bluuebunny/crossref_metadata_2025 huggingface dataset:
Chlamydia in Anterior Ischemic Optic Neuropathy
Authors: Vécsei Pia V. , Kircher Karl , Reitner Andreas , Khanakha Gelas , Stanek Gerold
Published: April 2003

There is an increasing body of evidence linking the common respiratory human pathogen Chlamydia pneumoniae with atherosclerosis and other vascular disorders. Our research was designed to investigate the association of this organism with anterior ischemic optic neuropathy (AION), representing an acute ischemic disorder of the optic nerve head. Sera were examined of 14 consecutive patients with AION and of 14 age- and sex-matched control subjects with noncardiovascular, nonpulmonary disorders. Antibodies against chlamydial lipopolysaccharide (LPS) and outer membrane proteins of C. pneumoniae were determined by ELISA. Further, nucleic acid amplification tests were done in order to detect C. pneumoniae-specific nucleotide sequences. Four patients (29%) were IgA positive, 11 (79%) were IgG positive and 1 (7%) was IgM positive for chlamydial LPS antibodies. In the control group, 36, 79 and 7% were IgA, IgG and IgM positive and showed no significant difference. IgA, IgG and IgM antibodies to C. pneumoniae were found in 43, 79 and 0% and did not differ from matched controls. By the nucleic acid amplification test, specific C. pneumoniae sequences were neither detected in the AION patients nor in the control group. These data do not support the association of AION with previous C. pneumoniae infection. However, it remains unclear whether Chlamydia actually initiates atherosclerotic injury, facilitates its progression or plays another role in other vascular disorders.
Optic Disk Vasculitis Associated with Chronic Active Epstein-Barr Virus Infection
Authors: Yamamoto Masahiro , Ohga Shouichi , Ohnishi Yoshitaka , Inomata Hajime
Published: April 2003

Purpose: To report two cases of optic disk vasculitis associated with chronic active Epstein-Barr virus infection (CAEBV). Method: We examined the eyes of two patients with CAEBV. Results: In the first case, a 6-year-old boy, visual acuity was 20/20 in both eyes. Papillary and peripapillary exudates were observed in the right eye. Fluorescein angiography showed hyperfluorescence of the optic disk and a leakage from the peripapillary retinal vessels in the right eye. Two months later, the exudates increased and preretinal hemorrhages appeared in the right eye. Visual acuity decreased to 20/60. He was treated with systemic administration of corticosteroid, globulin and acyclovir. Visual acuity returned to 20/20, but peripapillary exudates remained in the right eye. In the second case, a 16-year-old girl, visual acuity was 20/20 in both eyes. The right eye showed optic disk swelling and dilated retinal veins. Fluorescein angiography showed hyperfluorescence of the optic disk but no leakage from the retinal vessels. Visual field examination revealed an enlarged blind spot in the right eye in both cases. These ocular manifestations are compatible with those of optic disk vasculitis, which shows swelling of the optic disk and dye leakage on and around the optic disk in fluorescein angiography, with an almost normal visual acuity and an enlargement of the blind spot. Conclusion: Persistent Epstein-Barr virus infection may cause optic disk vasculitis.
Fünf Jahre flächendeckendes Hörscreening bei Neugeborenen in Vorarlberg
Authors: Elsässer Wolfgang , Münst Bernhard
Published: April 2003

Seit 5 Jahren wird im Bundesland Vorarlberg (350000 Einwohner) ein flächendeckendes Hörscreening mit der Messung von otoakustischen Emissionen (OAEs) bei Neugeborenen durchgeführt. Da 99% der Entbindungen in 6 Geburtenabteilungen stattfinden, werden die OAEs durch geschultes und motiviertes Pflegepersonal vorgenommen. Durch die zusätzliche Einbeziehung der niedergelassenen Fachärzte beschränkt sich der Anteil an Kindern, die der pädaudiologischen Ambulanz zugewiesen werden, auf etwa 1%: Kontrolluntersuchungen mittels OAEs und im Bedarfsfall Screening mit Hirnstammaudiometrie reduzieren den Anteil der Kinder, die eine eingehende pädaudiologische Hörabklärung benötigen. Bei 16 Kindern von 10000 wurde durch das Screening eine Schwerhörigkeit festgestellt. Das durchschnittliche Alter der Ersterfassung einer Schwerhörigkeit liegt in Vorarlberg bei 1,3 Lebensmonaten und der Zeitpunkt der Erstversorgung mit Hörgeräten bei 6,3 Lebensmonaten. Vor der Einführung des Hörscreenings lag die Erstdiagnose einer Schwerhörigkeit zwischen dem 2. und 3. Lebensjahr.
Expression of Cytokeratin Subtypes and Vimentin in Squamous Cell Carcinoma of the Floor of the Mouth and the Mobile Tongue
Authors: van der Velden Lilly-Ann , Schaafsma H. Ewout , Manni Johannes J. , Ramaekers Frans C.S. , Kuijpers Wim
Published: April 2003

Objectives: The assessment of the expression patterns of cytokeratin polypeptides (Cks) and vimentin in normal epithelium of the mobile tongue and floor of the mouth, squamous cell carcinomas and their lymph node metastases. Material and Methods: Chain-specific monoclonal antibodies to various Cks and vimentin were used, employing the immunoperoxidase technique. Results and Conclusions: Profound changes in the expression of pre-existing Cks and de novo expression of simple epithelium-related Cks and of vimentin occurred upon malignant transformation and tumor progression. Changes were mainly related to the degree of cellular differentiation, tumor cell morphology and tumor growth pattern. Low-grade tumors showed a pronounced decrease of the stratification Cks 4 and 13, and an increase of Cks 14, 16, and 17. With increasing tumor grade, expression of Cks 16 and 17 decreased. De novo expression of Cks 8 and 18 and of vimentin was most marked in high-grade tumors, in tumors with a basaloid phenotype and in tumors growing in small infiltrating tumor fields; it was proposed to be associated with poor prognosis.
Nature and evolution of B chromosomes in plants: A non-coding but information-rich part of plant genomes
Authors: Puertas M.J.
Published: April 2003

