bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effects of Scopolamine on Changes in Regional Cerebral Blood Flow during Classical Conditioning of the Human Eyeblink Response
Authors: Bahro Marcel , Molchan Susan E. , Sunderland Trey , Herscovitch Peter , Schreurs Bernard G.
Published: April 2003

We examined the effects of scopolamine on the functional anatomy of classical conditioning of the human eyeblink response. Ten healthy young normal female volunteers (mean age ± SEM: 26.7 ± 0.9 years) were administered 0.4 mg scopolamine intravenously 1 h before regional cerebral blood flow (rCBF) was measured with positron emission tomography (PET) and H215O. Scans occurred during three sequential phases: (1) explicitly unpaired presentations of the unconditioned stimulus (airpuff to the right eye) and conditioned stimulus (binaural tone), (2) paired presentations of the two stimuli (associative learning) and (3) explicitly unpaired presentation of the stimuli (extinction phase). Scopolamine impaired acquisition of the conditioned eyeblink response (54.7 ± 4.9%) relative to 18 untreated subjects from two previous PET studies. Regions that showed significant relative increases in rCBF during conditioning included the right lateral occipital cortex, the right inferior occipital cortex, the right lateral temporo-occipital cortex, the left medial temporo-occipital cortex, the posterior cingulate, the right cerebellum/brain stem area and the medial cerebellum. Significant relative decreases in rCBF were measured in the thalamus, the left putamen/insula area, the right putamen and the left and middle cerebellar cortex. The data partially replicate previous findings in unmedicated young volunteers of conditioning-specific rCBF changes in the cingulate cortex, the cerebellar cortex, the insula and the lateral temporo-occipital cortex. Our finding of decreased rCBF in the thalamus and increased rCBF in the occipital cortex may be attributable to effects of scopolamine per se rather than conditioning. Our data lend further support to the notion that classical conditioning involves distributed changes in multiple systems within the central nervous system.
Disturbances of Corticogenesis in Schizophrenia: Morphological Findings Provide New Evidence for the Maldevelopmental Hypothesis
Authors: Kalus Peter , Senitz Dieter , Beckmann Helmut
Published: April 2003

A comprehensive neuropathology of schizophrenic psychoses has not yet been established. According to the findings of clinical investigations, neurohistological studies mainly focused on limbic structures, the prefrontal cortex and the anterior cingulate cortex. The results of morphometric and stereological studies based on the classical neuropathological techniques are controversial and point to the necessity for a differentiated characterization of the morphological features of neurons. Therefore, methods of neurobiological fundamental research are employed for the detailed demonstration of the different neuron types that constitute cortical circuits. Using these techniques, the schizophrenic cortex is shown to contain a variety of characteristic alterations which are discussed in the light of hypotheses favoring a maldevelopmental pathogenesis of schizophrenic psychoses which can be looked upon as neuronal system disorders.
Alpha-1-Antichymotrypsin Polymorphism in Schizophrenia: Frequency, Age at Onset and Cognitive Function
Authors: Chiu Hsien-Jane , Hong Chen-Jee , Chen Jen-Yeu , Wang Ying-Chieh , Lin Chih-Yuan , Bai Ya-Mei , Song Hsiu-Li , Lai Hao-Che , Tsai Shih-Jen
Published: April 2003

A common polymorphism in the α1-antichymotrypsin (ACT) gene is associated with Alzheimer’s disease. ACT is also a trophic factor in the hippocampal neurons. In order to examine if the ACT gene plays a role in the pathogenesis of schizophrenic disorders, patients (n = 175) and control subjects (n = 114) were genotyped for ACT. We also investigated the relationship between genotypes and patients’ cognitive function as evaluated by the Clinical Dementia Rating Scale and the Mini-Mental State Examination. The results demonstrated no association between schizophrenia and/or cognitive deficit in schizophrenia and ACT polymorphism. The data suggest that the ACT gene is not of major importance for the genesis of schizophrenia. Further studies measuring ACT expression as messenger RNA or serum ACT level may help to exclude the role of ACT in the pathogenesis of schizophrenia.
A Syndrome of Psychosis following Discontinuation of an Estrogen-Progestogen Contraceptive and Improvement following Replacement: A Case Report
Authors: Huber T.J. , Nickel V. , Tröger M. , Schneider U. , Husstedt H. , Emrich H.M.
Published: April 2003

Mild forms of psychosis associated with low estrogen levels during the perimenopause are relatively frequent. There is scarce data on severe forms of psychosis in these conditions. We report the case of a 51-year-old woman with no previous psychiatric history who amputated her hand in a ‘psychotiform’ state after discontinuation of her contraceptive medication. Having subsequently jumped out of a window, she suffered a fracture of the dens with central spinal cord injury and symptoms of cruciate paralysis. The patient stabilized under a combined therapy with estrogen-progestogen substitution, antipsychotic medication and add-on oxcarbazepine.
Effects of Paroxetine on Heart Period Variability in Patients with Panic Disorder: A Study of Holter ECG Records
Authors: Yeragani Vikram K. , Jampala V.C. , Sobelewski Edward , Kay Jerald , Igel Gina
Published: April 2003

