bluuebunny/crossref_metadata_2025 huggingface dataset:
Further Evidence of the Validity and Reliability of the Skindex-29: An Italian Study on 2,242 Dermatological Outpatients
Authors: Abeni Damiano , Picardi Angelo , Pasquini Paolo , Melchi Carmelo Franco , Chren Mary-Margaret
Published: April 2003

Background: Quality of life is increasingly recognized as an important measure in dermatology. The Skindex-29 is a self-administered questionnaire recently developed to measure comprehensively the complex effects of skin diseases on patients’ quality of life. Objective: We aimed to provide further evidence of the reliability and validity of the Skindex-29 in a large sample of patients affected by a wide variety of skin diseases. Methods: An Italian version of the Skindex-29 was produced following accepted guidelines for the cross-cultural adaptation of questionnaires. All adult outpatients attending a dermatological hospital on predetermined days were given the Skindex-29 and the 12-item General Health Questionnaire (GHQ-12). Results: A total of 2,242 complete questionnaires were analyzed. The internal consistency and test-retest reliability of each scale were high. The factor structure of the Skindex-29 was strikingly similar to the one originally observed in American patients. The pattern of correlation with the GHQ-12 provided evidence of convergent validity of the Skindex-29. Conclusion: The instrument seems to measure three fundamental dimensions of skin health-related quality of life.
Electrolytic Ablation of Colorectal Liver Metastases: 1-Year Histological Patient Follow-Up
Authors: Berry D.P. , Dennison A.R. , Ward R. , Maddern G.J.
Published: April 2003

Whilst up to 50% of patients with colorectal carcinoma will develop liver metastases, only 20% of those patients will be amenable to potentially curative liver resection. There is therefore great need for other effective therapies, and we report complete ablation of a colorectal liver metastasis using electrolysis, which was histologically confirmed at 1 year. The clinical impact of complete tumour ablation at 1 year means that a proportion of those patients currently deemed inoperable and therefore incurable, may be suitable for curative treatment.
Evaluation of Splenic Circulation after Spleen-Preserving Distal Pancreatectomy by Dividing the Splenic Artery and Vein
Authors: Sato Yoshinobu , Shimoda Satoshi , Takeda Nobuo , Tanaka Norio , Hatakeyama Katsuyoshi
Published: April 2003

Background/Aim: In the present study, we investigated the acute and late phases of splenic circulation after spleen-preserving distal pancreatectomy (SPDP) involving the division of splenic vessels. Methods: An acute phase of splenic circulation was evaluated by laser flow meter and the late phase was estimated by 99mTc-galactosyl human serum albumin spleen scintigraphy. Results: Splenic blood supply, evaluated by laser flow meter immediately after SPDP, dropped to one half of the prior blood supply. However, blood supply recovered 10 days after SPDP, as estimated by 99mTc-galactosyl human serum albumin spleen scintigraphy. Conclusion: There are two variations of SPDP: SPDP without preservation of the splenic artery and vein, and SPDP with preservation of the splenic artery and vein. The disadvantage of the former is the resulting decrease in splenic blood supply. The present findings may help to make up for this disadvantage.
Gastric Duplication Cyst
Authors: Perek Asiye , Perek Sadık , Kapan Metin , Göksoy Ertuğrul
Published: April 2003

Background/Aim: The aim of this study is to evaluate the diagnostic and therapeutic difficulties of gastric duplication cysts. Methods: A 38-year-old female patient presented with dyspepsia and repeated episodes of epigastric pain. She was operated with the diagnosis of pancreatic pseudocyst according to her US and CT scans, and found to have a gastric duplication cyst. A cyst about 80×80 mm, localized on the posterior wall of the corpus of the stomach close to the fundus, was dissected from the surrounding tissues and partially from the gastric wall. The cyst did not have muscle layer on the common wall with the stomach, so the cystic mucosa was stripped away from the gastric muscle layer. The gastric lumen was not entered. Results: Although gastric duplication cysts do not have specific symptoms and signs, CT, MR and endoscopic ultrasonography may help the preoperative diagnosis, but the diagnosis is usually confirmed at laparotomy. Needle aspiration may cause complications. Conclusion: Because of the complications that may occur after needle aspiration and malignant potential of the tissue, the treatment of these cysts is surgical.
Duodenal Gangliocytic Paraganglioma as a Radiological Moving Defect
Authors: Kotsis Thomas , Voros Dionysios , Paphiti Agathi , Frangou Matrona , Mallas Elias
Published: April 2003

Background: Gangliocytic paraganglioma of the duodenum is a peculiar neuroendocrine tumor, often revealed as an incidental radiographic finding or as a result of gastrointestinal hemorrhage, due to frequent ulceration of the overlying mucosa. Most lesions are pedunculated and submucosal with distinctive histology, consisting of endocrine, ganglion and spindle-shaped Schwann cells. Methods: A case of a duodenal gangliocytic paraganglioma is reported in a 50-year-old woman presenting with episodes of melena. Enteroclysis revealed a pedunculated tumor observed either in the second or third portion of the duodenum. Upper gastrointestinal endoscopy revealed a pedunculated ulcerated tumor which was subsequently confirmed by computed tomography. The tumor was simply excised through a duodenotomy. Results: The size of the tumor was 4.5 × 3 × 1.5 cm. Immunohistochemical and ultrastructural features of the tumor classified it as a typical duodenal gangliocytic paraganglioma with positive cellular reaction for neuron-specific enolase, chromogranin, somatostatin, gastrin and S100. Conclusion: Forty-six months after surgery, the patient is well with no evidence of recurrence. The majority of the reported duodenal gangliocytic paragangliomas were of bening nature. However, the fact that in 4 isolated cases there was lymph node involvement indicates that thorough investigation for lymph node metastases is needed, as well as thorough postoperative follow-up.
Hepatic Adenoma Associated with Recombinant Human Growth Hormone Therapy in a Patient with Turner’s Syndrome
Authors: Espat Joseph , Chamberlain Ronald S. , Sklar Charles , Blumgart Leslie H.
Published: April 2003