This work reviews recent advances providing insights on the origin and evolution of B chromosomes (Bs) in representative plant species. Brachyome dichromosomatica has large and micro Bs. Both carry an inactive ribosomal gene cluster. The large Bs contain the B-specific Bd49 family, mainly located at the centromere. Multiple copies are present in the A chromosomes (As) of related species, whereas only a few copies exist in B. dichromosomatica As. The micro Bs share sequences with the As, the large Bs and have the B-specific repeats Bdm29 and Bdm54. It seems that the large and micro Bs are related in origin. It is very unlikely that the Bs originated by simple excision from the As. Rye Bs are composed of sequences predominantly shared with the As. B-specific sequences are located at the heterochromatic end of the long arm. Probably, they originated from the As after many rearrangements, with a tendency for duplication. The E3900 family derives from a Ty3 gypsy retrotransposon, but the D1100 family shows no evidence of genic origin. The overall composition of maize As and Bs is similar suggesting a common origin. Several B-specific sequences have been found, the most studied being pZmBs, which is located at the B centromere. It shows partial homology to the centromere of chromosome 4 and to the knobs. It is not known whether the B centromere derives from centromere 4, or whether both have a more distant common origin. The dynamics of Bs in populations depends on their non-Mendelian mechanisms of transmission, their effects on carrier fitness and on A genes modulating their parasitic properties. Three representative examples are reviewed. The Bs of Allium schoenoprassum are transmitted at a mean lower than Mendelian and adversely affect vigour and fertility. However, there is a differential selection operating in favour of B-containing seedlings. Rye Bs undergo strong drive, which is counteracted by harmful effects on fertility and instabilities at meiosis. Both nondisjunction and meiotic behaviour, and consequently the establishment of B polymorphisms, mainly depend on the Bs themselves. B nondisjunction in maize is controlled by the B, but the As control preferential fertilisation. Considering the non-equilibrium model, the Bs of Allium seem to have been neutralised by the A genome, the As of maize provide defence against B attack, whereas the Bs of rye are only slightly neutralized.
Maternal Selenium Nutrition and Neonatal Immune System Development
Authors: Dylewski Maggie L. , Mastro Andrea M. , Picciano Mary Frances
Published: April 2003

We evaluated the impact of dietary selenium intake on neonatal immune cell differentiation and function. A low selenium intake during pregnancy and lactation produced reductions in maternal plasma selenium (33%, p = 0.0001), milk selenium (36%, p = 0.001), and corresponding neonatal plasma selenium (47%, p = 0.008). Thymocytes from neonates receiving low-selenium milk showed an impaired activation in vitro (p = 0.001). The percentages of CD8 cytotoxic T cells (p = 0.03), CD2 T cells (p = 0.09), panB cells ( = 0.02), and natural killer cells (p = 0.07) were all decreased in neonates nursed by mothers fed a low-selenium diet. The results indicate that maternal selenium intake impacts neonatal selenium status which in turn influences the neonatal immune system development.
The Circulating Levels of Lipoproteins in Embryos and Newly Hatched Ducklings Change with Parental Age1
Authors: Braun Christie M. , Frank N. , Latour Mickey A.
Published: April 2003

The purpose of this study was to investigate the effects of duck breeder age on circulating very low density lipoprotein (VLDL) and low-density lipoprotein (LDL) levels in embryonic (day 25 of incubation) and newly hatched ducklings (hatch and 1, 2, 3, and 5 days after hatch). In this study, embryos and ducklings from one breeder flock were monitored at breeder ages 24 weeks (young breeders), 31 weeks (mature breeders and near peak egg production), and 47 weeks (after peak egg production). Embryos and newly hatched ducklings from young breeders (24 weeks of age) displayed lower levels of VLDL and LDL. The composition of VLDL was affected by breeder age such that embryos and ducklings from young breeders had less cholesterol ester/protein and triglyceride/protein ratios. Even though the overall levels were suppressed in embryos and newly hatched ducklings from 24-week-old breeders, the overall percentage of triglyceride within VLDL and LDL particles was higher. These data would suggest that breeder age affects concentration and composition of both VLDL and LDL in embryos and newly hatched ducklings.
Antenatal Treatment with Corticosteroids Affects mRNA Expression of Dopamine D1 and D2 Receptors in the Striatum of Developing Rabbit
Authors: Labaune Jean-Marc , Boutroy Marie-Jeanne , Bairam Aida
Published: April 2003

The expression levels of dopamine D1 and D2 receptor mRNA have been investigated using Northern blot analysis in developing rabbit striatum after antenatal exposure to betamethasone. Pregnant rabbits were given either 0.1 mg/kg betamethasone or 0.1 mg/kg saline doses twice within 24 h. Dopamine D1 receptor mRNA levels were found significantly higher in the fetuses exposed to antenatal betamethasone than in the saline-treated controls. After birth, dopamine D1 and D2 receptor mRNA levels were both significantly lower in 1- and 25-day-old treated pups but recovered to normal levels in adulthood. These data suggest that antenatal exposure to betamethasone can lead to lasting abnormalities.
Histological Evaluation of Osteochondral Defects: Consideration of Animal Models with Emphasis on the Rabbit, Experimental Setup, Follow-Up and Applied Methods
Authors: Rudert Maximilian
Published: April 2003

