bluuebunny/crossref_metadata_2025 huggingface dataset:
Dynamic Change of Fecal Calprotectin in Very Low Birth Weight Infants during the First Month of Life
Authors: Yang Qing , Smith P. Brian , Goldberg Ronald N. , Cotten C. Michael
Published: September 2008

Background: Calprotectin is a cytosolic component of neutrophils. Fecal calprotectin (FC) level is a useful marker for exacerbation of inflammatory bowel disease in children. FC may be a useful marker for necrotizing enterocolitis (NEC). Objective: To determine normal baseline levels of FC and observe dynamic changes of FC levels over the first postnatal month in very low birth weight (VLBW) infants. Methods: FC levels of 14 VLBW infants (gestational age 23–30 weeks, birth weight ≤1,500 g) were serially measured in the first postnatal month. Demographics, feeding regimens, antibiotic use, laboratory and x-ray results, and maternal information were recorded. We assessed how FC levels changed over time, varied with nutritional source and differed between sick versus well infants. Results: FC levels were not related to gestational age or feedings regimen. FC levels tended to decrease with increasing age (p = 0.121) and feeding volumes (p = 0.179). FC levels differed between ‘well’ and ‘sick’ infants (122.8 ± 98.9 vs. 380.4 ± 246.3 µg/g stool, p < 0.001). FC >350 µg/g stool was noted with signs of gastrointestinal injury, such as bloody stool and bowel perforation. FC levels decreased after initiation of treatments in sick infants who recovered. Conclusions: FC levels may be a marker for early diagnosis and resolution of gastrointestinal illnesses in VLBW infants. Its utility for early diagnosis and assessment of resolution of NEC should be studied in a larger cohort of VLBW infants.
A New Model of Oxidative Stress in Rat Pups
Authors: Gelfand Steven L. , Vento Maximo , Sastre Juan , Lust W. David , Smith Mark A. , Perry George , Walsh Michele , Martin Richard
Published: September 2008

Background: With current evidence, no specific oxygen concentration can yet be recommended in the resuscitation of the depressed term neonate. Objectives: To design a neonatal rat model of resuscitation that mimics birth hypoxia and allows the study of the effects of resuscitation on outcome. Methods: Several key determinants were established utilizing P12 Sprague-Dawley rat pups. These include the ventilatory settings necessary to maintain normocarbic conditions and the amount and duration of hypoxia required to cause significant disruption of oxidative metabolism in the subjects’ brains. Biochemical and cellular markers of oxidative injury were then compared in response to normoxic versus hyperoxic resuscitation. Results: Oxidative stress is produced in 12-day-old intubated rat pups with 15 min of 5% oxygen followed by 30 min of 100% oxygen or room air. Oxidized glutathione levels increased immediately after hypoxia and resuscitation then returned to control values at 24 h regardless of the resuscitate. Reduced glutathione levels were, however, significantly decreased 24 h after resuscitation with pure oxygen compared with the room air-resuscitated group (391 ± 35 vs. 508 ± 71 nmol/ml; p = 0.037). Stress from either resuscitate did not translate into evidence of oxidative modification detected by immunocytochemistry at 30 days. Conclusions: We have demonstrated the ability to ventilate, create hypoxic stress, and resuscitate neonatal rats. While resuscitation with 21 or 100% oxygen results in a transient increase in oxidative glutathione levels, the oxygen-resuscitated group alone demonstrated a reduction in reduced glutathione 24 h later. Furthermore, these pups can then be returned to their dams for rearing, allowing ongoing evaluation of long-term effects of hypoxia and various modes of resuscitation.
Endobronchial Obstruction from an Intubation Stylet Sheath
Authors: Koodiyedath B. , Tyler W. , Deshpande S.A. , Parikh D.
Published: September 2008

Many clinicians intubate newborns using a stylet, but how many always check if the device is intact after use? We describe a case of endobronchial obstruction by a plastic sheath coating the metal stylet, and suggest ways to reduce the incidence of this serious iatrogenic complication.
Maternal Abetalipoproteinemia Resulting in Multiple Fetal Anomalies
Authors: Seckeler Michael D. , Linden Jennifer
Published: September 2008

Abetalipoproteinemia is a rare genetic condition that results in an inability of the body to absorb dietary fats, including fat-soluble vitamins. Deficiencies of these vitamins are known to cause a wide range of clinical effects ranging from blindness to coagulopathy and neuropathy. We present the case of a child with multisystem anomalies born to a mother with abetalipoproteinemia and provide a brief review of the literature about vitamin A and fetal development. Mothers at high risk for vitamin deficiencies should be screened and counseled on the potential benefits, and risks, of vitamin supplementation.
Massively Elevated Nucleated Red Blood Cells and Cerebral or Pulmonary Hemorrhage in Severely Growth-Restricted Infants – Is There More than Coincidence?
Authors: Steurer M.A. , Berger T.M.
Published: September 2008