Background: Turner’s syndrome is a genetic disorder of females with well-described karyotypic abnormalities and phenotypic features. Recombinant human growth hormone (HGH) therapy is one component of a hormonal treatment strategy for these patients and is used to promote sexual maturity and to increase height. Methods: Literature review of hepatic complications following the initiation of growth hormone therapy for patients with Turner’s syndrome, and case report presentation of a 13-year-old female with Turner’s syndrome developing a hepatic adenoma following 3 years of HGH treatment. Results: The association between Turner’s syndrome and HGH treatment-associated hepatic adenoma has not been described previous to this report. In this patient, surgical resection was contraindicated and the patient was successfully treated by hepatic artery embolization. The unique management issues relating to this case, and a possible association between HGH therapy and the development of hepatic adenoma are discussed. Conclusion: This work represents the first documentation of a hepatic adenoma developing in a patient with Turner’s syndrome following HGH treatment, and suggests a novel and causal association between HGH treatment and the development of hepatic adenoma in patients with Turner’s syndrome.
Jejunal Diverticulosis: A Rare Entity with Multiple Presentations, a Series of Cases
Authors: Zager Jonathan S. , Garbus Jules E. , Shaw Jason P. , Cohen Matthew G. , Garber Shawn M.
Published: April 2003

Background/Aims: Jejunal diverticulosis (JD) is a rare disease that has a variable presentation. The signs, symptoms, diagnosis, complications and treatment of JD will be discussed through a review of the literature and a series of cases from our own institution. Methods: A retrospective analysis of the diagnosis, treatment and complications of JD was performed by a literature review. This was accompanied by a series of four cases of JD diagnosed and treated in our own institution. Conclusions: JD is a rare disease in which most patients are asymptomatic. However, JD’s different complications are serious and can be fatal. The treatment is mainly surgical; however, there have been cases where nonsurgical management was successful.
Unusual Presentation of Pancreatic Mucinous Cystadenocarcinoma by Spontaneous Splenic Rupture
Authors: Patrinou V. , Skroubis G. , Zolota V. , Vagianos C.
Published: April 2003

Background: Mucinous cystic neoplasms of the pancreas are uncommon tumors with varying potential for malignancy. Although traumatic splenic rupture is common, spontaneous rupture is a rare event. Case Report: We present an unusual case of spontaneous splenic rupture, due to an otherwise asymptomatic mucinous cystadenocarcinoma of the tail of the pancreas. Conclusion: A tumor of the tail of the pancreas may uncommonly present as spontaneous splenic rupture, probably due to venous congestion and infiltration of the spleen, requiring emergency surgical treatment.
Use of Laser in the Relief of Malignant Dysphagia: A District Hospital Experience
Authors: Aly Emad A.H. , Burgess Phillip
Published: April 2003

Background: Endoscopic laser treatment offers rapid relief from dysphagia. The major drawback of laser therapy is the need for repeated treatment at 4- to 6-week intervals. Laser therapy is often done in tertiary referral centres and is said to require special expertise that is not available in many peripheral hospitals. For smaller centres, intubation is likely to be the only treatment option even though it gives less quality of palliation. Aim: To report the experience of a district general hospital in laser treatment of malignant dysphagia. Methods: A retrospective study on patients who had laser therapy for relief from malignant dysphagia from march 1995 to January 2000 was performed in a district general hospital in the UK. Results: Forty patients (25 males and 15 females) with histologically proven oesophageal carcinoma were unsuitable for surgical resection. Trainees, under supervision, did 20% of the sessions. Treatment was done on a day case basis with no outpatient follow-up. The patients had direct access to the service whenever dysphagia got worse. The median number of sessions per patient was 4 (range 1–13). The median palliation period per session was 7 (range 1–32) weeks. The median total palliation period was 7 months. There was no procedure-related mortality. Conclusion: Laser therapy is a safe, easy to teach and learn technique for relief from malignant dysphagia. It can be done on a day case basis with minimum need for follow-up and hospital visits. Such a service could be provided in a district general hospital set-up once equipment and experience are available, thus saving patients from having to travel to specialist units.
Paraesophageal Bronchogenic Cyst Associated with Multiple Epithelial Splenic Cysts
Authors: Pogoda Pia , Izbicki Jakob R. , Langwieler Thomas E. , Staedtler Carsten , Busch Christoph
Published: April 2003

Background: Bronchogenic cysts are rare congenital cystic lesions of foregut origin. They are the result of abnormal budding of the primitive tracheobronchial tube. Nonparasitic, true splenic cysts are another rare entity that might occur as incidental findings but may lead to deleterious courses in case of ruptures. Case Report: We report here the first case of the uncommon association of a paraesophageal bronchogenic cyst and multiple primary splenic cysts in a 23-year-old woman suffering from dysphagia and chest pain. Successful complete resection of the paraesophageal cyst was performed using an abdominal, transhiatal approach and splenic cysts were subjected to organ-preserving TA stapler resection. Conclusion: Thus far there is no proof or genetic indication for a direct association of bronchogenic cysts and multiple splenic cysts, however, the uncommon coincidence of both lesions in our patient might suggest a common origin. Difficulties in preoperative diagnosis, histopathological characteristics and surgical treatment modalities are presented.
Substitution with Buprenorphine in Methadone- and Morphine Sulfate-Dependent Patients
Authors: Bouchez Jacques , Beauverie Patrick , Touzeau Didier
Published: April 2003