Regardless of their etiology, cartilage defects of articular joints remain one of the unsolved problems in medicine. Therefore, numerous techniques to enhance cartilage repair are under clinical or experimental investigation. In any serious approach experimental investigation should precede human application. If the decision is made to implement an animal model, which one should be used? What is a good experimental animal for osteochondral defects? Can chondral defects be evaluated? What is the critical size of the defect? How long should the experiment last? Which histological techniques should be used? What are the pitfalls when evaluating osteochondral defects histologically? What is the best scoring system? All these questions will be addressed to provide concise information on this topic with particular attention being paid to the rabbit as an experimental animal. Biotechnological techniques of investigation are developing rapidly. Hence special emphasis is placed on principles and reliable morphological examination.
Structure of the Palate and Pharynx in the House Musk Shrew (Suncus murinus)
Authors: Yoshida Mitsuhara , Kitoh Junzoh , Yanagita Noriyuki
Published: April 2003

Anatomical features of the palates and pharynges in Suncus murinus were examined through a dissecting microscope. The palatopharyngei (PP) on both sides join at the caudal, median line of the palatine velum and converge in an area immediately caudal to a mucosal notch, the pharyngeal torus before radiating into the dorsal wall of the esophagus. Some muscle bundles of the PP are attached to the veli palatini cartilage. The nasopharyngeal cartilage is situated rostral to curved mucosal plicae of the palatine velum. The pharyngeal torus interlocks with the rostrally lying corniculate tubercles. The structural relationships of the corniculate tubercles, pharyngeal torus and PP suggest that muscular tension of the PP sustains the epiglottis and retains it in the nasopharynx, i.e. the PP acts as a circumscribed sphincter around the epiglottis and establishes a short, secure air passageway to the larynx. The nasopharyngeal and veli palatini cartilages could keep the passageway in shape.
Chronic Pancreatitis and Pancreatic Cancer
Authors: Maisonneuve Patrick , Lowenfels Albert B.
Published: April 2003

Pancreatic cancer is the fourth leading cause of cancer deaths in the USA in both sexes. Early diagnosis is difficult and the overall mortality rate is high. Individuals at high risk for pancreatic cancer include smokers, and persons with all forms of chronic alcoholic, metabolic, tropical or hereditary pancreatitis. The duration of exposure to inflammation seems to be the major factor involved in the transition from benign to malignant condition. Smoking, which appears to further accelerate the carcinogenic transformation, remains the strongest risk factor amenable to preventive intervention.
Prenatal Resection of a Fetal Pericardial Teratoma
Authors: Sydorak Roman M. , Kelly Thomas , Feldstein Vickie A. , Sandberg Per L. , Silverman Norman H. , Harrison Michael R. , Albanese Craig T.
Published: April 2003

Objective: Pericardial teratomas are rare congenital tumors which invade the developing mediastinum, compressing the venous return to the heart, leading to hydrops. Tumors, with large cystic components, have been treated previously with in utero pericardiocentesis with some success. We present the first reported case of in utero open resection of a fetal pericardial teratoma. Methods: A 31-year-old G1P0 woman was found to have a fetus with a pericardial teratoma. Hydrops developed at 24 weeks’ gestation. After counseling, open fetal resection was performed via a fetal median sternotomy. Results: Although the tumor was successfully removed, the hydrops did not resolve. In addition, over the course of 3 weeks, the mother developed maternal mirror syndrome which prompted an emergent cesarean section. Neonatal death ensued shortly after birth. Conclusions: The fetus with a pericardial teratoma complicated by hydrops is compromised. Treatment options include early delivery, aspiration of the pericardial effusion, and in utero operative resection.
Effects of Voluntary Maneuvers on Tongue Base Function for Swallowing
Authors: Lazarus Cathy , Logemann Jeri A. , Song Chi Wook , Rademaker Alfred W. , Kahrilas Peter J.
Published: April 2003

Concurrent manometry and videofluoroscopy were utilized to examine tongue base function during swallowing in 3 patients with head and neck cancer. Subjects were instructed in four voluntary swallow maneuvers, including the supersupraglottic swallow, effortful swallow, Mendelsohn maneuver, and tongue-hold maneuver. Peak catheter pressures (mm Hg) at the tongue base-pharyngeal wall level were recorded and duration of tongue base to pharyngeal wall contact was measured for each swallow. This pilot study revealed that tongue base-pharyngeal wall pressures and contact duration increased with use of maneuvers. Preliminary data are provided to support the use of swallow maneuvers to improve tongue base posterior motion and pressures generated at the tongue base-pharyngeal wall level during swallowing in patients who exhibit this disorder.
Vestibular-Evoked Myogenic Potentials as a Test of Otolith Function
Authors: Al-Sebeih Khalid , Zeitouni Anthony
Published: April 2003