Background: An elevated nucleated red blood cell (NRBC) count is an independent risk factor for postnatal bleeding complications in growth-restricted infants. The etiology of this phenomenon is unclear. Objectives: To demonstrate a correlation between massively elevated NRBC counts, coagulopathies and unusual or severe bleeding complications. Methods: The medical records of all severely growth-restricted very low birth weight (VLBW) infants (gestational age <32 0/7 weeks and birth weight at or below the third percentile) admitted to the Neonatal and Pediatric Intensive Care Unit of the Children’s Hospital of Lucerne over a 6-year period were reviewed. NRBC counts and coagulation profiles of infants with unusual and/or severe bleeding complications were compared with those of infants without such complications. Results: From a total of 20 severely growth-restricted VLBW infants, 6 had severe or atypical bleeding complications. Among the infants with hemorrhagic complications, the NRBC counts were significantly higher than in the group without such complications (median 24.2 vs. 4.5 × 109/l, p = 0.028). In 2 infants with severe bleeding complications, in whom coagulation studies were performed prior to the occurrence of the hemorrhagic complications, severe clotting abnormalities in addition to massively elevated NRBC counts were detected. Conclusions: In infants with massively elevated NRBC counts, coagulation studies should be performed. Early and aggressive support of the coagulation system may help to prevent severe bleeding complications in such patients.
Body Composition of Women with Newborns Who Are Small for Gestational Age
Authors: Levario-Carrillo Margarita , Rodríguez Nora , Tufiño-Olivares Edith , del Refugio Jiménez María , Delgado-Monge Martha Cecilia , Reza-López Sandra
Published: September 2008

Background: The relationship between maternal and placental hemodynamic disorders and fetal growth is well known, but few studies have evaluated a link between maternal extracellular water (EW) and newborn birth weight. Objective: To identify the characteristics of body composition (BC) of women with small for gestational age (SGA) newborns, and to determine the relationship between maternal EW and birth weight of the baby. Methods: We studied maternal BC using multifrequency bioelectric impedance in the second and third trimesters of pregnancy. Newborns with weight below the 10th percentile were classified as SGA; those with weights between the 10th and 90th percentiles as appropriate for gestational age (AGA), and large for gestational age (LGA) were those with weights above the 90th percentile. Results: We studied 460 women and their BC varied depending on whether their newborns were SGA, AGA or LGA. EW was lower in the mothers of SGA (11 ± 2 l) compared to AGA (12 ± 3 l) newborns (p < 0.01). We identified a significant relationship (p < 0.01) between maternal EW in the second trimester and the weight of the newborn, β = 43 (95% CI 27–58). Conclusion: BC of women whose newborns are SGA differs significantly from that of women whose newborns are AGA, a result which suggests that the mothers of SGA infants may have a disordered hemodynamic state during the second trimester of pregnancy.
Effect of Phototherapy on Neonatal Heart Rate Variability and Complexity
Authors: Weissman Amir , Berkowitz Elad , Smolkin Tatiana , Blazer Shraga
Published: September 2008

Background: Phototherapy is a common mode of treatment for neonatal hyperbilirubinemia. However, phototherapy has been reported to alter cardiovascular function by causing increased peripheral blood flow, diminished cardiac output and increased sympathetic activity that may be of concern particularly in sick or premature newborns. The effects of phototherapy on the autonomic nervous system modulation of heart rate in term neonates have not yet been investigated. Objectives: The aim of the present study was to investigate the effects of phototherapy on the autonomic nervous system modulation of heart rate in healthy full-term jaundiced neonates. Methods: 30 full-term jaundiced infants were prospectively studied before and during phototherapy. Heart rate variability was analyzed with conventional time-domain, spectral, and time-dynamic techniques by using Poincaré plots. Results: Phototherapy was found to cause significant diminution in the short- and long-term variability of heart rate in newborns as documented by time-domain analysis of heart rate variability, and visually demonstrated by using Poincaré plots. Spectral indices and heart rate were unchanged during phototherapy. Conclusions: A significant diminution in heart rate variability was documented during phototherapy, a phenomenon assumed to be centrally mediated. The reasons for this decrease are yet unknown. The use of time-dynamic analysis methods may offer important details on the newborn’s physiology that cannot be revealed by traditional methods.
Impact of Maternal Smoking on Birth Size: Effect of Parity and Sex Dimorphism
Authors: Varvarigou Anastasia A. , Asimakopoulou Aspasia , Beratis Nicholas G.
Published: September 2008

Background: Maternal smoking during pregnancy causes a delay of intrauterine growth. Objective: To examine the effect of maternal smoking during pregnancy on fetal growth in relationship to maternal parity, age and number of cigarettes smoked/day, and offspring’s gender. Subjects: We studied 2,108 term newborns (1,102 male, 1,006 female) delivered at the General University Hospital of Patras from 1994 to 2004. The 1,443 were born to mothers who did not smoke and 665 to mothers who smoked during pregnancy. Methods: Birth weight, length and head circumference were measured prospectively in all newborns. Also, maternal smoking status and number of cigarettes smoked per day, age, and parity were recorded. For the analysis, t test, one-way ANOVA, Mann-Whitney U test, Spearman rank correlation, and factorial MANOVA with covariates were used. Results: With increasing parity, in the neonates of nonsmoking mothers there was a gradual increase of growth, whereas in neonates of smoking mothers there was a gradual decrease of growth. This effect was more pronounced in males. A significant negative main effect on growth resulted from the interaction of smoking with parity (p = 0.013), and with gender and parity (p = 0.001). There was a significant negative correlation between number of cigarettes smoked per day and growth, the strength of which increased with parity, mainly in males. Conclusion: Maternal smoking during pregnancy causes a delay in fetal growth, which is greater in male offspring, an effect that is enhanced with parity but is independent of maternal age.
Intestinal Hydrogen and Nitric Oxide Gases in Preterm Infants – Effects of Antibiotic Therapy
Authors: Sobko Tanja , Elfström Kristina , Navér Lars , Lundberg Jon O. , Norman Mikael
Published: September 2008