In France, during the 1990s, there have been some rapid developments in the treatment of opioid addiction with the introduction of legal substitution agents. Originally, some patients were treated with morphine sulfate, but this was superseded by high dose buprenorphine (Subutex®) and methadone. This resulted in those patients originally treated with morphine being transferred to either of these two licensed products. A study investigating the effects of the transition from morphine to either buprenorphine or methadone was undertaken. Supplementary to this, a trial investigating transition between these new compounds was also conducted. The primary outcome measures for these trials were retention rate, which was assessed at 5, 9 and 12 months, and the precipitation of withdrawal symptoms. The studies showed that transferring patients between substitution agents can be accomplished without severe withdrawal symptoms, although specific management may be required for transfer from high doses of methadone to buprenorphine. High long-term retention rates were observed in the studies, with most drop-outs occurring directly after transfer. Results suggest that patients on long-term buprenorphine maintenance therapy may have good compliance in comparison with other agents.
Differences between General Practitioner- and Addiction Centre-Prescribed Buprenorphine Substitution Therapy in France
Authors: Vignau Jean , Brunelle Emmanuel
Published: April 2003

The treatment of heroin addiction in France relies on either general practitioners (GP) or specialist Addiction Centres (ACs). In general, the GPs offer a more flexible approach regarding frequency of consultations, urine tests and dosing regimen while the AC approach is more structured. A cohort study was undertaken to compare the treatment strategies of buprenorphine therapy between these medical environments. To determine the efficacy of each treatment, a number of outcomes were measured including the Addiction Severity Index, retention rates at 90 and 180 days, the average dose prescribed, quality of life assessment, body weight and two self-reported measures: treatment perception and predictive total duration. A total of 69 patients were enrolled; 32 treated by GPs and 37 treated in ACs. Significant differences, including average age, addiction severity and employment status were apparent between each group. Nevertheless, significant improvements in the social and medical status were observed in all patients after 3 months, continuing after 6 months in both groups. Treatment retention was good in both groups with 65% of the total sample remaining after 180 days. The usually more flexible GP approach was more rigid in this study, resulting in an equally positive treatment outcome as seen in the ACs. The study highlights the effectiveness of buprenorphine in addicts with different social and medical backgrounds, regardless of the therapeutic approach.
Buprenorphine Maintenance in Pregnant Opiate Addicts
Authors: Fischer Gabriele , Etzersdorfer Petra , Eder Harald , Jagsch Reinhold , Langer Martin , Weninger Manfred
Published: April 2003

Opioid maintenance agents such as methadone and slow-release morphine have provided beneficial effects in pregnant opioid-dependent women in both themselves and their child. However, one of the major drawbacks involved with these agents is that they cause an increase in the severity of neonatal abstinence syndrome (NAS) when compared to mothers using heroin. Consequently, a trial was performed to investigate the effects of buprenorphine use during pregnancy. A total of nine pregnant opioid-dependent women were transferred from either a mean daily dose of 39.7 mg methadone or 400 mg slow-release morphine to a mean daily dose of 8.1 mg buprenorphine. The buprenorphine-maintained patients were integrated into an already established outpatient maintenance treatment programme covering all aspects of prenatal and perinatal care. Results demonstrated that buprenorphine administration in opioid-dependent pregnant patients is efficacious and well tolerated. Babies born to buprenorphine-maintained patients had birthweight and Apgar scores within the normal range (2,500–4,500 g and 9–10, respectively) and no evidence of opioid-related NAS was observed. The results from this preliminary study indicate the potential for buprenorphine maintenance therapy in pregnant addicts, although further research is required to confirm this hypothesis.
International Variations in Youth Drug Use: The Effect of Individual Behaviours, Peer and Family Influences, and Geographical Location
Authors: McArdle Paul , Wiegersma Auke , Gilvarry Eilish , McCarthy Steven , Fitzgerald Michael , Kolte Brigitta , Brinkley Aoife , Blom Maria , Stoeckel Ingo , Pierolini Anna , Michels Ingo , Johnson Rob , Quensel Stephan
Published: April 2003

This international study investigates factors underlying international variations in rates of youth drug use among representative samples of 15-year-olds in five cities (Bremen, n = 871; Dublin, n = 983; Groningen, n = 487; Newcastle upon Tyne, n = 880; Rome, n = 666). It reveals a higher level of drug use in English-speaking compared to continental populations. Drug use was associated with peer, family and individual factors. Logistic regression showed that family structure and sport were associated with lower rates and delinquent behaviour with higher rates of drug use in all cities and among males and females. Among males, city of residence also independently predicted drug use. The effect of traditional families and studiousness in reducing drug use was most evident for male drug use in low-use cities: higher rates of use in English-speaking cities appear partially due to the drug use of low-risk males.
Development and Stability of Alcohol Consumption from Adolescence into Adulthood: The Amsterdam Growth and Health Longitudinal Study
Authors: Koppes Lando L.J. , Kemper Han C.G. , Post G. Bertheke , Snel Jan , Twisk Jos W.R.
Published: April 2003

When studying long-term effects of alcohol consumption on health, the stability of alcohol consumption should be known. In this paper the development and stability of alcohol consumption were investigated. Seven measurements of alcohol consumption were carried out over a period of 20 years, starting at age 13 years, in a cohort of 65 men and 85 women. Effects of age, gender, and type of beverage on the stability of drinking as a dichotomous variable (drink or abstain) and on the stability of relative amounts of alcohol consumption were analyzed. The stability of the drink/abstain dichotomy was high (odds ratios >4) and increased with age. The stability of relative amounts of alcohol consumption was moderate (rS <0.6), and no effect of age was found. No sex effects were found, while the consumption of beer often showed higher stability than that of wine and spirits.
Modes and Impact of Coercive Inpatient Treatment for Drug-Related Conditions in Switzerland
Authors: Grichting Esther , Uchtenhagen Ambros , Rehm Jürgen
Published: April 2003