We investigated cardiac autonomic function in 16 patients with panic disorder before and after treatment with paroxetine using Holter ECG records. Our previous data suggest a relative increase in sympathetic activity in patients with panic disorder, especially during sleep. Data for 20 h and awake and sleep periods were analyzed using spectral analysis to quantify absolute and relative heart period variability in ultra low (ULF: <0.0033 Hz), very low (VLF: 0.0033–0.04 Hz), low (LF: 0.04–0.15 Hz) and high (HF: 0.15–0.5 Hz) frequency bands. We also obtained fractal dimensions (FD) for the 20-hour, awake and sleep time series of RR intervals. Paroxetine treatment (19.7 ± 4.7 mg/day for 105 ± 37 days) resulted in a significant improvement in the frequency and intensity of panic attacks and also on the state anxiety inventory. Paroxetine treatment produced a significant decrease of 20-hour absolute HF power, awake absolute LF power and sleep absolute HF power. There was also a significant decrease of FDs after treatment with paroxetine for the sleep period. The decrease in LF and HF powers, and sleep FD is likely due to the antimuscarinic effect of paroxetine. The decrease in day-time LF power may also be due to a decrease in relative cardiac sympathetic activity after paroxetine treatment.
Effects of Serotonin-Selective and Classical Antidepressants on the Auditory P300 Cognitive Potential
Authors: d’Ardhuy X. Liogier , Boeijinga P.H. , Renault B. , Luthringer R. , Rinaudo G. , Soufflet L. , Toussaint M. , Macher J.-P.
Published: April 2003

The cognitive potential, P300, is a phenomenon frequently studied in relation to template matching of the brain. To understand the neurochemical mechanisms of its generation, we compared the effects of three antidepressants, fluoxetine, tianeptine and clomipramine after single and repeated application as well as after 1 week of withdrawal on the P300 and N200 waves in an auditory ‘odd-ball’ paradigm in three parallel groups of 10 healthy volunteers. Following single administration, both fluoxetine and clomipramine reduced (–39 ± 14%, p < 0.01) the peak amplitude of P300 at the Pz electrode. For fluoxetine and tianeptine, reduced amplitudes of 19 ± 7% and 24 ± 11%, respectively, were found following 8 days of treatment, 2 h after administration. However, for clomipramine no additional diminution was found on day 8 with respect to day 1. Topographic distributions tended to be significantly modified at the frontal scalp area 1 h after the tianeptine administration on day 8, whereas the postdosing changes induced by fluoxetine were localised in the midline and right centrotemporal scalp regions. Only minor reductions in peak latencies have been observed. It can be concluded that serotonin selective drugs have a slower onset of P300 amplitude decrease than clomipramine, which has additional effects on monoaminergic and on cholinergic systems. These results suggest that serotonin has a regulatory function in the neurotransmission of cerebral structures which are involved in the evaluation of stimulus relevance.
Endocrine Responses after d-Fenfluramineand Ipsapirone Challenge: Further Support for Cloninger’s Tridimensional Model of Personality
Authors: Hennig J. , Toll C. , Schonlau P. , Rohrmann S. , Netter P.
Published: April 2003

The tridemensional model of personality introduced by Cloninger relates aspects of novelty seeking to the dopaminergic, harm avoidance (HA) to the serotonergic, and reward dependence to the noradrenergic neurotransmitter system. Using a neuroendocrine challenge paradigm, this study investigates whether subjects characterized by blunted cortisol (CORT) responses after ipsapirone (IPS) relate to different subfactors of HA from those characterized by blunted prolactin (PRL) responses after treatment with d-fenfluramine (D-FEN). Moreover, subjects blunted in both responses should differ in scale values of subfactors of HA from those with only one or no blunted reactions. In the first part of the experiment, 16 healthy male volunteers were treated with 15 mg D-FEN. The second part of the study (about 1 year later) consists of a challenge with the partial 5-hydroxytryptamine-1a (5-HT1a) agonist IPS (10 mg) in the same subjects. The results indicate that blunted PRL responses are accompanied by high values in HA, while the main effect of IPS responsivity did not relate significantly to this dimension. With respect to the subscales of HA, subjects blunted in both responses (PRL–/C–) exhibit significantly higher levels in fatigability and asthenia when compared to all other groups (PRL–/C+, PRL+/C–,PRL+/C+). The data demonstrate that combined challenge tests may shed more light on the biological basis of personality and that HA and most clearly fatigability and asthenia relate to the 5-HT system.
Correlation Dimension of the Human Electroencephalogram Corresponds with Cognitive Load
Authors: Lamberts J. , van den Broek P.L.C. , Bener L. , van Egmond J. , Dirksen R. , Coenen A.M.L.
Published: April 2003

This study aimed at assessing the effects of cognitive activity and mental task load on the correlation dimension of the human electroencephalogram (EEG). Three experimental conditions were created: a baseline condition and two cognitive task conditions, a calculation task and a time estimation task. The calculation task was supposed to induce a higher mental load than the time estimation task, which is regarded as a less complex one. This was verified by a subjective rating scale. All conditions differed significantly in subjective estimated task load. The correlation dimension appeared to be higher in both task conditions compared to the baseline condition. A comparison of the two tasks indicated that the difference in correlation dimension between calculation and time estimation was also significant, with the highest value for calculation. It is concluded that cognitive and mental activity is associated with a higher correlation dimension in the EEG. This implies that the correlation dimension is a sensitive parameter in the analysis of electrical brain activity.
Sleep Laboratory Studies in Restless Legs Syndrome Patients as Compared with Normals and Acute Effects of Ropinirole
Authors: Saletu B. , Gruber G. , Saletu M. , Brandstätter N. , Hauer C. , Prause W. , Ritter K. , Saletu-Zyhlarz G.
Published: April 2003