Objective: Measurements of hydrogen (H2) and nitric oxide (NO) levels in intestinal gas have recently been shown to be useful to monitor bacterial colonization in healthy term newborn infants. The significance of preterm birth and antibiotic therapy for intestinal gas production is not known and was the subject of this study. Methods: A minimally invasive tonometric technique was used for repeated measurements (44 samples) of luminal colonic H2 and NO in 23 preterm infants with gestational age 27–35 weeks, birth weight 1,170–2,996 g and postnatal age 2–31 days. Results: The measuring procedure was well tolerated in all infants. Intestinal H2 was 300 (4–1,990) ppm and NO was 34 (11–82) ppb. Intestinal H2 and NO increased during the first week (p < 0.05) to average levels that in the case of H2, exceeded those of healthy, term infants. In preterm infants treated with antibiotics (n = 12), H2 and NO levels were significantly lower than in those without such therapy (p < 0.05). Conclusion: These observations suggest that intestinal measurements of H2 and NO may be used to monitor birth-related bacterial colonization in relation to postnatal age, maturation and antibiotic therapy. In preterm infants, gaseous distension of the gut is common and may signal bacterial overgrowth. The potential role of intestinal gas measurements as a diagnostic tool for intestinal disorders remains to be clarified.
Transient Neonatal Myelosuppression after Fetal Exposure to Maternal Chemotherapy
Authors: Udink ten Cate Floris E.A. , ten Hove Christine H. , Nix Wendy M.L.E. , de Vries Johanna I.P. , van de Loosdrecht Arjan A. , van Elburg Ruurd M.
Published: September 2008

Transient neonatal myelosuppression (TNM) is a rare but potentially life-threatening adverse effect of fetal exposure to maternal chemotherapy during pregnancy. We report a case of TNM in a preterm infant born to a mother diagnosed with acute lymphoblastic leukemia during pregnancy. The mother received chemotherapy during the second and third trimester. The neonate was successfully treated with supportive care. In addition, we also conducted a medical literature review and identified another 14 cases of TNM. Although the long-term outcome of these children is not known, short-term survival is relatively good. Prompt recognition and aggressive treatment of infants at risk for TNM is mandatory.
Developing Stakeholder Involvement for Introducing Public Health Genomics into Public Policy
Authors: Burton H. , Adams M. , Bunton R. , Schröder-Bäck P.
Published: September 2008

Public health genomics (PHG) relies on developing knowledge from a variety of natural and social science research disciplines to shape public policies, health policy, education and training, and direct outreach to organisations and the population at large. All of these components rely on the involvement of stakeholders who, because of the diverse groups involved, will have a wide range of backgrounds. The significant challenges associated with the engagement of such a diverse range of stakeholders are compounded by the wide knowledge gaps that exist between scientists, the public, and different professional groups. In this paper we discuss some of the areas of public policy that might involve PHG, set out principles on the need for stakeholder involvement, and describe the range of potential stakeholders that need to be considered when working to incorporate PHG into new and existing policies. For specific projects in PHG, however, the question of who to involve and how must be addressed according to the work in question.
Genetic Clinics in Arab Communities: Meeting Individual, Family and Community Needs
Authors: Hamamy H. , Bittles A.H.
Published: September 2008

Arab societies are characterized by a wide range of family and social structures, religious and legal conventions, and highly variable economic resources. As might be expected under these circumstances, genetic services cannot readily be devised, delivered, and assessed according to a single model. However, in general terms, the provision of genetic services in Arab communities at all population levels is still inadequate given the prevalence and burden of genetic diseases. Improving this situation calls for major educational efforts that include increasing the genetic literacy of the general public, comprehensive courses and campaigns to familiarize primary health care workers with counseling needs and skills and with referral guidelines for high-risk families, updating medical, nursing, and paramedical curricula to incorporate information on community genetics, and training clinical and laboratory genetic specialists to meet the short- and long-term goals of genetic disease prevention and management.
Differences in Neuropsychiatric Symptoms according to Mild Cognitive Impairment Subtypes in the Community
Authors: Lee Kang Soo , Cho Hyun-Sang , Hong Chang Hyung , Kim Dong Goo , Oh Byoung Hoon
Published: September 2008

Background/Aims: Mild cognitive impairment (MCI) has been subtyped according to its cognitive features and its likely etiology. We aimed to investigate the neuropsychiatric features of the MCI using the Neuropsychiatric Inventory and compare them according to subtypes. Methods: MCI patients were classified according to cognitive features (e.g. amnestic vs. nonamnestic MCI), likely etiology (e.g. vascular vs. nonvascular MCI) and functional status (e.g. MCI-I vs. MCI-II). The percentage of subjects exhibiting each of the 12 behaviors in the Neuropsychiatric Inventory was compared among the groups using a χ2 test. Results: There were 382 subjects in the MCI group. In terms of each neuropsychiatric symptom, there were no differences in frequency between the MCI groups subtyped according to cognitive features or likely etiology. However, a significantly higher frequency of delusion, aggression, irritability and eating behavior was observed in the MCI-II group in comparison to the MCI-I group. Conclusion: The differences in neuropsychiatric symptoms were distinctive between the MCI groups subtyped according to functional status.
A Volumetric Magnetic Resonance Imaging Study of Entorhinal Cortex Volume in Dementia with Lewy Bodies
Authors: Kenny Eva R. , Burton Emma J. , O’Brien John T.
Published: September 2008