Background: Two forms of institutionalized pressure to treatment can be distinguished in Switzerland: civil commitment and court referral. In court referral, the referred patient has the right to refuse treatment. Objectives: To compare court referrals for inpatient treatment to voluntary therapy. Methods: Comparison of interviews at treatment entry and discharge records. Results: There were few systematic differences at entry except for voluntary subjects having had less contact with the legal system before treatment, independently of the specific court referral. At discharge, voluntary patients had a better social integration and fewer legal problems. Discussion: Legal problems waiting for court referrals at discharge may be a significant handicap for reintegration. Otherwise, voluntary patients and court referrals showed few systematic differences in inpatient treatment.
Taurine Prevents Interleukin-2-Induced Acute Lung Injury in Rats
Authors: Abdih H. , Kelly C.J. , Bouchier-Hayes D. , Barry Mary , Kearns S.
Published: April 2003

Background: The therapeutic efficacy of interleukin-2 (IL-2) has been limited by a dose-dependent vascular leak syndrome. This may be related to neutrophil-mediated endothelial injury. Taurine has been shown to decrease this injury in vitro. This study investigates the role of taurine in preventing IL-2-induced lung injury, and the role of neutrophil-endothelial interactions in mediating this injury. Methods:Study 1: Sprague-Dawley rats (n = 12/groups) were randomised to controls, IL-2-treated (1 × 106 units), and IL-2-treated with taurine (4% solution, orally for 48 h prior to IL-2 therapy). Lung injury was measured by extravascular lung water (wet/dry weight) and bronchoalveolar lavage protein concentration. Neutrophil infiltration was evaluated by measuring myeloperoxidase activity and bronchoalveolar lavage neutrophil concentration. Study 2: Rats (n = 10/group) were randomised into the same groups as study 1. Neutrophil-endothelial interactions in mesenteric vessels were assessed by intravital microscopy at half-hourly intervals. Results: Taurine reduced IL-2-induced acute lung injury as reflected by a decrease in wet-to-dry lung weight ratio from 7.2 ± 0.5 in the IL-2 group to 4.7 ± 0.3 in the taurine group (p < 0.05), and a decrease in bronchoalveolar neutrophil concentration from 823 ± 19.5 in the IL-2 group to 538 ± 18 in the taurine group (p < 0.05). Intravital microscopy demonstrated that IL-2 increased leucocyte adhesion and migration in mesenteric vessels, and that this was significantly reduced by taurine. Conclusion: These data suggest that taurine prevents IL-2-induced tissue injury in part by decreasing neutrophil-endothelial interactions.
Role of Apoptosis and Bcl-2/Bax in the Development of Tubulointerstitial Fibrosis during Experimental Obstructive Nephropathy
Authors: Zhang G. , Oldroyd S.D. , Huang L.H. , Yang B. , Li Y. , Ye R. , El Nahas A.M.
Published: April 2003

Background/Aims: To examine the role of apoptosis in experimental unilateral ureteral obstruction (UUO). Methods: Rat kidneys were examined 3, 7 and 11 days following UUO or sham operation (SO). Tissue was immunohistochemically stained for α-smooth muscle actin (α-SMA), proliferating cell nuclear antigen (PCNA), Bcl-2 and Bax proteins. Apoptotic analysis was carried out in kidney sections using in situ end labelling of endonuclease cleaved DNA. Results: The relative volume (Vv) of cortical interstitium and interstitial α-SMA increased progressively following UUO. ED1-positive monocytes/macrophages peaked at day 7 and significantly decreased at day 11. PCNA-positive cells in tubulointerstitium were significantly increased on day 3. Staining returned to the level of the SO group by day 11, meanwhile those in the interstitium remained much higher than baseline. TUNEL-positive cells were persistently raised following UUO. Transient tubular cell proliferation seemed unable to counteract the apoptosis since tubular atrophy was apparently present by day 11 of UUO. However, interstitial cell proliferation was high enough to overwhelm apoptosis, particularly with respect ot myofibroblasts, since α-SMA immunostaining and Vv remained elevated. The ratio of the number of PCNA-positive cells to apoptotic cells formed a predictive pattern for the staining score of interstitial α-SMA (R2 = 47.23%, p < 0.05) and Vv (R2 = 49.93%, p < 0.05). Tubular Bcl-2 immunostaining peaked on day 3, and then gradually decreased to baseline by day 11. The expression of Bax protein was inhibited on day 3 when compared with that of the SO group, but increased with time following UUO. Conclusion: These findings suggest an important role for apoptosis and its regulatory proteins in the processes of tubular atrophy and fibrogenesis following UUO.
Volume Regulation of Thick Ascending Limb of Henle Cells: Significance of Organic Osmolytes
Authors: Grunewald R. Willi , Fahr Milena , Fiedler G. Martin , Jehle Peter M. , Müller Gerhard Anton
Published: April 2003