Although the restless legs syndrome (RLS) is a disorder with a relatively high prevalence rate (8% in Austria) and leads to insomnia and excessive daytime tiredness, there is a paucity of sleep laboratory data concerning objective and subjective sleep and awakening quality. Thus, the aim of this study was to investigate 12 untreated RLS patients as compared with 12 normal controls and subsequently measure the acute effects of 0.5 mg ropinirole (Requip®) – a nonergoline dopamine agonist – as compared with placebo. In 3 nights (adaptation, placebo, ropinirole night) sleep induction, maintenance and architecture were measured objectively by polysomnography, subjective sleep and awakening quality were assessed by self-rating scales and visual-analog scales, and objective awakening quality was evaluated by a psychometric test battery. In polysomnography, RLS patients demonstrated, as compared with normal controls, a decreased total sleep time (TST) and sleep efficacy, increased wakefulness during the total sleep period and frequency of nocturnal awakenings, increased sleep stage S1, decreased S2 and increased stage shifts. Subjective sleep quality tended to decrease, and morning well-being, mood, affectivity and wakefulness were deteriorated. In the noopsyche, fine motor activity and reaction time performance were deteriorated. Ropinirole 0.5 mg induced, as compared with placebo, an increase in TST, sleep efficacy, S2 sleep and stage shifts. In the morning, somatic complaints increased slightly, while fine motor activity and reaction time performance improved. Our findings suggest a key-lock principle in the diagnosis/treatment of RLS and a dopaminergic mechanism in its pathogenesis, which is supported by the data on periodic leg movements during sleep and arousals of the subsequent paper.
Influence of Various Drugs on the Voluntary Intake of Nicotine by Rats
Authors: Kameda G. , Dadmarz M. , Vogel W.H.
Published: April 2003

The effects of the dopaminergic agonists (L-dopa, pergolide) and antagonists (haloperidol, clozapin) and a cholinergic agonist (tacrine) and antagonist (mecamylamine) on the voluntary intake of nicotine were investigated with the 2-bottle paradigm with the test drugs being dissolved directly in the drinking fluid of the animals. This method was found to be a reliable procedure to quickly screen compounds with specific sites of action in the brain for their effects on the voluntary intake of nicotine or perhaps other substances of abuse as well. L-dopa, pergolide and haloperidol did not affect the intake of nicotine, whereas tacrine increased it slightly and clozapine and mecamylamine markedly. These results indicate that blockade of nicotinic and dopaminergic D4 receptors partially reduce the desired effect of nicotine by forcing the animals to consume more of this substance.
Human Research on MDMA (3,4-Methylene- dioxymethamphetamine) Neurotoxicity: Cognitive and Behavioural Indices of Change
Authors: Parrott A.C.
Published: April 2003

Laboratory animals can develop serotonergic neurotoxicity after repeated doses of 3,4-methylenedioxymethamphetamine (MDMA) or ‘Ecstasy’. If similar neural damage occurs in humans, this may be evident in cognitive or behavioural impairments. In a review of the behavioural skills shown by drug-free recreational Ecstasy users, three aspects of cognitive performance are often affected: reduced memory for new information (Rivermead Behavioral Memory, supraspan word recall), impaired higher executive processing (Wisconsin Card Sort, Tower of London), and heightened impulsivity (Impulsiveness, Venturesomeness and Empathy Questionnaire, Matching Familiar Figures test). Performance on other more basic cognitive functions is generally unimpaired (simple reaction time, choice reaction time, number vigilance, Stroop, trail making). Some Ecstasy users also complain of poor memories and/or concentration difficulties, which they attribute to MDMA use. There are many methodological problems and uncertainties with research in this field: non-random allocation of subjects to drug conditions, the deleterious effects of other psychoactive drugs, and the possibility that these adverse profiles reflect pre-existing personality characteristics in Ecstasy users. However, this particular pattern of cognitive decrements in humans, is consistent with the animal data on those brain areas showing serotonergic damage following MDMA: the frontal cortex (impulsivity and higher cognitive impairments), and hippocampus (memory deficits). Finally, this profile of cognitive deficits is also consistent with a hypothetical integrative construct: namely reduced cortical inhibition.
Effects of Selective Serotonin Reuptake Inhibitors on Objective and Subjective Sleep Quality
Authors: Oberndorfer S. , Saletu-Zyhlarz G. , Saletu B.
Published: April 2003

The purpose of this paper is to review the effects of selective serotonin (5-HT) reuptake inhibitors on objective and subjective sleep and awakening quality measures. Polysomnography (PSG) demonstrated in both healthy volunteers and depressed patients a decrease in sleep efficiency and total sleep time, a lengthening of sleep latency and a deterioration in sleep continuity, including an increase in the number of awakenings and wake time during the total sleep period. Sleep architecture mostly showed an increase in S1 and S2 and a decrease in S3, S4 and REM sleep as well as a lengthening of REM latency. Objective awakening quality, if measured at all by psychometry, generally showed no decrements. Concerning subjective sleep and awakening quality, normals demonstrated either no changes or a tendency towards a deterioration, while in patients some improvement was observed. Reasons for this discrepancy will be discussed. Novel 5-HT reuptake inhibitors with additional modes of action such as 5-HT2 antagonism (e.g. trazodone, nefazodone) are more likely to improve objective and subjective sleep quality, although some shortcomings may be inherent in regard to comorbidity (e.g. sleep-related breathing disorders). Thus, PSG seems to be a necessity for diagnosis and treatment of complex sleep disorders.
Genome Scan for Susceptibility Loci for Schizophrenia
Authors: Bailer Ursula , Leisch Friedrich , Meszaros Kurt , Lenzinger Elisabeth , Willinger Ulrike , Strobl Rainer , Gebhardt Christian , Gerhard Elisabeth , Fuchs Karoline , Sieghart Werner , Kasper Siegfried , Hornik Kurt , Aschauer Harald N.
Published: April 2003