Aims: To investigate whether subjects with dementia with Lewy bodies (DLB), Alzheimer’s disease (AD) and Parkinson’s disease with dementia (PDD) have reduced entorhinal cortex (EC) volumes compared to controls and cognitively intact Parkinson’s disease (PD) subjects. Methods: Volumes of the EC were measured on magnetic resonance imaging (MRI) scans of 144 individuals (aged over 65 years): 20 with DLB, 26 with AD, 30 with PDD, 31 with PD and 37 normal age-matched controls. Results: Total normalised EC volumes were significantly smaller in DLB, AD and PDD patients compared to controls, and in DLB and AD patients compared to PD patients (p < 0.001). The percentage volume reduction in EC volume in the dementia groups relative to controls was 19.9% in DLB, 21.9% in AD and 14.7% in PDD. Conclusions: MRI measurements of the EC have shown that volumes are smaller in dementia subjects compared to controls and patients with non-dementia disorders. Further research is required to recognise those at risk of dementia and to differentiate between the dementias.
Cortical Neural Activity Underlying Speech Perception in Postlingual Adult Cochlear Implant Recipients
Authors: Henkin Yael , Tetin-Schneider Simona , Hildesheimer Minka , Kishon-Rabin Liat
Published: September 2008

Auditory event-related potentials (AERPs) and the simultaneously obtained behavioral measures (performance accuracy and reaction time) were used to study speech perception in postlingual adult cochlear implant (CI) recipients and in normal-hearing (NH) controls. AERPs were recorded while subjects were performing oddball discrimination tasks with increasing acoustic-phonetic demand. The tasks consisted of pairs of natural syllables that differed by one of the following phonetic contrasts: vowel place, voicing, vowel height, and place of articulation. Results indicated that the P3 potential was comparable in CI recipients and NH controls when the acoustic cues to the perception of the phonetic contrast were accessible. With the reduction in accessibility to the essential temporal and/or spectral cues, CI recipients exhibited delayed (prolonged P3 latency) and less synchronous (reduced amplitude) central speech-sound processing compared to NH controls. Among the phonetic contrasts used in the present study the place of articulation contrast yielded (1) the most prominent differences between CI recipients and NH controls across all measures, and (2) significant correlations between the neurophysiologic manifestation of speech discrimination (i.e. P3 latency), and conscious integration of perceptual information (i.e. performance accuracy and reaction time). Thus, P3 exposed the difficulties imposed on the impaired auditory system of CI recipients especially when elicited by speech contrasts that required processing of brief temporal-spectral cues. These findings support the P3 potential as a sensitive neural index of cortical processing that may provide information regarding accessibility and neural encoding of distinct acoustic-phonetic cues in CI recipients.
Comparison of Kidney Size between Patients with Balkan Endemic Nephropathy and Other Kidney Diseases
Authors: Ležaić Visnja , Marić Ivko , Jovanović Dijana , Radović Milan , Kovačević Zoran , Bukvić Danica , Pavlović Stevan , Matić Mihajlo , Ajdačić Mirjana , Djukanović Ljubica
Published: September 2008

Background: The aim of this study was to assess the relationship between kidney dimensions and creatinine clearance (Ccr) in patients with Balkan endemic nephropathy (BEN), nephrosclerosis (NSc), glomerulonephritis (GN), diabetic nephropathy (DN) and in healthy persons. The main objective was to find out at which stage of BEN the kidneys start to shrink. Methods: The study involved 84 patients with BEN, 39 with NSc, 56 with GN, 55 with DN, and 52 healthy subjects, allocated to group 1 (n = 28) sex- and age-matched with BEN/NSc patients, or group 2 (n = 24) sex- and age-matched with GN/DN patients. Based on Ccr, patients were classified according to the NKF/DOQI guidelines. Results: The kidney dimensions of BEN patients in all stages of the disease were significantly shorter than those of healthy controls and patients with GN and DN. In stages 3–5, BEN patients had significantly smaller kidneys than patients with NSc. Patients with NSc had smaller kidney dimensions than controls and GN/DN patients but all of these differences were not significant. Conclusion: BEN patients had significantly smaller kidneys than sex- and age-matched healthy persons and patients with GN and DN in all stages of the disease and patients with NSc in stages 3–5 of the disease.
Effect of High Haematocrit on the Efficiency of High-Flux Dialysis Therapies
Authors: Spalding Elaine M. , Pandya Priya , Farrington Ken
Published: September 2008

Background: There is a concern that high haematocrit (Hct) levels will reduce the efficiency of dialysis treatments, particularly in post-dilution haemodiafiltration (HDF) where there is the potential for intense haemoconcentration within the dialyser. Methods: We measured serial Hct and performed serial clearance measurements for urea, phosphate, β2-microglobulin and myoglobin in 12 patients with Hct >35% on high-flux haemodialysis (HFHD) or HDF. We assessed whether changes in the intra-dialyser Hct influenced solute clearance and whether there were differences between the two modalities. Results: Hct rose significantly in all treatments studied. Convective and total solute clearances were higher in the HDF group when compared to the HFHD group. Phosphate clearance in HFHD fell towards the end of dialysis when the Hct was highest but no differences were detected for the other solutes. Conclusion: Despite marked haemoconcentration, the impact on solute clearance across the range of molecular size studied is small. These findings are reassuring in the current era of widespread erythropoietin use.
Regional Cerebral Blood Flow Changes after Low-Frequency Transcranial Magnetic Stimulation of the Right Dorsolateral Prefrontal Cortex in Treatment-Resistant Depression
Authors: Kito Shinsuke , Fujita Kenichi , Koga Yoshihiko
Published: September 2008