The thick ascending loop of Henle (TALH) is exposed to high osmotic stress, which is particularly due to high sodium and chloride reabsorption and very low water permeability of the luminal membrane. Therefore, the volume regulation of TALH cells, derived from the TALH loop of rabbit kidneys, was analyzed. The volume was determined by impedance measurements. TALH cells, which were adapted to different osmolarities (300 and 600 mosm/l), showed no significant differences in their cell volume. Therefore, a complete volume regulation could be supposed. An increase in extracellular osmolarity from 300 to 600 mosm/l (osmolarity adjusted by addition of 150 mM NaCl) immediately led to a reduction in the cell volume by 37 ± 6% (n = 6). A regulatory volume increase (RVI) was not observed within 10 min but after 24 h. Conversely, a sudden cell swelling by 44 ± 5% (n = 4) was detected within 20 s following an extracellular hypoosmotic challenge (from 600 to 300 mosm/l). The subsequent volume regulatory decrease (RVD) required a period of 7 days. Specific inhibitors of important ion transporters had no effect on volume regulation. Thus, changes in the ion conductivity do not seem to influence the processes of RVI and RVD. Conversely, the intracellular content of the organic osmolytes, sorbitol, inositol, betaine, and glycerophosphorylcholine, changed in the course of RVI and RVD. These results provide evidence that TALH cells are capable of maintaining their volume despite large extracellular osmotic changes. RVI and RVD are mainly regulated by changes in the intracellular content of organic osmolytes within 1 and 7 days.
Pericyte Regulation of Renal Medullary Blood Flow
Authors: Pallone Thomas L. , Silldorff Erik P.
Published: April 2003

Pericytes are contractile smooth muscle-like cells that surround descending vasa recta (DVR) and provide their capability for vasomotion. The importance of the medullary pericyte derives from the role of DVR to distribute most or all of the blood flow from juxtamedullary cortex to the renal inner and outer medulla. Physiological processes that are likely to be influenced by pericyte constriction of DVR include the urinary concentrating mechanism and pressure natriuresis. Oxygen tensions in the medulla are low, so that subtle variation of pericyte vasomotion might play a role to abrogate hypoxia and prevent insult to the medullary thick ascending limb of Henle. Known vasoconstrictors of DVR include angiotensin II, endothelins, norepinephrine, acetylcholine, and adenosine. Vasodilators include prostaglandin E2, adenosine, acetylcholine, bradykinin, and nitric oxide.
Inhibition of TNF-α, Induced Cytokine and Adhesion Molecule
Authors: Tomita Naruya , Morishita Ryuichi , Tomita Sawako , Kaneda Yasufumi , Higaki Jitsuo , Ogihara Toshio , Horiuchi Masatsugu
Published: April 2003

Activation of certain cytokines and adhesion molecules has been postulated being involved in the pathogenesis of experimental and human glomerulonephritis. In this study, we examined whether the transcription factor, nuclear factor ĸB (NFĸB), mediated the expression of these genes involved with the inflammatory response of mesangial cells by using transcription factor decoy oligodeoxynucleotides (ODN) to block NFĸB binding to the promoter site of its target genes. We hypothesized that the NFĸB decoy ODN can inhibit the coordinated activation of cytokines and adhesion molecules induced by TNF-α. Increased binding activity of NFĸB induced by TNF-α was effectively blocked by the NFĸB decoy ODN. TNF-α stimulated CAT expression, which was significantly inhibited by transfection of NFĸB, but not by scrambled decoy ODN. Of importance, NFĸB, but not scrambled decoy ODN, significantly attenuated the increase in RNA and protein levels of IL-1α, IL-1β, IL-6, ICAM-1 and VCAM-1 induced by TNF-α assessed by RT-PCR. Moreover, in vivo transfection of NFĸB decoy ODN inhibited expressions of these cytokines and adhesion molecules induced by TNF-α injection. These results suggest a novel therapeutic strategy for the treatment of glomerulonephritis using decoy ODN to block the binding of NFĸB, inhibiting the coordinated transactivation of the key cytokines and adhesion molecules, and thereby suppressing the inflammatory process.
Troglitazone Stimulates Basolateral Rheogenic Na+/HCO–3 Cotransport Activity in Rabbit Proximal Straight Tubules
Authors: Muto Shigeaki , Miyata Yukio , Imai Masashi , Asano Yasushi
Published: April 2003

Thiazolidinedione derivatives, new insulin-sensitizing antidiabetic agents, are expected to have potential clinical use. Since these drugs cause edema in a variable proportion of patients, we examined whether troglitazone (Tro) has direct action on Na+ transport of rabbit proximal straight tubule perfused in vitro. For this purpose, we measured basolateral membrane voltage (VB) by conventional microelectrode techniques and intracellular pH (pHi) by microscopic fluorescence spectrophotometry with a pH-sensitive fluorescent dye, 2’, 7’-bis-2-carboxyethyl-5-carboxyfluorescein. Tro at 50 µM in the bath significantly depolarized both transepithelial voltage and VB. To examine whether the basolateral rheogenic Na+/HCO–3 cotransport activity is affected by Tro, we observed VB deflection upon abrupt 10-fold decrease in bath HCO–3 in the absence and presence of Tro. The apparent transference number of HCO–3 (tHCO3), as calculated from the VB deflection, was significantly greater in the presence of Tro (50 µM) than that seen in its absence. Tro caused cell acidification and increased the intracellular acidification rates (dpHi/dt) upon abrupt 10-fold decreases in bath HCO–3 and Na+ concentrations. The stimulatory effects of Tro on tHCO3 and dpHi/dt were dose dependent between 5 and 50 µM, but they were unaffected at 0.5 µM. From these results, we conclude that Tro acts on the proximal straight tubule and stimulates the basolateral rheogenic Na+/HCO–3 cotransport activity. The stimulatory action of Tro may partly account for edema formation.
Decreased Glomerular Expression of Agrin in Diabetic Nephropathy and Podocytes, Cultured in High Glucose Medium
Authors: Yard B.A. , Kahlert S. , Engelleiter R. , Resch S. , Waldherr R. , Groffen A.J. , van den Heuvel L.P.W.J. , van der Born J. , Berden J.H.M. , Kröger S. , Hafner M. , van der Woude F.J.
Published: April 2003