Objectives: To evaluate the use of 75 auditory clicks rather than the usual 100–256 for production of the vestibular-evoked myogenic potential (VEMP) response and to assess if the VEMP correlates with measures of cochlear function such as hearing loss (decibels on pure-tone testing) or auditory brainstem response (ABR). Subjects and Methods: Testing of the VEMP was carried out on 24 subjects: 7 normal individuals and 13 hard-of-hearing patients, 2 patients with known vestibular lesions, 1 with profound sensorineural hearing loss and 1 patient with unilateral acoustic neuroma prior to resection. The recording was performed using a conventional ABR machine. Using 75 refraction clicks as auditory stimuli, VEMP responses were measured from a surface electrode applied to the sternocleidomastoid muscle. The 75 responses were averaged. Results: A consistent unilateral biphasic response, the first negative and the second positive (nI, pII), was elicited from 39 of 40 ears (7 normal and 13 hard-of-hearing subjects with no known vestibular dysfunction). No statistical difference was found between the right and left ear responses for nI or pII wave latencies. Two patients with loss of peripheral vestibular function showed no VEMP responses on the affected side. The responses, however, were elicited bilaterally in a patient with congenital profound sensorineural hearing loss. In addition, ABR latencies did not correlate with VEMP latencies. Conclusion: Clear VEMP responses were elicited by using only 75 auditory clicks. This shortens the testing time and facilitates the procedure for the tested subject. Our data also indicate that the VEMP is generated secondary to auditory stimulation of the vestibular end organs (specifically the saccule) and does not correlate with cochlear function.
Modulation of the Negative Inotropic Effect of Haloperidol by Drugs with Positive Inotropic Effects in Isolated Rabbit Heart
Authors: Hatip-Al-Khatib Izzettin , Bolukbaşi-Hatip Funda
Published: April 2003

Haloperidol is a typical antipsychotic drug with inhibitory effects on dopamine and calcium homeostasis. In this study, the effect of haloperidol on the inotropism of rabbits’ isolated heart was investigated by measuring the isovolumetric left ventricular pressure using a balloon in a modified Langendorff perfusion apparatus. Haloperidol at 0.01–0.3 µmol/l induced a negative inotropic effect (Emax = 77.95 ± 0.19; EC50 = 0.043 ± 0.002 µmol/l). The effect of haloperidol was decreased by Ca2+ (Emax = 42.93 ± 3.22; EC50 = 0.37 ± 0.07 µmol/l; pD’2 = 7.01 ± 0.16), Bay K 8644 (Emax = 30.75 ± 1.33; EC50 = 10.43 ± 1.5 µmol/l, pD’2 = 7.13 ± 0.12), and digoxin (Emax  = 42.03 ± 3.72, EC50 = 0.32 ± 0.05 µmol/l, pD’2 = 6.81 ± 0.14). The effect of haloperidol was also reduced by norepinephrine (Emax = 37.16 ± 1.84; EC50 = 1.73 ± 0.24 µmol/l, pD’2 = 6.97 ± 0.08) and dopamine (Emax = 35.68 ± 2.78; EC50 = 0.69 ± 0.01 µmol/l, pD’2 7.48 ± 0.15). However, the effect of haloperidol was nonsignificantly reduced by dobutamine (Emax = 58.89 ± 5.18; EC50 = 0.15 ± 0.06 µmol/l, pD’2 = 5.88 ± 0.47). These results show that the drugs that increase the influx of Ca2+ into the cardiomyocyte decrease the negative inotropic effect of haloperidol, suggesting that the effect of haloperidol could be mediated via mechanisms involving actions on Ca2+ entry into the cardiomyocyte. Haloperidol should be used carefully when prescribed for patients with cardiovascular disorders.
Loss of Antinociceptive Efficacy in Rat Pups Infused with Morphine from Osmotic Minipumps
Authors: Stoller Dawn C. , Thornton Suzanne R. , Smith Forrest L.
Published: April 2003

We determined the susceptibility of two ages of rat pups to become tolerant to and dependent on morphine infusions from osmotic minipumps. Neonatal rats (postnatal day 6; P6) were infused for 72 h with morphine at 0.175 or 0.7 mg/kg/h. On P9, morphine’s antinociceptive efficacy was reduced in both groups. P14 infant rats were also infused at 0.7 mg/kg/h. Unlike P9 neonates, morphine’s potency was reduced in P17 infant rats, without a loss in efficacy. Yet raising the infusion rate to 1.1 mg/kg/h reduced morphine’s efficacy. 3H-DAMGO D-Ala2, N-MePhe4, Gly5-ol-enkephalin) binding revealed no change in the affinity or density of mu-opioid receptors at any age or in any treatment group. P9 and P17 pups were physically dependent on each infusion dose. Thus, chronic infusion of morphine affected both ages to such an extent that acutely administered morphine doses of even 1,000 mg/kg failed to restore antinociception. However, this effect cannot be attributed to changes in mu-opioid receptor number or affinity.
Acid-Inhibitory Potency of Ranitidine in Diabetic Rats
Authors: Chang Full-Young , Chen Tseng-Shing , Lee Shou-Dong , Yeh Guey-Hwa , Doong Ming-Luen , Wang Paulus S.
Published: April 2003

The pharmacological potency of ranitidine to inhibit pentagastrin-stimulated gastric acid outputs was studied in early diabetic rats. Diabetes was induced by intravenous injection of streptozotocin 4 days before the acid study. The gastric acid output was measured every 5 min by automatic titration of collected gastric perfusates. Basal acid was collected for 45 min before a 90-min infusion of pentagastrin. Thirty minutes after onset of the pentagastrin infusion, the rats received intravenous bolus injections of ranitidine at doses of 0.03, 0.3, or 3 mg/kg. Diabetes induction obviously increased the acid-secretory ability during the pentagastrin stimulation period. Ranitidine given at the low dose to diabetic rats showed no apparent inhibitory potency (mean ± SE 106 ± 3.4 vs. 63.9 ± 3.3%, p < 0.01) with shorter duration (21.3 ± 5.4 vs. 44.4 ± 7.9 min, p < 0.05) of inhibited acid output as compared with controls. The median dose of ranitidine treatment produced less effect of an acid-inhibitory potency in diabetic rats (p < 0.05). Among the rats which received the high dose of ranitidine, the inhibitory action on the acid secretion remained diminished in diabetic rats (39.3 ± 2.1 vs. 55.1 ± 4.2%, p < 0.05). In conclusion, short-term diabetes induction in rats enhances their stimulatory acid output ability, but attenuates the pharmacologically inhibitory action of ranitidine on the stimulated acid output.
Fatal Re-Expansion Pulmonary Edema Associated with Increased Lung IL-8 Levels following High-Dose Chemotherapy and Autologous Stem Cell Transplant
Authors: Garantziotis Stavros , Bhalla Karan S. , Long Gwynn D. , Vredenburgh James J. , Folz Rodney J.
Published: April 2003