Several studies have proved that low-frequency transcranial magnetic stimulation (TMS) of the right dorsolateral prefrontal cortex (DLPFC) showed an antidepressant effect, although its mechanism is still not completely elucidated. The aim of the present study was to clarify the alteration in neuroanatomical function elicited by low-frequency TMS of the right DLPFC in treatment-resistant depression and to detect the difference between responders and nonresponders to TMS. Single-photon emission computed tomography with 99mTc-ethyl cysteinate dimer was performed in 14 right-handed male patients with treatment-resistant unipolar depression before and after low-frequency TMS of the right DLPFC. Five 60-second 1-Hz trains were applied and 12 treatment sessions were administered within a 3-week period (total pulses, 3,600). The Hamilton Rating Scale for Depression was administered and the regional cerebral blood flow (rCBF) was analyzed using statistical parametric mapping (SPM2). After TMS treatment in 14 patients, the score on the Hamilton Rating Scale for Depression decreased significantly, and considerable decreases in rCBF were seen in the bilateral prefrontal, orbitofrontal, anterior insula, right subgenual cingulate, and left parietal cortex, but no significant increase in rCBF occurred. Additionally, as compared with 8 nonresponders, 6 responders showed significant increases in rCBF at baseline in the left hemisphere including the prefrontal and limbic-paralimbic regions. These results suggest that the antidepressant effect of low-frequency TMS of the right DLPFC is associated with a decrease in rCBF in the limbic-paralimbic regions via the ipsilateral subgenual cingulate, and increased rCBF at baseline in the left hemisphere may be involved in the response to low-frequency TMS treatment.
FDG-PET Study in Pathological Gamblers
Authors: Hollander Eric , Buchsbaum Monte S. , Haznedar M. Mehmet , Berenguer Jessica , Berlin Heather A. , Chaplin William , Goodman Chelain R. , LiCalzi Elizabeth M. , Newmark Randall , Pallanti Stefano
Published: September 2008

Background: Pathological gambling affects 1–3% of the adult population, and has high comorbidity. Although mood stabilizers and serotonin reuptake inhibitors have shown some efficacy in the treatment of this condition, there is little known about how these pharmacological interventions work. Methods: Twenty-one patients with pathological gambling, who met lifetime comorbid bipolar spectrum diagnoses, received baseline PET scans. Sixteen of these patients were entered into a randomized double-blind placebo-controlled parallel group design trial of lithium, and received follow-up PET scans at 10 weeks. A comparison group of 32 age- and sex-matched controls was also available. Anatomical MRIs were obtained as a structural template. Results: In patients with pathological gambling, relative glucose metabolic rates (rGMR) in the orbitofrontal cortex and medial frontal cortex were significantly increased at baseline compared to normal controls. Lithium increased rGMR further in the orbitofrontal cortex, heightening normal/patient differences, but it also increased the rGMR of the posterior cingulate and the dorsolateral frontal cortex normalizing the metabolic rate in these regions. Conclusion: Cortical areas implicated in impulse control disorders show increased rGMR in pathological gambling at baseline. Lithium treatment, while alleviating the symptoms, further increases rGMR in these areas.
Dietary Habits in a Child Population in Relation to Caries Experience
Authors: Llena C. , Forner L.
Published: September 2008

Sugar consumption in Spain has remained constant at around 80 g/day since the 1970s. Although intake as sugar has fallen considerably, to around 13.5 g/person/day, the intake in processed foods has risen. Meanwhile, caries prevalence is falling or stabilizing. This situation is common in developed countries, where the impact of diet on caries has altered, probably through greater use of fluoridated products. In the Valencia region, children habitually eat sugary foods and drinks and snacks that contain starches or sugars and starches. The present study analyzed the association between caries experience, quantified as the sum of the dfs and DMFS indices, and the consumption of cariogenic foods in a population of children between the ages of 6 and 10 with low caries prevalence. A self-administered food consumption frequency questionnaire filled in by the parents was used to evaluate how often the foods on the list were consumed by the children, which was then related to their caries experience. Sweet snacks, industrial bread and soft drink consumption showed a positive association with caries while cheese and nuts showed a negative association. Logistic regression suggested that consuming sugary liquids and foods rich in semi-hydrolyzed starch increased the chances of suffering caries by 1.05 and 1.13 respectively.
Calcium Pre-Rinse Greatly Increases Overnight Salivary Fluoride after a 228 ppm Fluoride Rinse
Authors: Vogel G.L. , Chow L.C. , Carey C.M.
Published: September 2008

Background: Large increases in salivary fluoride were reported 1 h after a calcium pre-rinse/NaF rinse. Aims: This study examined the persistence of these increases. Methods: 12 subjects rinsed in the evening with water, with a 228 µg/g (ppm) F rinse or with 150 mmol/l calcium lactate followed by a 228 µg/g F rinse. In a second experiment these same patients rinsed with a 912 µg/g F rinse. Saliva samples were obtained the morning after rinsing, centrifuged and the supernatants analyzed. Results: The Ca pre-rinse/228 µg/g F rinse induced an increase in overnight salivary F over the 912 µg/g F rinse (≈2.5 times) and a statistically significant increase over the 228 µg/g F rinse (≈5.5 times). Conclusions: The results suggest that a Ca pretreatment may increase the cariostatic effect of topical F agents.
Safety and Efficacy of Modified FOLFOX6 for Treatment of Metastatic or Locally Advanced Colorectal Cancer
Authors: Matsumoto Shigemi , Nishimura Takafumi , Kanai Masashi , Mori Yukiko , Nagayama Satoshi , Kawamura Jun’ichiro , Nomura Akinari , Miyamoto Shin’ichi , Kitano Toshiyuki , Ishiguro Hiroshi , Yanagihara Kazuhiro , Teramukai Satoshi , Sakai Yoshiharu , Chiba Tsutomu , Fukushima Masanori
Published: September 2008