Aim: A decrease in glomerular heparan sulfate (HS) proteoglycan (PG), without apparent decrease in HSPG core protein expression, has been reported to occur in diabetic nephropathy (DN). In most studies however, agrin, the major HSPG core protein in the glomerular basement membrane, has not been studied. This prompted us to study the glomerular expression of agrin in parallel to the expression of HS-glycosaminoglycans (GAG) in biopsies of patients with DN. Furthermore, the influence of glucose on agrin production in cultured podocytes and the expression of agrin in fetal kidneys was investigated. Methods: Cryostat sections of renal biopsies from patients with DN (n = 8) and healthy controls (HC, n = 8), were stained for agrin and HS-GAG. Sections of fetal kidneys were double stained for agrin and CD35 or CD31. Stainings were performed by indirect immunofluorescence (IIF). The production of agrin by cultured human podocytes was tested by ELISA and IIF. Results: The expression of agrin, detected by AS46, was significantly reduced in biopsies from patients with DN compared to HC (p < 0.01). Similar findings were observed when monoclonal antibody JM72 was used (p < 0.05). In addition, a significant reduction in the glomerular expression of HS-GAG was detected with JM403 in these patients (p < 0.01). Agrin is expressed in cultured podocytes, the expression hereof was reduced when the cells were cultured in the presence of 25 mM D-glucose (p < 0.01). In biopsies of human fetal kidneys, glomerular expression of agrin coincided with the expression of CD31. In early stages of glomerular differentiation there was a strong staining for agrin and CD31 while CD35 was only slightly positive. Conclusions: Our data argue against a selective dysregulation in HSPG sulfation in DN, but suggest a pivotal role for hyperglycemia in the downregulation of agrin core protein production.
Phosphate Depletion in Opossum Kidney Cells: Apical But Not Basolateral or Transepithelial Adaptions of Pi Transport
Authors: Barac-Nieto M. , Alfred M. , Spitzer A.
Published: April 2003

Monolayers of opossum kidney (OK) cells are widely used as models for the renal proximal tubule. OK cells adapt to phosphate (Pi) depletion by increasing their capacity for apical and basolateral Na+-dependent Pi uptake. Because NMR-visible cell Pi was found to be decreased in Pi-deprived kidney cells, we suggested that up-regulation of basolateral Pi efflux also occurs during adaptation to Pi deprivation [American Journal of Physiol 1994;267:C915–919]. In order to test this hypothesis, we measured the cell Pi pool, basolateral Pi efflux and transepithelial Pi fluxes in OK cells grown on permeable plastic filters, exposed overnight to solutions containing either 0.5 mM (deprived) or 2.0 mM (replete) Pi or 32Pi. Following steady state or acute loading with 32Pi, the specific activity (SA) of cell Pi, the cell Pi pool and the basolateral efflux of 32Pi were measured. In the steady state, a 2-fold increase in Pi uptake sustained the intracellular Pi pool at 85% of the control level (30 ± 5 nmol/mg) in spite of a decrease in extracellular Pi from 2 to 0.5 mM. When the extracellular Pi was acutely (1 h) reduced to 0.1 mM, the cell Pi pool decreased (to 3 ± 1 nmol/mg) both in cells previously adapted overnight to either 0.5 or to 2 mM Pi (p >0.3). The rates of absolute and fractional basolateral washout of cell 32Pi after 1 h loading with 0.1 mM32Pi were similar in cells adapted to 0.5 compared to 2 mM Pi. This indicates that Pi depletion did not affect the effective permeability of the basolateral membranes to Pi. Adaptation for 16 h to 0.5 compared to 2 mM Pi did not alter the rate of net transepithelial transport of 0.1 mM Pi from the apical to the basal compartment but reduced (p < 0.05) the unidirectional fluxes of both 32Pi and 14C-mannitol. An insufficient driving force (unchanged or low Pi concentration in the transport pool, low electrical or coupled-anion gradients) and a constant effective basolateral Pi permeability must have limited basolateral Pi efflux in cells exposed to 0.1 mM Pi. Thus, in OK cells grown on plastic support there are no adaptive increases in either basolateral Pi efflux, or in transcellular and paracellular Pi transport, in response to Pi depletion. Adaptations are limited to increases in apical and basolateral sodium-dependent Pi uptakes that can maintain the cell Pi pool as long as apical Pi is not too low (≧0.5 mM). The OK cells adapt to low Pi concentrations conserving cell Pi but not increasing basolateral Pi efflux nor transepithelial Pi transport.
Word Length Effects on EMG/Vowel Duration Relationships in Apraxic Speakers
Authors: Strauss Monica , Klich Richard J.
Published: April 2003

The effects of word length on the timing of lip electromyographic (EMG) activity for production of the vowel /u/ and the relationship of this activity to vowel duration were examined in matched male and female pairs of normal and apraxic speakers. Both apraxic speakers had suffered left cerebrovascular accidents, which resulted in apraxia of speech as the primary communication deficit. For all participants, the interval of time in which lip muscle activity was present prior to the onset of voicing for the /u/ (EMG onset interval) in each word systematically decreased as word length increased. However, EMG activity offset intervals, which were measured from the onset of voicing for /u/ to the onset of the reduction of EMG activity during the vowel (EMG termination interval), decreased as word length increased only for the normal speakers. Relative onset of EMG activity was not significantly related to relative offset of EMG activity or relative vowel duration. However, the relative EMG onset interval was correlated with the duration of an entire word. Findings for the relative EMG termination interval were variable and are discussed relative to the severity of apraxia of speech.
Verbal Fluency in Elderly Bilingual Speakers: Normative Data and Preliminary Application to Alzheimer’s Disease
Authors: de Picciotto Janet , Friedland Deborah
Published: April 2003