Objective: Schizophrenia is a relatively common, often chronic and debilitating mental illness. Evidence from various studies has clearly demonstrated that genetic factors contribute substantially to the etiology. The goal of this study was to identify chromosomal regions likely to contain schizophrenia susceptibility genes. Methods: A genome-wide map of 388 microsatellite DNA markers was genotyped in 5 schizophrenia families. Nonparametric linkage analysis (Genehunter) was used to assess the pattern of allele sharing at each marker locus relative to the presence of disease. Results: Nonparametric linkage scores did not reach a genome-wide level of statistical significance (p < 0.00002) or a p value suggestive of linkage (p < 0.007) for any marker; however, one p value suggested replicated linkage (p < 0.01) at chromosome 6p24 in region D6S309 (p = 0.0047). Furthermore, 11 markers resulted in p < 0.05 at chromosomes 6p, 6q, 10q, 12q and 14q. Conclusions: Despite the differences in diagnostic schemes, in markers used and methods of analyses between studies published so far, we think that our result supports the notion that there is possibly some consistent evidence for replicated linkage of a schizophrenia susceptibility locus around the region of D6S309 at chromosome 6p24.
A Comparison of Patterns of Tranquiliser Intake, Anxiety and Health Locus ofControl between Short- and Long-TermBenzodiazepine Users
Authors: Gutiérrez-Lobos Karin , Fröhlich Sabine , Miller Carl , Whitworth Alexandra B. , Quiner Sylvia , Barnas Christian
Published: April 2003

This study investigates the impact of physical illness, health locus of control and anxiety level on long- and short-term benzodiazepine (BZD) use in patients of an internal medicine department. There was no significant difference observed between the continuing and discontinuing group after hospital admission in terms of average daily dose of BZD. However, the continuing patients rated the condition of their somatic illness significantly higher than the discontinuing group, although this difference was not confirmed by the objective assessment of the treating physician. The non-continuing group displayed significantly higher control over health- and sickness-related events. The somatic and physical anxiety factor was significantly higher in the continuing group at initial investigation as well as at follow-up. On the basis of these results, we conclude that an increased focus on the psychosomatic element might reduce the risk of long-term tranquiliser use in patients with physical illness.
Topical Lomefloxacin 0.3% Twice Daily versus Tobramycin 0.3% in Acute Bacterial Conjunctivitis: A Multicenter Double-Blind Phase III Study
Authors: Gallenga P.E. , Lobefalo L. , Colangelo L. , Della Loggia G. , Orzalesi N. , Velati P. , Bujtar E. , Ponte F. , Damiani S. , Bucci M.G. , Bonini S. , Curatola M.R. , Palma L.A. , Bonomi L. , Tomazzoli Gerosa L. , Pagliarusco A. , Milan E. , Jauch A.
Published: April 2003

Aims/Background: To evaluate in a double-masked comparative, prospective, randomized multicenter trial the efficacy of lomefloxacin 0.3% eye drops twice daily and of tobramycin eye drops 4 times daily in patients with acute bacterial conjunctivitis. Methods: Ninety-nine subjects were enrolled: 50 were treated with lomefloxacin 0.3% eye drops twice daily and 49 with tobramycin 0.3% eye drops 4 times daily. In all patients, conjunctival swabbing and assessment of objective signs and of subjective symptoms were performed. Results: There was no statistical difference for any individual sign or symptom or for the sum score of either key or other signs and symptoms at any of the examination days. The sum score of both key and other signs and symptoms decreased in both groups at day 3–4 as compared to baseline values (p < 0.0001). The decrease in both these scores continued significantly from day 3–4 to day 7–8 (p < 0.05) and was similar in the two treatment groups (p > 0.4). The lowest resistance rate was seen in lome-floxacin (3.5%) and in neomycin (7.0%), while tobramycin showed resistance in 10 out of 88 resistance strains (11.4%). Conclusion: Both lomefloxacin 0.3% twice daily and tobramycin 0.3% administered 4 times daily were well tolerated and showed a high degree of clinical and microbiological efficacy in the treatment of acute bacterial conjunctivitis. Lomefloxacin caused less resistance than other antibiotics evaluated.
Effect of Conjunctival Structure and Inflammatory Cell Counts on Intraocular Pressure after Trabeculectomy
Authors: Arıcı Mustafa Kemal , Demircan Süleyman , Topalkara Ayşen , Güler Cenap , Aker Handan , Arıcı Dilek Sema
Published: April 2003

Purpose: To evaluate the conjunctival structure and inflammatory cell counts and to determine the predictive value of these histological parameters for postoperative intraocular pressure (IOP) levels after trabeculectomy. Methods: A clinical and histological study was performed on consecutive patients. Postoperative (mean 32.8 ± 18.4 months; range 6–60 months) conjunctival biopsies of 36 eyes of 28 primary open-angle glaucoma patients who had trabeculectomy between 1992 and 1995 were included in the study. According to postoperative pressure control, patients with ≤16 mm Hg and those with >16 mm Hg were taken as groups 1 and 2, respectively. The control group (group 3) consisted of 15 age-matched patients without glaucoma, who had received no topical therapy. We compared the conjunctival structure and cell counts within these groups. Goblet cells, acute inflammatory cells, chronic inflammatory cells, fibroblasts, epithelial thickness, vascular density, mucopolysaccharides and collagen compositions were determined in groups 1, 2 and 3. Results: The number of goblet cells was significantly higher in group 1 (6.74 ± 7.23) than group 2 (3.09 ± 2.77; p = 0.017). No statistical difference was observed in the number of acute inflammatory cells, chronic inflammatory cells, fibroblasts, epithelial thickness, vascular density, mucopolysaccharide or collagen compositions between groups 1 and 2 (p > 0.05). In addition, when groups 1 and 2 were compared with the control group, there was a significant decrease in goblet cells (p < 0.001), an increase in acute inflammatory cells, chronic inflammatory cells, fibroblasts, epithelial thickness and vascular density (p < 0.001), but there was no significant difference in mucopolysaccharide and collagen compositions (p > 0.05). Conclusions: This study suggests that at the time of surgery a high number of goblet cells may be a predictor of lowered IOP (≤16 mm Hg) following trabeculectomy without antimetabolite.
Experimental Hemispherectomy and Hemicerebellectomy and Their Influence on Vestibular Habituation
Authors: Każmierczak Henryk , Pawlak-Osińska Katarzyna , Osiński Pawel
Published: April 2003