Re-expansion pulmonary edema (REPE) leading to hypoxic respiratory failure and death occurred following a unilateral low-volume (750 ml) thoracentesis in a young patient 8 days after high-dose chemotherapy and autologous stem cell transplantation (HDC/ASCT) for advanced-stage breast cancer. A higher volume (1,000 ml) thoracentesis from the contralateral lung, 2 weeks prior to HDC/ASCT, showed no clinical consequences. We have recently demonstrated increased levels of inflammatory cytokines in the lungs of patients following HDC/ASCT, a finding which may predispose them to exaggerated inflammatory lung injury. In postmortem analysis, this patient’s lung demonstrated substantial intra-alveolar edema and marked elevation in interleukin-8, detected by immunohistochemistry. This suggests that patients who have recently undergone HDC/ASCT may be at increased risk for the development of REPE following thoracentesis.
Elevation of ELISA D-Dimer Levels in Patients with Primary Pulmonary Hypertension
Authors: Shitrit D. , Bendayan D. , Rudensky B. , Izbicki G. , Huerta M. , Fink G. , Kramer M.R.
Published: April 2003

Background: Vasoconstriction, vascular wall remodeling and thrombosis are considered as possible etiologies of primary pulmonary hypertension (PPH). D-dimer, a degradation product of fibrin, has been increasingly used as a marker and prognostic factor in various diseases. Objective: To assess elevated ELISA D-dimer levels as a marker of endogenous fibrinolysis in patients with PPH. Patients and Methods: Comparison of ELISA D-dimer levels of 12 PPH patients (11 female, 1 male) aged 27–73 years (median 51 years) with those of sex- and age-matched healthy controls. Results: Eleven patients had New York Heart Association (NYHA) class III or IV symptoms, and one patient had NYHA class II symptoms. All patients with PPH were treated with anticoagulants and vasodilators: 5 patients were treated with continuous intravenous prostacyclin, 4 patients with continuous UT-15 and 2 patients with intermittent intravenous iloprost. Mean ELISA D-dimer levels ± SD were significantly higher in the PPH group than in the matched control group (473 ± 109 vs. 182 ± 103 ng/ml; mean difference: 291 ± 79, 95% CI: 240–341, p < 0.0001). Conclusion: These results suggest the possible involvement of endogenous fibrinolysis in the pathophysiology of PPH.
Severity of Illness and Outcome in Adult Patients with Primary Varicella Pneumonia
Authors: Gregorakos Leonidas , Myrianthefs Pavlos , Markou Nikolaos , Chroni Despina , Sakagianni Ekaterini
Published: April 2003

Background: Varicella pneumonia is a serious complication of primary varicella infection in adults that often results in respiratory failure and death. Objective: To analyze the clinical and laboratory manifestations of primary varicella pneumonia in patients admitted to our intensive care unit (ICU). Methods:  Retrospective study on patients treated in our ICU with a diagnosis of primary varicella pneumonia during a period of 15 years. We recorded age, gender, smoking habits, clinical and laboratory findings, arterial blood gases, chest radiograph, illness severity (SAPS II), length of stay, necessity for mechanical ventilation, complications, therapy and survival. We examined the influence of the duration of respiratory symptoms and rash prior to admission, and the influence of illness severity on outcome. Results: There was a statistically significant difference in duration of respiratory symptoms, duration of rash and SAPS II on admission between: (a) mechanically ventilated patients vs. spontaneously breathing patients (p < 0.007, p < 0.00, p < 0.00), (b) patients who survived vs. patients with poor outcome (p < 0.001, p < 0.000, p < 0.000), and (c) mechanically ventilated patients with poor outcome vs. mechanically ventilated patients who survived (p < 0.001, p < 0.00, p < 0.000). Overall mortality was 13.6%; death occurred only in mechanically ventilated patients (mortality 33.3%). Conclusions: Primary varicella pneumonia remains a critical problem with significant mortality. When recognized before respiratory failure ensues and mechanical ventilation becomes mandatory, patients could have an excellent outcome. Adult patients who delay asking for medical support, the disease may lead to the need for mechanical ventilation and severe complications with a fatal outcome.
Topographic Distribution of Aquaporin 2 mRNA in the Kidney of Dehydrated Rats
Authors: Michimata Mari , Nogae Shoji , Ohta Masahiro , Kaizuma Sakiko , Imai Yutaka , Ito Sadayoshi , Matsubara Mitsunobu
Published: April 2003