Background: Although a variety of FOLFOX regimens (5-fluorouracil and L-leucovorin combined with oxaliplatin) are widely used for the treatment of advanced colorectal cancer, the neurotoxicity caused by oxaliplatin is often problematic. The aim of this observational study was to assess the safety and efficacy of a modified version of the FOLFOX6 regimen (mFOLFOX6) when administered using the ‘stop-and-go’ strategy. Patients and Methods: A total of 112 eligible patients treated between June 2005 and July 2007 were identified using the prospective cohort database system of Kyoto University Hospital. Results: The median follow-up was 16.3 months (range 1.6–33.9), and the response rate was 33.3% (95% CI 14.5–52.2), 40.0% (95% CI 22.5–57.5) and 14.0% (95% CI 3.6–24.3) for patients who received mFOLFOX6 as first-line therapy, second-line therapy and third- or later-line therapy, respectively. The estimated median progression-free survival was 8.7 months (95% CI 2.3–15.1) and 8.2 months (95% CI 7.3–9.1) for patients on first-line and second-line therapy, respectively. The median overall survival was not reached as of April 2008 for the patients on first-line therapy, while it was 27.1 months (95% CI 22.0–32.2) for those on second-line therapy. Severe neurotoxicity occurred in only 4 patients (3.6%). Conclusion: mFOLFOX6 administered using the stop-and-go strategy significantly reduced oxaliplatin-induced neurotoxicity relative to conventional FOLFOX treatment, without compromising efficacy.
Skin Permeation and Distribution of Two Sunscreens: A Comparison between Reconstituted Human Skin and Hairless Rat Skin
Authors: Monti D. , Brini I. , Tampucci S. , Chetoni P. , Burgalassi S. , Paganuzzi D. , Ghirardini A.
Published: September 2008

The aims of this work were (a) to develop a simple and reproducible procedure for percutaneous absorption and distribution tests of sunscreens using one human skin culture model (Epiderm™ 606; reconstructed epidermis, RE), (b) to compare the said model with rat skin (RS) in vitro and (c) to evaluate the effect of different formulations. The cutaneous permeation and distribution of two UV filters, ethylhexylmethoxycinnamate (MC80) and ethylhexyltriazone (T150), using 3 different vehicles were investigated. The permeation studies demonstrated that neither MC80 nor T150 permeated through both RS and RE in spite of different thicknesses of the 2 substrates. Distribution studies demonstrated that sectioning by cryomicrotome to obtain horizontal skin layers was suitable for both RS and RE (apart from its small thickness) with a good reproducibility of data. The amounts of sunscreens retained in the 2 substrates were in the same order of magnitude for all formulations with a greater depot in RS. Different distribution profiles of the tested formulations could be ascribed to the different lipid compositions of RE and RS. Since the physicochemical characteristics of RE are closer to those of human skin, the results obtained with reconstructed human skin models could be suitable to replace human skin in ‘in vitro testing’.
Respiratory Muscle Strength Predicts Decline in Mobility in Older Persons
Authors: Buchman A.S. , Boyle P.A. , Wilson R.S. , Leurgans S. , Shah R.C. , Bennett D.A.
Published: September 2008

Objectives: To test the hypothesis that respiratory muscle strength is associated with the rate of change in mobility even after controlling for leg strength and physical activity. Methods: Prospective study of 890 ambulatory older persons without dementia who underwent annual clinical evaluations to examine change in the rate of mobility over time. Results: In a linear mixed-effect model adjusted for age, sex, and education, mobility declined about 0.12 unit/year, and higher levels of respiratory muscle strength were associated with a slower rate of mobility decline (estimate 0.043, SE 0.012, p < 0.001). Respiratory muscle strength remained associated with the rate of change in mobility even after controlling for lower extremity strength (estimate 0.036, SE 0.012, p = 0.004). In a model that included terms for respiratory muscle strength, lower extremity strength and physical activity together, all three were independent predictors of mobility decline in older persons. These associations remained significant even after controlling for body composition, global cognition, the development of dementia, parkinsonian signs, possible pulmonary disease, smoking, joint pain and chronic diseases. Conclusion: Respiratory muscle strength is associated with mobility decline in older persons independent of lower extremity strength and physical activity. Clinical interventions to improve respiratory muscle strength may decrease the burden of mobility impairment in the elderly.
Fertility in Essential Tremor
Authors: Louis Elan D.
Published: September 2008

Background: The view of essential tremor (ET) as a degenerative disorder, which is now gaining support from postmortem studies, is at odds with traditional views of ET as a ‘super-healthy’ condition characterized by increased longevity and fertility. Longevity has recently been re-examined in ET, yet fertility, measured by number of offspring, has never been critically assessed in this disease. The objective was to determine whether ET cases and controls differ in terms of number of children. Methods: Family history data were collected on ET cases and controls from 2 distinct sources, a population and a clinical (referred) sample. Results: In the population, the number of children was similar in 59 cases vs. 72 controls [mean ± SD (median) = 2.3 ± 2.9 (1) vs. 2.2 ± 1.8 (2); p = 0.26]. In the referred sample, number of children was similar in 184 cases vs. 241 controls [2.0 ± 1.5 (2) vs. 1.9 ± 1.7 (2); p = 0.33]. In adjusted analyses, results were similar. Conclusions: Fertility, measured by number of children, was similar in cases and controls. With a newer understanding of the biological substrate of ET emerging from postmortem studies, it is important to critically reassess this and other fundamental biological questions about the disease.
Procalcitonin N-Terminal Peptide Causes Catabolic Effects via the Hypothalamus and Prostaglandin-Dependent Pathways
Authors: Tavares Eva , Miñano Francisco J.
Published: September 2008