The aim of the study was to estimate the influence of hemispherectomy and hemicerebellectomy on acquisition and retention of vestibular habituation in pigeons. The habituation training was performed using a rotatory test. The frequency of head nystagmus and postural reflexes was examined before and after acquisition of habituation and some days later, for the evaluation of the retention process. Our results suggested that the hemispherectomy did not inhibit the acquisition of habituation but retention of this phenomenon was shorter at that time. The hemicerebellectomy made it impossible to reveal the vestibular habituation.
Vestibular Evoked MyogenicPotentials in Patients with Bilateral Profound Hearing Loss
Authors: Ozeki Hidenori , Matsuzaki Masaki , Murofushi Toshihisa
Published: April 2003

We report vestibular evoked myogenic potentials (VEMPs) in 3 patients with bilateral profound hearing loss in order to confirm that they are not of cochlear origin. All of the 3 patients (31-year-old man, 67-year-old man and 47-year-old woman) had bilateral profound hearing loss. They were diagnosed as having congenital hearing loss, bilateral Ménière’s disease and inner ear syphilis. Their pure-tone hearing ranged from 81 dB HL to nearly total hearing loss. Stimulation by click (95 dB nHL) evoked biphasic myogenic responses (p13–n23) on the sternocleidomastoid muscle ipsilateral to the stimulated ear. The ear in which the stimulation did not evoke biphasic myogenic responses did not have a caloric response either. These results suggested that VEMPs are not likely of cochlear origin but of vestibular origin.
Cervical Metastasis of Occult Papillary Thyroid Carcinoma Associated with Epidermoid Carcinoma of the Larynx
Authors: López-Escámez J.A. , López-Nevot A. , Moreno-García M.I. , Gámiz M.J. , Salinero J.
Published: April 2003

An occult, laterocervical papillary thyroid carcinoma tissue was found in a functional neck dissection for larynx cancer. The patient was a 76-year-old man with a history of smoking and alcohol ingestion who presented with a supraglottic carcinoma of the larynx located at the laryngeal surface of the epiglottis, left aryepiglottic fold, band and left ventricle with extension to the left vocal cord. Light microscopy showed a lymph node with a fibrous stroma with lymphoid follicles that presented a total substitution of the parenchyma by a papillary thyroid carcinoma. Although examination of the thyroid gland by seriated sections did not reveal any neoplasm, we argue that the papillary thyroid tissue is metastatic.
Einfluss der Tonsillektomie auf metabolische Kontrolle und Insulinbedarf bei erwachsenen Diabetikern
Authors: Obrebowski Andrzej , Wierusz-Wysocka Bogna , Zozulinska Dorota , Majchrzak Anna , Rydzewski Bogdan
Published: April 2003

Fragestellung: Das Ziel dieser Arbeit war, die klinische Beurteilung des Tonsillektomie-Einflusses auf den Stand der metabolischen Kontrolle zu beurteilen und den Insulintagesbedarf bei erwachsenen Typ-I-Diabetikern festzustellen. Patienten: Es wurden 50 Patienten (♂ 23, ♀ 27, Durchschnittsalter 28,9 Jahre, Durchschnittskrankheitsdauer 20,6 Jahre) untersucht. Trotz Therapie wiesen die Patienten eine unzureichende Stoffwechseleinstellung des Diabetes auf. Man diagnostizierte bei ihnen eine chronische Tonsillitis als einzigen Entzündungsherd. Methoden: Nach entsprechender diabetologischer Vorbereitung wurde die Tonsillektomie nach Prämedikation unter Lokalanästhesie ohne Komplikationen durchgeführt. Bei allen Patienten wurden 2 Tage nach dem Eingriff, 3 Wochen und 3 Monate postoperativ der Blutzuckerspiegel, Fruktosamin- und HbAIc-Werte bestimmt. Ergebnisse: Nach Ablauf von 3 Wochen nach Tonsillektomie wurde eine statistisch signifikante Senkung des Blutzuckerspiegels im nüchternen Zustand und 2 h postprandial sowie eine Senkung der Fruktosaminwerte registriert. Der Insulintagesbedarf hatte sich beträchtlich reduziert. Die Beobachtungen wurden bei Kontrolluntersuchungen nach Ablauf von 3 Monaten bestätigt. Die Werte für glykosyliertes Hämoglobin (HbAIc) erfüllten zu dieser Zeit die Kriterien einer befriedigenden Stoffwechseleinstellung. Schlussfolgerungen: Die erzielten Ergebnisse zeigen die Notwendigkeit der Sanierung chronischer Entzündungsherde bei Typ-I-Diabetikern.
Aggressive and Ineffective Therapy for Otitis media
Authors: Cantekin Erdem I.
Published: April 2003

