfel Christian , Sakado Kaoru , Washino Kaei , Inoue Masato , Ogawa Naoshi
Published: April 2004

Background: Traditionally, Typus melancholicus (TM) was considered, a priori, to represent unidimensionality. Recent studies have suggested that TM is not a personality trait, but rather a constellation of personality traits. The purpose of this study was to examine whether TM on Kasahara’s Inventory for the Melancholic Type Personality (KIMTP), considered to represent one of the valid TM questionnaires, is comprised of personality dimensions, and if so, which dimension is essential for distinguishing depressive subjects from control subjects. Subjects and Methods: To clarify the dimensionality of TM scores on KIMTP, factor analysis of the TM scores was conducted using principal factor analysis followed by varimax rotation. Comparisons were then made between endogenous depressive patients (n = 38), nonendogenous depressive patients (n = 20), and healthy volunteers (n = 81) for total KIMTP score and factor scores using analysis of covariance, adjusting for sex and age. Results: Factor analysis of KIMTP revealed 2 distinct clusters of items, i.e. ‘harmony in personal relationships’ (factor 1) and ‘social norms’ (factor 2). Endogenous and nonendogenous depressive patients showed significantly higher KIMTP total and factor 1 scores than did control subjects. However, no significant differences were observed for KIMTP total score and scores of individual factors between endogenous and nonendogenous depressive patients. Conclusions: The present results indicate that TM on KIMTP represents a constellation of personality traits, and that the factor ‘harmony in personal relationship’ possesses the essential meaning for assessing TM.
Relation between Maternal Body Composition and Birth Weight
Authors: Sanin Aguirre Luz Helena , Reza-López Sandra , Levario-Carrillo Margarita
Published: April 2004

In order to establish the relationship between maternal body composition indicators (fat-free mass, fat mass, total body water) and birth weight, a cross-sectional study was designed, based on 196 pairs of mothers and live singleton newborns with gestational age of 37 weeks or more. Immediately after delivery, the mothers were interviewed to obtain information about different birth weight predictors. An analysis of maternal body composition through bioelectric impedance was held. Multiple linear regression was used to measure the effect of each variable on birth weight. The birth weight mean was 3,251 ± 514 g. Maternal height was 160.44 ± 6.3 cm, total net weight gain was 5.85 ± 5.15 kg, fat mass consisted of 15.84 ± 6.72 kg, and fat-free mass was 50.42 ± 7.65 kg; total body water was 34.82 ± 5.61 liters. The model which included total body water and all predictors found to be associated with birth weight in the bivariate analysis (maternal age, gestational age, gender, placenta weight, and placenta weight squared) was found to be the best in explaining the variability of birth weight (R2 = 45.26%). Fat mass was an important predictor only in the subgroup of women within the low tertile of body mass index. In conclusion, fat-free mass and total body water explained a major proportion of the variability of birth weight in comparison with the mother’s weight gain during the pregnancy period, which has already been considered an important predictor of birth weight.
Population prevalence of psychiatric disorders in Chile: 6-month and 1-month rates
Authors: Vicente Benjamin , Kohn Robert , Rioseco Pedro , Saldivia Sandra , Baker Christine , Torres Silvero
Published: March 2004

Background

Few South American studies have examined current prevalence rates of psychiatric disorders.

Aims

To examine prevalence rates in a nationally representative adult population from Chile.

Method

The Composite International Diagnostic Interview was administered to a stratified random sample of 2978 individuals from four provinces representative of the country's population. Six-month and 1-month prevalence rates were estimated. Demographic correlates, comorbidity and service use were examined.

Results

Nearly a fifth of the Chilean population had had a psychiatric disorder during the preceding 6 months. The 6-month and 1-month prevalence rates were 19.7% and 16.7% respectively. For the 6-month prevalence the five most common disorders were simple phobia, social phobia, agoraphobia, major depressive disorder and alcohol dependence. Less than 30% of those with any psychiatric diagnosis had a comorbid psychiatric disorder and the majority of them had sought treatment from mental health services.