Background: Stimulation of arginine vasopressin results in an immediate redistribution of water channels (aquaporin 2; AQP2) in the apical membrane of the collecting ducts, leading to water reabsorption. Water restriction for ≧24 h increases AQP2 proteins in the whole collecting duct which is highest in the inner medulla of the kidney, indicating that dehydration enhances synthesis of this protein. Although increased expression of AQP2 mRNA under this condition has been reported, the increased ratio of mRNA expression in the three regions of the kidney, cortex, outer medulla, and inner medulla, during the dehydration is still unclear. Methods: We investigated the AQP2 transcripts using male Sprague-Dawley rats deprived of water for 24 h. Mimic cDNA for competitive polymerase chain reaction (PCR) was constructed by deleting 180 bp at the middle of a 780-bp partial PCR product for rat AQP2 cDNA. In situ hybridization of the kidney and Northern blotting of inner medulla were performed using a 60-bp oligo-cDNA probe which identified rat AQP2 transcripts in the collecting duct. Results: Dehydration resulted in a significant increase in plasma osmolality and arginine vasopressin concentration and urinary osmolality. Competitive PCR demonstrated that dehydration increased AQP2 transcripts in all parts of the kidney, but was highest in the inner medulla. Northern blotting confirmed the high increased rate of AQP2 transcription in the inner medulla. In situ hybridization showed markedly intensified signals in the inner medulla of dehydrated rats. Conclusions: Our data indicate that dehydration increases the abundance of AQP2 transcripts which may be closely associated with enhancement in AQP2 protein synthesis reported previously. This topographically variable increase in transcription is considered to be one of the mechanisms involved in long-term regulation of water permeability in the collecting duct.
Interferon-γ Receptor β-Chain Expression and Formation of α- and β-Chain Complexes after Receptor Conjugation on Human Peripheral Eosinophils
Authors: Ishiharu Chie , Ochiai Kenichi , Kagami Masaru , Matsuyama Gou , Koya Niroku , Tomioka Hisao
Published: April 2003

Background: It has been unclear whether or not the interferon-γ receptor (IFN-γR) on human peripheral eosinophils is completely functional. Accordingly, we examined the expression of IFN-γR α- and β-chains and the association of the two chains after binding of IFN-γ to the receptor. Methods: Peripheral blood eosinophils were obtained from 8 patients (bronchial asthma, n=6, and hypereosinophilic syndrome, n=2), and expression of the α- and β-chain was investigated by flow cytometry with specific antibodies. Expression of mRNA for the α- and β-subunits was also investigated by the reverse transcriptase-polymerase chain reaction. Results: Eosinophils from all the patients were positive for both the α- and β-chains by flow cytometry. In addition, mRNA for both chains was detected by the polymerase chain reaction. Furthermore, coprecipitation of the α- and β-chains was only found after eosinophil stimulation with IFN-γ. Conclusions: Human peripheral eosinophils apparently express both the α- and β-chains of the IFN-γR, and the two chains may only form the receptor complex after ligand binding.
Future Directions in the Treatment of IgA Nephropathy
Authors: Lai Kar Neng
Published: April 2003

IgA nephropathy (IgAN) is the most common primary glomerulonephritis yet its etiology remains uncertain. Recent data suggest a structural aberration of the IgA molecule in IgAN that may exert pathophysiologic effects on target cells, reduce clearance of IgA-immune complexes (IC), or favor mesangial IC trapping. Mesangial reactivity to immune complexes triggers off the release of cytokines and the alteration of prostaglandin and thromboxane A2 production promoting mesangial cell proliferation. Angiotensin II-induced mesangial cells contraction with efferent arteriolar vasodilatation initiates glomerular injury and eventually lead to glomerulosclerosis following increased local production of transforming growth factor-β (TGF-β) and platelet-derived growth factor (PDGF). This paper highlights the potential therapeutic strategies in the future. These strategies include: (i) decreasing the synthesis of IgA-IC; (ii) limiting the mesangial uptake of IgA-IC; (iii) antagonizing the effect of PDGF and TGF-β to reduce mesangial proliferation and glomerulosclerosis; and (iv) reducing the noxious glomerular injury due to infiltrating neutrophils. The effective treatment of IgAN requires a better clarification of the pathogenesis of the nephropathy. Future therapeutic attempts to slow down the renal deterioration should target at prevention of mesangial IgA deposition and the amelioration of inflammatory injury induced by infiltrating neutrophils and the released cytokines.
Differential Effects of Adenosine on Antegrade Fast Pathway, Antegrade Slow Pathway, and Retrograde Fast Pathway in Atrioventricular Nodal Reentry
Authors: Lai Wen-Ter , Lee Kun-Tai , Wu Jung-Chou , Tung Chung-Po , Voon Wen-Chol , Sheu Sheng-Hsiung
Published: April 2003

Adenosine has a potent negative dromotropic effect. However, comparative effects of adenosine on the three pathways of atrioventricular (AV) nodal reentry remain unclear. In this study, we sought to determine the effects of adenosine on the antegrade fast, antegrade slow, and retrograde fast pathway conduction in patients with AV nodal reentrant tachycardia (AVNRT). Twenty patients with common slow-fast AVNRT (mean cycle length 360 ± 49 ms) were studied. The effects of adenosine on the antegrade slow pathway and on the retrograde fast pathway conduction were determined during sustained AVNRT and constant right ventricular pacing at identical cycle lengths (mean 360 ± 49 ms), respectively. Incremental doses of adenosine were rapidly administered: initial dose of 0.5 mg, followed by stepwise increases of 0.5 or 1.0 mg given at 5-min intervals until termination of AVNRT or second-degree ventriculoatrial block occurred. After the antegrade slow pathway conduction was selectively and completely ablated by radiofrequency catheter ablation, the effect of adenosine on the antegrade fast pathway conduction was evaluated. The dose-response curve of adenosine and the dose of adenosine required to produce AV or ventriculoatrial block among the representative three conduction pathways were compared. The dose-response curve for the effect of adenosine on the antegrade fast pathway lies to the left and upward to that of the effect of adenosine on the antegrade slow pathway which in turn lies to the left and upward to that of the retrograde fast pathway. The mean dose of adenosine required to produce conduction block at antegrade fast, antegrade slow, and retrograde fast pathways were 1.4 ± 0.5, 4.2 ± 1.6, and 8.5 ± 2.6 mg, respectively (p < 0.01). Adenosine has a differential potency to depress antegrade fast, antegrade slow, and retrograde fast pathway conduction in patients with AVNRT. The depressant effect of adenosine on the antegrade fast pathway is more potent than that on the antegrade slow pathway which in turn is more potent than that on the retrograde fast pathway conduction.
Prehospital Delay in Individuals with Acute Coronary Disease: Concordance of Medical Records and Follow-Up Phone Interviews
Authors: Goldberg Robert J. , Osganian Stavroula , Zapka Jane , Mitchell Paul , Bittner Vera , Daya Mo , Luepker Russell
Published: April 2003