Objective: The standard American clinical practice for the management of acute otitis media (AOM), otitis media with effusion (OME), and recurrent otitis media (ROM) calls for repeated courses of wide-spectrum antibiotic therapy including extended duration antibiotic prophylaxis, followed by surgical insertion of typanostomy tubes with or without adenoidectomy. This is an attempt to assemble the scientific evidence to justify this practice. Methods: A systematic review of the literature involving clinical studies, randomized clinical trials (RCTs), and meta-analyses to summarize the existing database. Results: For the efficacy of antibiotics for AOM, only 3 of the 13 clinical studies and RCTs had positive results with marginal benefits. Among the 16 RCTs on the effectiveness of antibiotics for OME involving 2,067 children, 8 RCTs with placebo controls had pooled average antibiotic efficacy of 4% or less. Pooled data from 13 RCTs on antibiotic prophylaxis, ranging in duration 1 week to 2 years, for ROM provided no significant clinical prevention (less than 0.4 episodes per year). The surgery, based on the outcome of 22 RCTs, is not shown to be effective with the exception of extreme disease cases. In fact, it is estimated that over 90% of surgical cases for otitis media in the US are unnecessary. Conclusions: A scientific database is lacking to support the present American clinical practice of aggressive interventions. It is not an evidence-based medical practice that yields patient benefits. Rather, it is an unnecessary intervention with compelling adverse effects to the patient and the community.
Zur Bedeutung der Melanozyten des Innenohres im Rahmen der Spiralganglienzelldegeneration beim Akustikusneurinom
Authors: Sánchez-Hanke M. , Koch U. , Ahrendt I. , Uβmüller J.
Published: April 2003

Einleitung: Degenerative Veränderungen der Neuralzellen des Ganglion spirale sind eine Folge des Akustikusneurinoms (ACN). Das langsame Wachstum dieses Tumors führt zur einer metabolischen Adaptation der Neuralstrukturen der Cochlea, insbesondere des Ganglion spirale. Ziel der vorliegenden Studie war die Erforschung von histopathologischen Veränderungen der angrenzenden Strukturen des Ganglion spirale, wie Kapillaren, Bindegewebe und vor allem Melanozyten. Material und Methode: Es wurden insgesamt 30 Akustikusneurinome anhand von HE-gefärbten Felsenbein-Serienschnitten (Wittmaack-Sammlung) histopathologisch untersucht. Die degenerativen Veränderungen des Ganglion spirale und des Corti-Organs und Veränderungen der Nachbarstrukturen wurden analysiert und semiquantitativ ausgewertet. Anschliessend wurden Korrelationsstudien zwischen den einzelnen Wachstumsstadien des Tumors und den unterschiedlichen histopathologischen Befunden durchgeführt. Ergebnisse: Bereits bei den kleinen Akustikusneurinomen (Durchmesser ≤8 mm des Meatus auditivus internus) konnte eine sekundäre retrograde Degeneration etwa der Hälfte der Spiralganglienzellen nachgewiesen werden. Die in der Umgebung des Ganglion spirale liegenden Melanozyten waren im Frühstadium in der Nähe von Kapillaren vermehrt nachweisbar. Bei Tumoren im Spätstadium (Tumordurchmesser ≥25 mm) waren hingegen keine Ganglienzellen oder Melanozyten mehr vorhanden. In Fällen einer tumorbedingten Gefässstenosierung des inneren Gehörgangs war das Corti-Organ komplett zerstört. Schlussfolgerungen: Die degenerativen Veränderungen des Spiralganglions im Frühstadium des Akustikusneurinoms führen zunächst zu einer Vermehrung von Melanozyten. Die Melanozyten scheinen hier im Sinne eines Reparaturorgans auf Zellebene im Innenohr zu wirken. Das Fehlen von Melanozyten bei kompletter Degeneration im fortgeschrittenen Stadium des ACN ist auf den nun fehlenden Zellmetabolismus des Innenohres zurückzuführen.
Ist die Positronen-Emissions-Tomographie (PET) zum Nachweis tumorbefallener Halslymphknoten bei Plattenepithelkarzinomen des Kopf-Halsbereiches in der klinischen Routine sinnvoll einsetzbar?
Authors: Kau R.J. , Alexiou C. , Werner M. , Schwaiger M. , Arnold W.
Published: April 2003

Zielsetzung: Bei Patienten mit Plattenepithelkarzinomen der Kopf-Halsregion ist zur Festlegung einer individualisierten Therapie die genaue Bestimmung der Halslymphknotenbeteiligung unabdingbar. In einer vorangegangenen Untersuchung konnten wir zeigen, dass 18F-FDG-PET mit und ohne Schwächungskorrektur in einem wissenschaftlichen Untersuchungsprotokoll der Kernspintomographie überlegen ist. In der vorliegenden Arbeit sollte die diagnostische Genauigkeit eines verkürzten PET-Protokolls (Aufnahmezeit 20 min) untersucht werden. Studiendesign: Statische, nicht-schwächungskorrigierte PET-Aufnahmen, wurden in 2 Bettpositionen 40 min. im Anschluss an die intravenöse Gabe von 370 MBq 18F-FDG gewonnen und mit den morphologischen bildgebenden Verfahren (CT u. MRT) verglichen. 70 nicht vorselektierte Patienten wurden so zur Festlegung des Lymphknotenstatus untersucht. Die postoperativen pathologischen Ergebnisse dienten als «gold standard». Ergebnisse: Die diagnostische Genauigkeit der Positronenemissionstomographie zur Beurteilung der tumorbefallenen «Halsseiten» war dem morphologischen Verfahren mit einer Sensitivität von 87% und einer Spezifität von 94% gegenüber CT 65%, bzw. 47% und MRT mit 88% bzw. 41% deutlich überlegen. Schlussfolgerung: Ein abgekürztes PET-Protokoll ist für die klinische Routine einsetzbar und dem morphologischen Verfahren (CT u. MRT) in der Diagnostik von malignen, infiltrierten Lymphknoten des Kopf-Hals-Bereiches, auch in der klinischen Routine, überlegen.
Hypoglossal-Facial Anastomosis in Complete Unilateral Facial Palsy
Authors: Stewart R.A. , Goswami S.C. , Primrose W.J. , Kerr A.G.
Published: April 2003