Conclusions

Current prevalence studies are useful indicators of service needs. People with comorbid psychiatric conditions have high rates of service use. The low rate of comorbidity in Chile merits further study.
Prognostic value of frontal functional neuroimaging in late-onset severe major depression
Authors: Navarro Víctor , Gastó Cristóbal , Lomeña Francisco , Torres Xavier , Mateos José J. , Portella María , Masana Guillem , Marcos Teodoro
Published: March 2004

Background

There is growing evidence of a relationship between frontal neuroimaging and neuropsychological abnormalities and the physiopathology and course of late-onset major depression.

Aims

To assess acute antidepressant response in late-onset major depression in relation to baseline frontal perfusion ratios.

Method

A 99mTc HMPAO single photon emission computed tomographic brain scan was performed in medication-free patients with late-onset major depression, who were then included in a 12-week antidepressant treatment regimen. Logistic regression was used to define a predictive model of non-remission.

Results

Atotal of 47 patients completed the study 34 of whom were classed as remitters and 13 as non-remitters. The variable left anterior fronto-cerebellar perfusion ratio had a global predictive power of 87%. Analysing this variable together with the baseline variables age of onset and duration of index episode, the predictive power of the model rose to 94%.

Conclusions

Our study suggests that a specific frontal functioning could predict the acute antidepressant response in late-onset severe major depression.
Longitudinal syndromal and sub-syndromal symptoms after severe depression: 10-year follow-up study
Authors: Kennedy Noel , Abbott Rosemary , Paykel Eugene S.
Published: March 2004

Background

Few follow-up studies of depression have evaluated depressive symptomatology over time at both threshold and sub-threshold levels.

Aims

To evaluate long-term longitudinal symptomatic course after an episode of severe depression.

Method

A total of 61 participants from a previous study cohort underwent a detailed interview covering the longitudinal course of depression and pharmacological treatment over 8–11 years of follow-up.

Results

Of the follow-up months, 52% were spent at an asymptomatic level, 15% at minor symptom level, 20% at residual symptom level and 13% at full depression level. Also, 30% of follow-up months were spent in an episode of depression, and 18% of patients never achieved asymptomatic status during follow-up. The percentage of patients at each symptom level remained relatively stable after the first 2 years, but levels in individuals fluctuated, with a mean of two changes in symptom levels per follow-up year.

Conclusions

After severe episodes, sub-syndromal levels of depression are common and persistent, with considerable fluctuation suggesting a continuum between sub-syndromal subtypes and full depression.
Diabetes and its prevention: Pragmatic solutions for people with schizophrenia
Authors: Gough Stephen , Peveler Robert
Published: March 2004

Background

Patients with schizophrenia have an increased risk of developing diabetes. However, no pragmatic pathway of care has ever been proposed in order to identify individuals at risk and manage that risk effectively.

Aims

To develop practical recommendations for the screening and management of diabetes in schizophrenia.

Method

Staged review of evidence for the under recognition of diabetes in people with schizophrenia and of the applicability of current screening strategies to this population. Recommendations for pragmatic pathways of care were developed.

Results

All patients with schizophrenia should be screened and managed as a high-risk group for the development of diabetes. Psychiatrists should be responsible for screening and diabetes risk management; primary care physicians and/or diabetologists should be responsible for managing diabetes. Choice of antipsychotics should be based on achieving good control of schizophrenia, which may improve compliance with diabetes risk reduction strategies.

Conclusions

Effective multi-disciplinary team working should reduce the burden of diabetes in schizophrenia.
Diagnosis, epidemiology and pathogenesis of diabetes mellitus: An update for psychiatrists
Authors: Holt Richard I. G.
Published: March 2004

Background

Diabetes mellitus is a complex metabolic disorder characterised by persistent hyperglycaemia. The prevalence of diabetes is increased in people with schizophrenia.

Aims

To provide an update of current thinking in diabetes for practising psychiatrists.

Method

Literature review.

Results

Diabetes is a costly condition in individual, social and economic terms, and the global burden of diabetes is increasing in most populations. The insidious onset and asymptomatic nature of diabetes results in many people remaining undiagnosed and at great risk of developing life-threatening vascular complications. Lifestyle and pharmacological interventions can reduce incident diabetes and delay its progression.

Conclusions

Public health policies are urgently required to encourage people to follow a healthy lifestyle. Primary prevention strategies for diabetes should target individuals at especially high risk of developing type 2 diabetes, including those with severe mental illness.