bluuebunny/crossref_metadata_2025 huggingface dataset:
PYRIMIDINE AND PURINE BIOSYNTHESIS AND DEGRADATION IN PLANTS
Authors: Zrenner Rita , Stitt Mark , Sonnewald Uwe , Boldt Ralf
Published: February 2006

Nucleotide metabolism operates in all living organisms, embodies an evolutionarily ancient and indispensable complex of metabolic pathways and is of utmost importance for plant metabolism and development. In plants, nucleotides can be synthesized de novo from 5-phosphoribosyl-1-pyrophosphate and simple molecules (e.g., CO2, amino acids, and tetrahydrofolate), or be derived from preformed nucleosides and nucleobases via salvage reactions. Nucleotides are degraded to simple metabolites, and this process permits the recycling of phosphate, nitrogen, and carbon into central metabolic pools. Despite extensive biochemical knowledge about purine and pyrimidine metabolism, comprehensive studies of the regulation of this metabolism in plants are only starting to emerge. Here we review progress in molecular aspects and recent studies on the regulation and manipulation of nucleotide metabolism in plants.
MOLYBDENUM COFACTOR BIOSYNTHESIS AND MOLYBDENUM ENZYMES
Authors: Schwarz Günter , Mendel Ralf R.
Published: February 2006

The molybdenum cofactor (Moco) forms the active site of all eukaryotic molybdenum (Mo) enzymes. Moco consists of molybdenum covalently bound to two sulfur atoms of a unique tricyclic pterin moiety referred to as molybdopterin. Moco is synthesized from GTP by an ancient and conserved biosynthetic pathway that can be divided into four steps involving the biosynthetic intermediates cyclic pyranopterin monophosphate, molybdopterin, and adenylated molybdopterin. In a fifth step, sulfuration or bond formation between Mo and a protein cysteine result in two different catalytic Mo centers. There are four Mo enzymes in plants: (1) nitrate reductase catalyzes the first and rate-limiting step in nitrate assimilation and is structurally similar to the recently identified, (2) peroxisomal sulfite oxidase that detoxifies excessive sulfite. (3) Aldehyde oxidase catalyzes the last step of abscisic acid biosynthesis, and (4) xanthine dehydrogenase is essential for purine degradation and stress response.
Women's Mental Health Research: The Emergence of a Biomedical Field
Authors: Blehar Mary C.
Published: February 2006

This review surveys the field of women's mental health, with particular emphasis on its evolution into a distinct area of biomedical research. The field employs a biomedical disease model but it also emphasizes social and cultural influences on health outcomes. In recent years, its scope has expanded beyond studies of disorders occurring in women at times of reproductive transitions and it now encompasses a broader study of sex and gender differences. Historical and conceptual influences on the field are discussed. The review also surveys gender differences in the prevalence and clinical manifestations of mental disorders. Epidemiological findings have provided a rich resource for theory development, but without research tools to test theories adequately, findings of gender differences have begged the question of their biological, social, and cultural origins. Clinical depression is used to exemplify the usefulness of a sex/gender perspective in understanding mental illness; and major theories proposed to account for gender differences are critically evaluated. The National Institutes of Health (NIH) is the primary federal funding source for biomedical women's mental health research. The review surveys areas of emphasis in women's mental health research at the NIH as well as some collaborative activities that represent efforts to translate research findings into the public health and services arenas. As new analytic methods become available, it is anticipated that a more fundamental understanding of the biological and behavioral mechanisms underlying sex and gender differences in mental illness will emerge. Nonetheless, it is also likely that integration of findings predicated on different conceptual models of the nature and causes of mental illness will remain a challenge. These issues are discussed with reference to their impact on the field of women's mental health research.
POLITICAL ISLAM: Asking the Wrong Questions?
Authors: Sadowski Yahya
Published: February 2006