Hypoglossal-facial nerve anastomosis is a popular technique for the treatment of unilateral complete facial palsy when restoration of the continuity of the facial nerve by grafting or repair is not possible. Thirteen cases of complete facial palsy treated with hypoglossal-facial nerve anastomosis between 1984 and 1995 are reviewed. In 11 patients good facial symmetry at rest was restored. All patients achieved voluntary facial movements to varying degrees by learned changes in placement of the tongue. Hemi-atrophy of the tongue was eventually noted in all cases, being marked in 2. However, no patient described subjective difficulty with speech or swallowing. Twelve of the 13 patients expressed satisfaction with the outcome of the procedure.
Stapedotomy Piston Diameter – Is Bigger Better?
Authors: Teig Erik , Lindeman Henrik H.
Published: April 2003

Introduction: An important question, which confronts every otosclerosis surgeon, is which type of stapes prosthesis should be chosen. A wide variety of prostheses with different shapes, material and shaft diameters is commercially available. This paper addresses the importance of the piston shaft diameter. Patients and Material: In this retrospective study of 225 consecutive stapedotomies performed in the period 1981–1998, prostheses with a diameter of 0.4, 0.6 and 0.8 mm have been compared. Results: Bigger pistons give better hearing results for frequencies up to and including 2 kHz.
Approche psychosociale en ORL
Authors: Archinard Marc
Published: April 2003

En ORL, les domaines actuels d’application de l’approche psychosociale sont nombreux: oncologie, infectiologie, troubles de l’audition et de l’équilibre. La médecine psychosociale n’est pas une spécialité, mais une attitude et une approche centrées sur le patient et les dimensions psychologiques et relationnelles de son affection, sous divers angles, tels que la recherche d’éventuels facteurs psychologiques, l’évaluation et la prise en charge des répercussions psychosociales de la maladie, et la psychologie de la plainte, centrale pour la relation médecin-malade: l’auteur discute la nature, la signification et la prise en compte des acouphènes et des vertiges de ce point de vue, et formule quelques recommandations pour l’approche psychologique des patients qui en souffrent.
La prise en charge prothétique du patient acouphénique
Authors: Bizaguet Eric , Ohresser Martine , Bischoff Hervé
Published: April 2003

La prise en charge du patient atteint d’un acouphène chronique invalidant devrait être pluridisciplinaire. Parmi les intervenants, l’audioprothésiste tient une place très importante. Notre prise en charge prothétique de l’acouphène a beaucoup évolué au long de ces dernières années et ce travail présente les résultats obtenus avec les masqueurs, les atténuateurs de son ainsi qu’avec d’autres réalisations apparentées. Les meilleurs résultats sont obtenus avec des appareils correcteurs de la surdité. Les principes de l’adaptation prothétique diffèrent selon que la perte auditive est supérieure à 35 dB, situation qui ne pose pas de difficulté majeure ou inférieure à 35 dB. L’appareillage numérique présente là de grands avantages. Les prothèses avec canaux tolalement séparés offrent plus de possibilités d’adaptation pour couvrir au mieux l’acouphène en fonction du bruit du milieu ambiant. L’adaptation prothétique diminue l’impact de l’acouphène et augmente notablement le confort du patient dans 70–80% des cas.
Obstructive Sleep Apnea Syndrome and Snoring: What Is the Role of Surgery?
Authors: Pasche Philippe , Pellanda A. , Jaques Bertrand
Published: April 2003

This paper evaluates the different surgical treatments used in obstructive sleep apnea syndrome and snoring. This critical analysis is based on an extensive review of the literature and the authors’ experience. In snoring patients, the success rate of surgery focusing on the soft palate does not exceed 50–60%, and the risk of pharyngeal narrowing is high. Therefore, this treatment should be selectively performed. More conservative approaches are now under development. The surgical treatment of the obstructive sleep apnea syndrome is controversial. Surgery of the soft palate is associated with a high rate of complications and, therefore, is restricted to a limited number of cases. The compliance with continuous positive airway pressure is low, especially among young patients. Therefore, maxillofacial surgery has regained interest with two opposite concepts. Some authors favor a step-by-step approach, while others proceed in a one-stage surgery. The latter is more aggressive, but its success rate is superior (90%). Results and indications of hyoid myotomy and suspension associated with genioplasty (phase 1) and maxillomandibular osteotomy and advancement (phase 2) are reviewed in detail.
Cytoskeletal Reorganization Induced by Retinoic Acid Treatment of Human Endometrial Adenocarcinoma (RL95-2) Cells Is Correlated with Alterations in Protein Kinase C-α
Authors: Carter Charleata A. , Parham Groesbeck P. , Chambers Timothy
Published: April 2003