This study investigated verbal fluency abilities in 30 healthy elderly English-Afrikaans bilingual speakers, and 6 bilingual subjects with Alzheimer’s disease. Three 1-min semantic verbal fluency tasks (animals) were obtained in the bilingual mode, Afrikaans and English. Results were analysed in terms of total correct, and semantic clusters. There was no significant difference between monolingual and bilingual performance. Some healthy bilingual subjects used code switching as a strategy but with no direct increase in the number of exemplars generated, and there was no relationship between age of acquisition, pattern of use and verbal fluency scores. In comparison, subjects with Alzheimer’s disease did not make use of code switching strategies, and there was some relationship between age of acquisition, pattern of use and verbal fluency scores.
Early Reading for Low-SES Minority Language Children: An Attempt to ‘Catch Them before They Fall’
Authors: Hus Yvette
Published: April 2003

Minority language and low socioeconomic status (SES) students are at high risk for language and learning disabilities. In an attempt to ‘catch them before they fall’, an early reading project was initiated in four kindergarten classes, in a low-SES bilingual school (English/French as a second language), where minority language children form a majority. The project included: (1) teaching reading and writing to kindergarten students, and outcome research: individual pre- and post-treatment assessment using a computer software to measure phonological processing and decoding skills; (2) reading testing of grade 1 students, graduates of traditional kindergartens with no explicit reading instruction programs. Statistical analyses of the pre- and post-tests showed that in only 9 weeks the kindergarten students were able to learn phonological skills critical to the reading process. By contrast, a significant number of the grade 1 students, all graduates of a traditional kindergarten, showed serious reading lags on a group reading test, indicating that early reading instruction is justifiable for this high-risk student population.
Multimodal Oestrus Advertisement in a Small Nocturnal Prosimian, Microcebus murinus
Authors: Buesching C.D. , Heistermann M. , Hodges J.K. , Zimmermann E.
Published: April 2003

Females of many simian primates have evolved distinct signals to advertise their oestrus. Until recently little was known about oestrus advertisement in prosimians. In this paper, we present data on the activity pattern, olfactory and vocal behaviour of female grey mouse lemurs in relation to their reproductive state. Phases of the oestrus cycle were determined according to plasma progesterone levels and changes in vaginal morphology. Females showed significantly increased locomotor activity, scent marking behaviour and changes in self-grooming activity only on the day of oestrus. Furthermore, they uttered a call with a complex acoustic structure which is not heard during other reproductive phases, the oestrus advertisement trill call. Therefore, in mouse lemurs, a combination of olfactory and acoustical signals can serve as multimodal oestrus advertisement.
Interplay of Phenology and Reproduction in Ring-Tailed Lemurs: Implications for Ring-Tailed Lemur Conservation
Authors: Sauther Michelle L.
Published: April 2003

Data are presented on ring-tailed lemur feeding ecology and resource use at the Beza Mahafaly Special Reserve in southwestern Madagascar. The phenological availability of food resources was sampled monthly from 199 trees and 31 species. Results indicate that Lemur catta feeding ecology is finely tuned to the seasonal nature of specific food resources. Key species provide important food items during critical periods of the reproductive cycle. During a drought year, mortality for mothers and infants increased dramatically, providing indirect evidence that this species is highly dependent on the phenological reliability of food resources. These results indicate that in such highly seasonal habitats, the loss of any key species could have enormous impact on ring-tailed lemur demography and survival.
Feeding Rates and Daily Path Range of the Colombian Woolly Monkeys as Evidence for Between- and Within-Group Competition
Authors: Stevenson Pablo R. , Castellanos Maria Clara
Published: April 2003

Data on fruit feeding rates and daily path length were compared for four groups of woolly monkeys in Tinigua National Park, Colombia. Indirect evidence was found for feeding competition both within and between groups. Feeding rates were similar across groups of different sizes, but daily path lengths were longer in small and large groups when compared to medium-sized groups. The results suggest that the optimal group size in this study site is close to 20 individuals. Although the sample size was small and it was difficult to assess the influence of home range quality in some of the comparisons, this is one of the few studies providing empirical evidence supporting the importance of intergroup competition affecting group size in primates.
Earliest Record of a Parapithecid Anthropoid from the Jebel Qatrani Formation, Northern Egypt
Authors: Simons Elwyn L. , Seiffert Erik R. , Chatrath Prithijit S. , Attia Yousry
Published: April 2003

A fifth anthropoid (= anthropoidean, simian or simiiform) genus and species from the late Eocene Fayum Quarry L-41, Abuqatrania basiodontos gen. et sp. nov., further augments the already remarkable primate diversity from this locality and provides the first convincing extension of the enigmatic family Parapithecidae into the oldest productive vertebrate fossil-bearing stratum of the Jebel Qatrani Formation. A. basiodontos exhibits no clear autapomorphies nor any apomorphies that are shared exclusively with any other parapithecid species, and it is most parsimoniously interpreted as the sister taxon of a Qatrania -Parapithecus -Apidium clade. Reevaluation of two contemporaries of A. basiodontos, Serapia and Arsinoea, suggests that neither genus should be ranked as a basal parapithecid. Serapia is more derived than primitive parapithecids in the morphology of the lower fourth premolar and exhibits greater overall similarity to Proteopithecus in cusp placement and the shape and proportions of its lower teeth; accordingly, we place Serapia in the family Proteopithecidae. Arsinoea is much more problematic and does not fit well with any hitherto known Afro-Arabian anthropoid group; we place this genus in a new anthropoid family, Arsinoeidae.
Die Häufigkeit von Kaiserschnitten in Österreich (1996–1998)
Authors: Klein M. , Waldhör T. , Vutuc C. , Beck A.
Published: April 2003