Recent evidence suggests that the free amino-terminal fragment of procalcitonin (N-PCT) plays a role in the central control of feeding behavior and energy homeostasis. However, little is known about the mechanisms through which N-PCT works. Here we report that intracerebroventricular administration of N-PCT to free-feeding male rats induced a significant decrease of longer-term food intake and body weight gain. Conversely, N-PCT increased body temperature. We also show that intracerebroventricular administration of N-PCT induced a marked neuronal activation in key thermoregulatory and feeding areas of the hypothalamus. We further show that N-PCT increases the responsiveness of proopiomelanocortin anorexigenic neurons in the arcuate nucleus of the hypothalamus, and that stimulation of the de novo synthesis of prostaglandins is crucial for the central effects induced by N-PCT. Results support the role of N-PCT to the central control of feeding behavior and suggest that N-PCT, acting probably through the eicosanoid cyclooxygenase pathway, may act as a signaling molecule in the hypothalamus by regulating the activity of anorexigenic neurons in the hypothalamus.
Multigene Methylation in Serum of Sporadic Chinese Female Breast Cancer Patients as a Prognostic Biomarker
Authors: Jing Feng , Jun Lu , Yong Zhang , Wang Yuping , Fei Xie , Zhang Jicai , Hu Lihua
Published: September 2008

Objective: DNA methylation is a common molecular alteration in human neoplasia and can be detected easily in the bloodstream of patients. Here, we investigated whether DNA methylation in sera is of prognostic significance in breast cancer patients. Methods: Methylation status of BRCA1, p16 and 14-3-3σ was examined by methylation-specific PCR assay in the sera of sporadic breast cancer patients and healthy serum controls. Results: The panel gene methylation frequencies were 29% of sporadic breast cancers for p16, 32% for BRCA1 and 82% for 14-3-3σ; all were significantly associated with grades and estrogen receptor status. Only p16 methylation was associated with histological type. p16 and BRCA1 methylation were associated with progesterone receptor status, while 14-3-3σ was significantly associated with lymph node metastases. Seventy percent of patients with p16 methylation showed elevated serum CEA levels; of the breast cancer patients with BRCA1 methylation, 75.8% showed elevated serum CEA levels and 69.7% showed elevated serum CA15.3 levels. When analyzing all investigated patients, multivariate analysis showed methylated BRCA1 and/or p16 serum DNA to be independently associated with poor outcome, with a relative risk of death of 6.0. Conclusions: Epigenetic markers in sera, especially BRCA1/p16, may be more promising targets for the diagnosis of sporadic breast cancer than previous prognostic markers.
Effect of Yacon (Smallanthus sonchifolius) on Colonic Transit Time in Healthy Volunteers
Authors: Geyer M. , Manrique I. , Degen L. , Beglinger C.
Published: September 2008

Background: Yacon is a root crop which contains high amounts of fructooligosaccharides (FOS). The aim of this study was to investigate the effects of yacon syrup on colon transit time in healthy volunteers. Methods: In a placebo-controlled, double-blind study yacon was administered to 16 healthy individuals (8 males, 8 females) in a dose of 20 g daily (equal to 6.4 g FOS) in a 2-week crossover design. Each period was interrupted by a 2-week wash-out phase. Transit time was assessed by a radio-opaque marker technique. Results: Transit time (mean ± SEM) through the gastrointestinal tract was significantly decreased from 59.7 ± 4.3 to 38.4 ± 4.2 h (p < 0.001). Yacon was well tolerated with an excellent side effect profile. Bloating is not an uncommon side effect observed with FOS, but bloating-related disturbances were not significantly more often reported with yacon compared to placebo. Stool frequency increased from 1.1 ± 0.1 to 1.3 ± 0.2 times per day and the consistency showed a tendency for softer stools as assessed by a numerical depicted stool protocol. Neither parameter did, however, reach statistical significance. Conclusion: Yacon markedly accelerates colonic transit in healthy individuals. Further studies are needed in constipated patients to confirm these preliminary data. Due to the low caloric content of yacon, the root could be a useful treatment in constipated diabetics or obese patients.
Fetal Asphyxia Leads to a Decrease in Dorsal Raphe Serotonergic Neurons
Authors: Strackx Eveline , van den Hove Daniël L.A. , Steinbusch Hellen P. , Prickaerts Jos , Vles Johan S.H. , Blanco Carlos E. , Steinbusch Harry W.M. , Gavilanes A.W. Danilo
Published: September 2008