Patient-associated delay in seeking medical care in persons with acute coronary disease is receiving increasing importance given the time-dependent benefits associated with myocardial reperfusion therapies. We examined the extent of concordance between self-reported information about prehospital delay provided by patients to hospital staff at the time of hospitalization for coronary disease compared with information obtained from a telephone interview approximately 2 months following hospital discharge. The sample included 316 patients with acute myocardial infarction or unstable angina at 43 hospitals who had delay time information available from both data sources. The extent of agreement between the medical record and telephone accounts of delay was 47% in the total study sample, 53% in patients with acute myocardial infarction, and 40% in patients with unstable angina. These results suggest that a telephone interview carried out several months following hospitalization for acute coronary disease may not provide sufficiently reliable information about prehospital delay.
Enhancement of Classic Kaposi’s Sarcoma Growth after Intralesional Injections of Desferrioxamine
Authors: Simonart T. , Boelaert J.R. , van Vooren J.P.
Published: April 2003

We have previously shown that iron may be involved in the pathogenesis of Kaposi’s sarcoma (KS) and that the iron chelator desferrioxamine (DFO) inhibits the growth and induces the apoptosis of KS cells in vitro. We treated an 85-year-old man with classic KS with 5 weekly intralesional injections of DFO and observed the opposite effect in vivo. The DFO-treated lesion was characterised by the development of numerous KS papules within the drug diffusion area, whereas no change was noted in untreated or control saline-treated lesions. This suggests that intralesional iron chelators are not indicated in patients with KS.
Proteus Syndrome of the Hand
Authors: Fraiture Anne Laure , Ihou E. David , Piérard Gérald E.
Published: April 2003

Proteus syndrome exhibits an expanded phenotype. We report a case with restricted macrodactyly and cerebriform hypertrophy of one palm. The differential diagnosis with macrodactyly and other hamartomatous overgrowth syndromes is discussed.
Tacalcitol Ointment for Long-Term Control of Chronic Plaque Psoriasis in Dermatological Practice
Authors: Lambert J. , Trompke C.
Published: April 2003

Background: Various studies have shown the benefit of topical vitamin D3 analogues in the treatment of mild to moderate plaque psoriasis. Objective: Assessment of the efficacy, tolerability and safety of tacalcitol ointment in the long-term treatment of chronic plaque psoriasis in daily dermatological practice. Design and Methods: In this open, multicentre, clinical phase IV study with a pre/post comparison design, 157 patients with chronic plaque psoriasis were included. Patients showing chronic plaque psoriasis, covering 7–20% of their body area, were treated with tacalcitol ointment (4 µg/g, Curatoderm®) once daily and were assessed at baseline and monthly during the 6-month treatment period. The efficacy parameter psoriasis area and severity index (PASI) and total body surface involvement were assessed at each visit. Laboratory parameters were assessed at the beginning and at the end of the study. Adverse events were recorded at each visit. Results: The mean PASI score decreased by 67%, and a marked reduction in sum scores of erythema, infiltration and desquamation was detected. The body area affected declined by 33% from 13.3 to 8.8%. There were no changes in laboratory parameters, and no case of hypercalcaemia was observed. No serious adverse events occurred during the study period. The recorded local side-effects were usually transient and mainly mild. Conclusion: Tacalcitol ointment is safe, well tolerated and provides a further option for patients with psoriasis up to 20% body surface affected. Tacalcitol treatment can be recommended as effective therapy for long-term control of chronic plaque psoriasis in dermatological practice.
A Case of Early Congenital Syphilis
Authors: Kolivras A. , De Maubeuge J. , Song M. , Hansen V. , Toppet V. , van Herreweghe I.
Published: April 2003

A case of early congenital syphilis is reported in order to emphasize that syphilis is still present nowadays and that detection of syphilis in pregnant women is primordial for the prevention of this disease.
Assessment of p57KIP2 Gene Mutation in Beckwith-Wiedemann Syndrome
Authors: Gaston V. , Le Bouc Y. , Soupre V. , Vazquez M.P. , Gicquel C.
Published: April 2003

Beckwith-Wiedemann syndrome (BWS) is an overgrowth disorder involving developmental anomalies, tissue and organ hyperplasia and an increased risk of embryonic tumours (most commonly Wilms’ tumour). This multigenic disorder is caused by dysregulation of the expression of imprinted genes in the 11p15 chromosomal region. It may involve paternal uniparental disomy (UPD), loss of imprinting of the IGF2 gene, maternal inherited translocations and trisomy with paternal duplication. Recently, a small proportion of BWS patients has been shown to have a mutation in the paternal imprinted p57KIP2 gene, which encodes a cyclin-dependent kinase inhibitor and negatively regulates cell proliferation. We screened for p57KIP2 gene mutations in 21 BWS patients with no 11p15 UPD in leucocyte DNA. All patients had a phenotype typical of BWS. We analysed the entire coding sequence of p57KIP2, including intron-exon boundaries, by direct sequencing of five PCR-amplified fragments. No mutation was found in the p57KIP2 gene. Our results are consistent with those of previous studies showing that mutation of p57KIP2 is infrequent in BWS. Thus, other mechanisms of p57KIP2 silencing (imprinting errors) and/or other 11p15 genes are probably involved in the pathogenesis of BWS.
Fracture Rates in Patients with Growth Hormone Deficiency
Authors: Wüster Christian
Published: April 2003