Fragestellung: Während von zahlreichen europäischen Ländern detailierte Angaben zur Häufigkeit von Kaiserschnittentbindungen vorliegen, gibt es dazu aus Österreich nur punktuelle Daten einzelner Zentren. Ziel dieser Studie war es daher, den aktuellen Anteil an Schnittentbindungen für Österreich zu evaluieren. Methodik: Dazu wurden sämtliche Geburten aus den Jahren 1996 (n = 89 208), 1997 (n = 84 408) und 1998 (n = 81 568) analysiert. Neben der allgemeinen durchschnittlichen Sectiorate wird der Einfluss der Schwangerschaftsdauer, des Geburtsgewichtes und der Parität dargelegt. Die statistische Auswertung erfolgte mit Hilfe des Chi-Quadrat-Tests. Ergebnisse: Im Beobachtungszeitraum stieg der Anteil an Schnittentbindungen von 13,08% (1996) auf 14,0% (1997) und 14,55% (1998). Dieser Anstieg erwies sich als statistisch signifikant (p = 0,0001). 47% der Frühgeburten (≦ 35. Schwangerschaftswoche) werden durch Kaiserschnitt entbunden, bei Schwangerschaften nach der 35. Schwangerschaftswoche sind es noch 13,24% (1998). Schwangere mit dystrophen Kindern (<2000 g) werden auch jenseits der 35. Schwangerschaftswoche in mehr als 50% der Fälle sektioniert. Bei der ersten Geburt ist in über 17% der Fälle (1998) mit einem Kaiserschnitt zu rechnen, mit zunehmender Parität sinkt die Rate an Schnittentbindungen kontinuierlich ab. Schlussfolgerungen: Dem allgemeinen Trend folgend steigt auch in Österreich die Häufigkeit von Kaiserschnitten kontinuierlich an. Die Ergebnisse dieser Arbeit können als Basis sowohl für internationale Vergleiche als auch für abteilungsinterne Qualitätssicherungsmassnahmen dienen.
Retrospektive Analyse zur Dosisintensität von Epirubicin beim Mammakarzinom
Authors: Konecny G. , Frank M. , Kahlert S. , Untch M. , Hepp H.
Published: April 2003

Fragestellung: Die Wirksamkeit von Epirubicin wird in der Therapie des Mammakarzinoms möglicherweise von der applizierten Dosisintensität (DI) beeinflusst. Wir haben den Einfluss der tatsächlich applizierten DI auf die Verträglichkeit und das Ansprechen in der adjuvanten und metastasierten Situation überprüft. Patientinnen und Methoden: Epirubicin, Fluorouracil und Cyclophosphamid (FEC) wurden entweder in einer Dosierung von 500/50/500 mg/m2 (FE50C) oder in einer intensivierten Dosierung von 500/75/500 mg/m2 (FE75C) 3-wöchentlich gegeben. Die tatsächlich applizierte DI wurde berechnet und mit den Nebenwirkungen und dem Therapieansprechen korreliert. Von 66 Patientinnen waren 63 auswertbar; 43 hatten eine metastasierte Erkrankung, und 20 wurden adjuvant behandelt. Ergebnisse: Adjuvant wurden für FE50C und FE75C 81 bzw. 96% der geplanten DI und 70 bzw. 88% der geplanten Gesamtdosis tatsächlich appliziert. In der metastasierten Situation wurden 94 bzw. 92% der geplanten FE50C- bzw. FE75C-DI gegeben. Dies entsprach einer tatsächlichen Erhöhung der DI von Epirubicin um 81% in der adjuvanten und um 53% in der metastasierten Situation. Die hämatologischen und nicht hämatologischen Toxizitäten beider Regime waren vergleichbar. Im retrospektiven Vergleich liess sich das mittlere Gesamtüberleben nach 4 Jahren in der adjuvanten Situation von 40 auf 48% verbessern (p = 0.47), und die Remissionsrate beim metastasierten Mammakarzinom konnte von 34 auf 44% erhöht werden. Schlussfolgerung: Die applizierte DI von Epirubicin war in allen Gruppen niedriger als initial geplant. Höhere DI von Epirubicin führten beim primären und fortgeschrittenen Mammakarzinom zu vergleichbaren Toxizitäten. Die Einhaltung der geplanten DI scheint eine wichtige Voraussetzung für den optimalen Therapieerfolg zu sein. Unsere Ergebnisse unterstreichen ferner die Notwendigkeit, eine Intensivierung von Anthrazyklinen beim Mammakarzinom weiter in prospektiven Studien zu untersuchen.
Ärzte in den Netzen der Industrie?
Authors: Haller U. , Hepp H. , Winter R.
Published: April 2003

Bisher akzeptierte Formen von Zuwendungen von Firmen an Ärzte werden zunehmend kritisch hinterfragt. Fälle von Vorteilsannahme bis Bestechlichkeit werden von den Medien breit an die Öffentlichkeit gebracht. Die traditionelle Beziehung zwischen Ärzteschaft und Industrie kommt damit zunehmend unter Beschuss, aber die Entwicklung neuer Pharmaka und medizintechnischer Produkte kann nur in enger Zusammenarbeit mit der Industrie erfolgen. Man kann aber nicht öffentliche Gelder für Lehre und Forschung zusammenstreichen, nach Drittmittelfinanzierung rufen, Professoren nach Einwerbung von Drittmitteln bewerten und schliesslich wegen Vorteilsannahme oder Bestechlichkeit verurteilen. Zur Zeit kann in der ärztlichen Fortbildung nicht vollständig auf Drittmittel verzichtet werden, es müssen aber Transparenz garantiert und Verhaltensregeln aufgestellt werden. Keineswegs darf durch Antikorruptionsgesetz und Korruptionsstrafrecht die Forschung behindert werden.