We have shown previously that treatment of human endometrial adenocarcinoma (RL95-2) cells with either 13-cis or all-trans retinoic acid results in reorganization of actin filaments, indicating reversion to a stationary phenotype. In the present study, we investigated the role of protein kinase C (PKC) in this process. Treatment of cells with PKC inhibitors (staurosporine, bisindolylmaleimide, or Gö6976) resulted in morphological alterations and reorganization of actin filaments similar to retinoic-acid-treated cells. For example, RL95-2 cells treated with staurosporine flattened, exhibited cell surface extensions and some actin filaments. Bisindolylmaleimide-treated cells flattened, and actin filaments reorganized similar to retinoic-acid-treated cells. RL95-2 cells treated with Gö6976, which inhibits only PKCα, β, and γ, exhibited many cell surface extensions and some actin filament reorganization. We then investigated whether retinoic acid affected the subcellular localization of PKC-α. In control cells, PKC-α was mainly evident as diffuse cytoplasmic immunostaining, with a small percentage of total PKC-α also evident in the plasma membrane. Retinoic acid treatment dramatically altered PKC-α localization, since a more distinct cytoplasmic and perinuclear staining pattern was apparent. Western blot analysis confirmed these results, since the amount of cytosolic PKC-α increased following retinoic acid treatment. Thus, retinoic-acid-induced endometrial differentiation may be associated with alterations in PKC-α localization and signaling.
The NF-κB and IκB System in Injured Arteries
Authors: Lindner Volkhard
Published: April 2003

Activation of endothelial cells and dedifferentiation of smooth muscle cells (SMC) are events in the development of vascular disease. The NF-κB transcription factor family and its inhibitory proteins (IκB) have been implicated in regulating the expression of genes associated with the concomitant inflammatory response. To determine the role of the NF-κB/IκB system in vivo, the present study used the balloon catheter injury model in the rat carotid artery. Immunoblotting revealed that higher levels of the NF-κB family members p50, p52, p65, c-Rel, and RelB were expressed in injured arteries during lesion formation compared to normal vessels. Using electromobility shift assays, low levels of constitutively activated NF-κB were seen in normal carotid arteries and an induction occurred during times of rapid SMC proliferation. Furthermore, immediately after injury, the levels of the inhibitor proteins IκBα, IκBβ, and p105 were dramatically reduced. Consistent with the activation of NF-κB, vascular cell adhesion molecule-1 (VCAM-1) and monocyte chemotactic protein-1 (MCP-1) were induced in SMC and endothelial cells as early as 4 h after injury and this was accompanied by adhesion of monocytes/macrophages. SMC forming a pseudoendothelium in chronically denuded vessels continued to express high levels of VCAM-1 and MCP-1, thus perpetuating the inflammatory response. These findings link the activation of NF-κB to the inflammatory response and to intimal lesion formation following vascular injury.
Enhancement of Atherosclerosis in Beta-2-Glycoprotein I-Immunized Apolipoprotein E-Deficient Mice
Authors: Afek Arnon , George Jacob , Shoenfeld Yehuda , Gilburd Boris , Levy Yair , Shaish Aviv , Keren Pnina , Janackovic Zora , Goldberg Iris , Kopolovic Juri , Harats Dror
Published: April 2003

We have previously shown that low density lipoprotein receptor-deficient (LDL-RD) mice immunized with β2-glycoprotein I (β2GPI; a target of autoimmune anticardiolipin antibodies) developed enhanced early atherosclerosis, when fed a normal chow diet. The current study was undertaken to evaluate the effect of immunization with β2GPI and the addition of a high fat diet on the progression of atherosclerosis in the apolipoprotein E (ApoE)-deficient mouse. Six-week-old female ApoE-deficient mice (n = 10) were immunized subcutaneously with either human β2GPI or with ovalbumin, both emulsified in complete Freund’s adjuvant and fed a high fat diet for 6 weeks. The β2GPI-immunized mice were found to develop accelerated atherosclerosis when compared with their ovalbumin-immunized littermates (aortic lesion area of 137,500 ± 13,801 vs. 72,444 ± 14,465 µm2, respectively; p = 0.0067). The β2GPI-immunized mice developed high titers of anti-β2GPI antibodies, 10 days after the procedure, which were sustained until the sacrifice. LDL extracted from both study groups displayed similar susceptibility to ex vivo oxidation. These results confirm our previous study in which we found increased atherosclerosis in β2GPI-immunized LDL-RD mice fed a chow diet. In the current study we show that the proatherogenic effect of β2GPI immunization is maintained despite high cholesterol levels and is not associated with increased susceptibility of LDL to ex vivo oxidation.
Reconstructed Human Cornea Produced in vitro by Tissue Engineering
Authors: Germain Lucie , Auger François A. , Grandbois Eric , Guignard Rina , Giasson Marcelle , Boisjoly Hélène , Guérin Sylvain L.
Published: April 2003

The aim of the present study was to produce a reconstructed human cornea in vitro by tissue engineering and to characterize the expression of integrins and basement membrane proteins in this reconstructed cornea. Epithelial cells and fibroblasts were isolated from human corneas (limbus or centre) and cultured on plastic substrates in vitro. Reconstructed human corneas were obtained by culturing epithelial cells on collagen gels containing fibroblasts. Histological (Masson’s trichrome staining) and immunohistological (laminin, type VII collagen, fibronectin as well as β1, α3, α4, α5, and α6 integrin subunits) studies were performed. Human corneal epithelial cells from the limbus yielded colonies of small fast-growing cells when cultured on plastic substrates. They could be subcultured for several passages in contrast to central corneal cells. In reconstructed cornea, the epithelium had 4–5 cell layers by the third day of culture; basal cells were cuboidal. The basement membrane components were already detected after 3 days of culture. Integrin stainings, except for the α4 integrin, were also positive after 3 days. They were mostly detected at the epithelium-stroma junction. Such in vitro tissue-engineered human cornea, which shows appropriate histology and expression of basement membrane components and integrins, provides tools for further physiological, toxicological and pharmacological studies as well as being an attractive model for gene expression studies.