There is some evidence that bone mass is reduced in the majority of adult patients with growth hormone deficiency (GHD), suggesting that such patients have an increased risk of fractures and clinically significant osteoporosis. To date, there have been only two reports of fracture rates in patients with hypopituitarism. Both these retrospective studies show an increased fracture prevalence in this patient group compared with the general population, but patient numbers were low for assessing fracture rates. However, an analysis of data from a large-scale pharmacoepidemiological survey of adults with GHD, KIMS (Pharmacia International Metabolic Database), confirms the findings of these earlier studies. The prevalence of all fractures among patients in KIMSwas 2.7 times that in the control population, and the risk of fracture was independent of whether patients had isolated GHD or multiple pituitary hormone deficiencies. The results suggest that GHD is a risk factor for fractures, if a direct endocrine cause is assumed. Notably, there are some data on subgroup analyses from KIMS suggesting that growth hormone replacement therapy may help to reduce fracture risk, although further evidence is needed to confirm this effect.
Inhibition of the Insulin-Like Growth Factor (IGF)–IGF-Binding Protein Interaction
Authors: Baxter Robert C.
Published: April 2003

A family of six insulin-like growth factor (IGF) binding proteins transport IGFs in the circulation and regulate their extravascular distribution. The acid-labile subunit (ALS) combines with IGF-binding protein (IGFBP)-3 or IGFBP-5 to form abundant and stable heterotrimeric IGF-transporting complexes which are confined to the circulation. The factors that determine ALS dissociation, and regulate IGF and IGFBP passage out of the circulation, are poorly understood. Binary IGF–IGFBP complexes have high affinities and slow dissociation rates, which may be accelerated by partial IGFBP proteolysis and interaction with glycosaminoglycans. IGFBPs can interfere in IGF analyses, so removal of IGFBPs, and minimization of their influence in IGF assays, is essential to ensure valid quantification of IGFs.
Role of Complement in Tubulointerstitial Injury from Proteinuria
Authors: Tang Sydney , Lai Kar Neng , Sacks Steven H.
Published: April 2003

The complement system is being increasingly implicated in the pathogenesis of progressive renal disease resulting from persistent proteinuria. It has recently been established that renal tubular cells can produce complement, activate complement, and respond to complement activation. Complement proteins that pass through the glomerular barrier along with other serum proteins in the proteinuric state may become activated at the tubular epithelial brush border, and lead to a cascade of events culminating in cell injury. Furthermore, nephrotic components in the urinary space may cause direct activation of the tubular cells to overexpress complement and contribute to local tissue injury. In this review, we will discuss the current evidence supporting a role for complement in the pathogenesis of progressive tubulointerstitial damage in the proteinuric state. The possibility of complement inhibition intervening in progressive tubulointerstitial injury due to proteinuric glomerular disease will also be considered.
Prenatal Programming of Depression and Schizophrenia?
Authors: Dafotakis Manuel , Vehoff Jochen , Korr Hubert , Schmitz Christoph
Published: April 2003

In recent years the concept has been explored that the pathologies of depression and schizophrenia originate during intrauterine life. Several animal models have been developed to investigate the etiopathogenesis of both depression and schizophrenia. However, most of these models have focussed only on single aspects of the corresponding pathology, whereas integrated models using a ‘neural systems’ approach are missing. Over recent last years, our laboratory has developed two novel animal models related to depression and schizophrenia based on such a neural systems approach, using prenatal stress (PS) and prenatal low-dose X-irradiation (PLDI) as damaging agents. This paper provides a comprehensive overview on the cellular and molecular mechanisms mediating the damaging influence of PS and PLDI on the developing brain, and discuss these novel animal models in the context of the relevant literature. Both models provide rationales for future prophylactic interventions in perinatal and adult life, developed on the basis of a better understanding of the underlying mechanisms.
Neurotrophin Receptors and Retrograde Signaling: A Long-Distance Relationship
Authors: Krüttgen Alex , Saxena Smita , Evangelopoulos Maria Eleptheria , Weis Joachim
Published: April 2003

During development, targets of outgrowing axons produce neurotrophins. These signaling molecules exert short-distance effects on neuronal growth cones as well as long-distance effects on neuronal cell bodies and nuclei. The retrograde signaling from axon tips to cell bodies is essential for the regulation of neuronal survival during the period of naturally occurring programmed cell death in the nervous system. During this time window, neurons that fail to establish appropriate connections with their target tissues are eliminated by apoptosis. Neurotrophins (nerve growth factor, brain-derived neurotrophic factor, neurotrophin-3 and neurotrophin-4/5) may influence neuronal survival not only via signaling through Trk receptors but also through interactions with p75NTR. Retrograde transport of neurotrophins and their receptors within organelles coined ‘signaling endosomes’ is one potential mechanism contributing to retrograde signaling. However, alternative pathways not involving retrograde transport of neurotrophins are emerging. The current models of retrograde neurotrophin signaling from synapses to cell bodies are discussed, with special focus on potential roles of the enigmatic p75NTR receptor in neurotrophin trafficking.