The aim of the present study was to determine the effects of fetal asphyxia (FA) on anxiety and serotonergic neurons in young adult and middle-aged rats. FA was induced at embryonic day 17 by clamping the uterine circulation for 75 min. Anxiety-related behavior was tested in an open field, and design-based stereology was used for counting serotonergic (5-hydroxytryptamine/serotonin, 5-HT) neurons in the dorsal raphe nucleus (DRN). The open field revealed increased anxiety in the 19-month-old FA rats in comparison to control animals. No significant differences were found in DRN 5-HT neuron numbers at 6 months. At 19 months, however, FA significantly lowered the mean density and volume of 5-HT neurons in the DRN as compared to controls. Further, an age-related reduction was found in the total number, the mean density and the mean volume of 5-HT neurons within the FA group. In conclusion, FA is associated with increased anxiety and age-related changes in 5-HT immunohistochemistry within the DRN. These results support the notion that insults caused by asphyxiation during critical periods of brain development could create a predisposition to serotonergic abnormalities and anxiety deficits in adulthood.
Obesity Decreases Time to Claudication and Delays Post-Exercise Hemodynamic Recovery in Elderly Peripheral Arterial Disease Patients
Authors: Ritti Dias Raphael Mendes , Forjaz Cláudia Lúcia de Moraes , Cucato Gabriel Grizzo , Costa Luis Augusto Riani , Câmara Lucas Caseri , Wolosker Nelson , Marucci Maria de Fátima Nunes
Published: September 2008

Background: Althoughobesity is usually observed in peripheral arterial disease (PAD) patients, the effects of the association between these diseases on walking capacity are not well documented. Objective: The main objectives of this study were to determine the effects of obesity on exercise tolerance and post-exercise hemodynamic recovery in elderly PAD patients. Methods: 46 patients with stable symptoms of intermittent claudication were classified according to their body mass index (BMI) into normal group (NOR) = BMI <28.0 and obese or in risk of obesity group (OBE) = BMI ≥28.0. All patients performed a progressive graded treadmill test. During exercise, ventilatory responses were evaluated and pre- and post-exercise ankle and arm blood pressures were measured. Results: Exercise tolerance and oxygen consumption at total walking time were similar between OBE and NOR. However, OBE showed a lower claudication time (309 ± 151 vs. 459 ± 272 s, p = 0.02) with a similar oxygen consumption at this time. In addition, OBE presented a longer time for ankle brachial index recovery after exercise (7.8 ± 2.8 vs. 6.3 ± 2.6 min, p = 0.02). Conclusion: Obesity in elderly PAD patients decreased time to claudication, and delayed post-exercise hemodynamic recovery. These results suggest that muscle metabolic demand, and not total workload, is responsible for the start of the claudication and maximal exercise tolerance in PAD patients. Moreover, claudication duration might be responsible for the time needed to a complete hemodynamic recovery after exercise.
Laparoscopic Left Lateral Liver Sectionectomy: A Safe, Efficient, Reproducible Technique
Authors: Abu Hilal M. , Pearce N.W.
Published: September 2008

Background: Laparoscopic left lateral sectionectomy (LLLS) is procedure with potential for future transformation into a primarily laparoscopic procedure where surgeons can safely develop laparoscopic experience and gain proficiency. Methods: Between August 2004 and December 2007, 80 patients underwent laparoscopic liver resections in our unit, 30 of these were left lateral sectionectomies. The indications for surgery were both oncological and non-oncological. Results: 30 LLLS were performed. Median operative time and median postoperative hospital stay group were 180 (40–340) min and 4 (1–6) days, respectively, and were noted to fall significantly between the first (15 patients) and second parts of this series. The median free resection margin was 11 (1.5–30) mm and median perioperative blood loss was 80 (25–800) ml. Two minor complications were observed with no mortality and no conversions to open. Conclusion: LLLS is a feasible, safe and efficient procedure, associated with a quick, smooth learning curve. We report our technique illustrating methods and particulars which would be of great help to surgeons developing new laparoscopic liver services.
Striated Myogenesis and Peristalsis in the Fetal Murine Esophagus Occur without Cell Migration or Interstitial Cells of Cajal
Authors: Rishniw M. , Fisher P.J. , Doran R.M. , Bliss S.P. , Kotlikoff M.I.
Published: September 2008

Esophageal striated myogenesis progresses differently from appendicular myogenesis, but the mechanism underlying this process is incompletely understood. Early theories of transdifferentiation of smooth muscle into striated muscle are not supported by transgenic fate-mapping experiments; however, the origin of esophageal striated muscle remains unknown. To better define the process of striated myogenesis, we examined myogenesis in murine fetal cultured esophageal whole-organ explants. Embryonic day 14.5 (E14.5) esophagi maintained a functional contractile phenotype for up to 7 days in culture. Striated myogenesis, as evidenced by myogenin expression, proceeded in a craniocaudal direction along the length of the esophagus. Esophageal length did not change during this process. Complete, but not partial, mechanical disruption of the rostral esophagus inhibited myogenesis distally. Addition of fibroblast growth factor-2 (FGF-2) to the culture media failed to inhibit striated myogenesis, but attenuated smooth muscle actin expression and reduced peristaltic activity. Inhibition of c-kit failed to inhibit peristalsis. These results suggest that striated myogenic precursors are resident along the entire length of the esophagus by day 14.5 and do not migrate along the esophagus after E14.5. Induction of myogenesis craniocaudally appears to require physical continuity of the esophagus and is not inhibited by FGF-2. Finally, peristalsis in E14.5 esophagi appears not to be regulated by interstitial cells of Cajal.
The Hemodynamics of the Pig-tailed Monkey
Authors: Rahlmann D. F.
Published: September 2008

Hemodynamic characteristics for the systemic and pulmonary circulation of the unanesthetized, semi-restrained, male, pig-tailed monkey have been determined. The effects of isolation, hypothermia, and the administration of epinephrine and norepinephrine on the cardiovascular system were also observed. These physiological data are discussed in relation to findings in other macaques and in man.