▪ Abstract  The empirical literature on political Islam is fairly rich and getting better, but theoretical interpretations of these data are still quite primitive. This gap is a product of Orientalist traditions that “essentialize” Islamic movements, a resulting lack of appreciation for their global diversity, and the inevitable politicization of the subject matter. This essay seeks not only to identify the most important studies in the field but to show how they suggest a typology, chronology, and problematic that might lead to more fruitful analysis in the future.
A mathematical model for the mating-induced prolactin rhythm of female rats
Authors: Bertram Richard , Egli Marcel , Toporikova Natalia , Freeman Marc E.
Published: February 2006

For the first 10 days of pregnancy and the first 12 days of pseudopregnancy, the secretion of prolactin (PRL) from pituitary lactotrophs is rhythmic, with two surges/day. This rhythm can also be triggered by bolus injection of oxytocin (OT). We describe a mathematical model for the initiation, maintenance, and termination of the OT-induced PRL rhythm. In our model, the mechanism for this circadian rhythm is mutual interaction between lactotrophs and neuroendocrine dopamine (DA) neurons. This rhythm is, under normal lighting conditions, entrained by the suprachiasmatic nucleus (SCN) but persists in the absence of input from the SCN. We postulate that OT injection triggers the rhythm by activating a population of bistable hypothalamic neurons that innervate and inhibit DA neurons. The bistable nature of these neurons allows them to act as a memory device, maintaining the rhythm long after OT has been cleared from the blood. The mechanism for this memory device and the arguments supporting it are detailed with computer simulations. Finally, we consider potential targets for a rhythm-terminating factor and make predictions that may be used to determine which mechanism is operational in terminating the OT- or mating-induced PRL rhythm.
P38 MAP kinase mediates transforming growth factor-β2 transcription in human keloid fibroblasts
Authors: Xia Wei , Longaker Michael T. , Yang George P.
Published: February 2006

Keloids are abnormal fibrous growths of the dermis that develop only in response to wounding and represent a form of benign skin tumor. Previous studies have shown increased protein levels of TGF-β in keloid tissue, suggesting a strong association with keloid formation leading us to examine mechanisms for why it is more highly expressed in keloids. Here, we use serum stimulation as an in vitro model to mimic a component of the wound microenvironment and examine differential gene expression in keloid human fibroblasts (KFs) vs. normal human fibroblasts (NFs). Transcription of TGF-β2 was rapid and peaked between 1 and 6 h after serum stimulation in KFs vs. NFs. We confirmed increased TGF-β activity in the conditioned medium from KFs, but not NFs. Inhibition of second messenger signaling pathways demonstrated that only the p38 MAPK inhibitor SB-203580 could block upregulation of TGF-β2 following serum stimulation in KFs. Immunoblotting demonstrated that p38 MAPK was phosphorylated within 15 min and was maintained at a high level in KFs but not in NFs. The transcription factors activating transcription factor-2 and Elk-1 are activated by p38 MAPK, and also showed rapid and prolonged phosphorylation kinetics in KFs but not in NFs. In conclusion, increased TGF-β2 transcription in response to serum stimulation in KFs appears to be mediated by the p38 MAPK pathway. This suggests the mechanism of keloid pathogenesis may be due in part to an inherent difference in how the fibroblasts respond to wounding.
Acute effect of high glucose on long-term cell growth: a role for transient glucose increase in proximal tubule cell injury
Authors: Samikkannu Thangavel , Thomas Justin J. , Bhat G. Jayarama , Wittman Vaughan , Thekkumkara Thomas J.
Published: February 2006

Although chronic exposure of renal cells to high glucose has been shown to cause cell injury, the effect of acute exposure has not been elucidated. In this study, we demonstrate that acute (10 min) exposure of human proximal tubule epithelial cells (hPTEC) to high glucose (25 mM) induces a time-dependent dual effect consisting of an early proliferation and a late apoptosis. Acute exposure of hPTEC to high glucose induced a twofold increase in DNA synthesis and cell number at 12 h. However, after 36 h, a significant decrease in cell growth is observed, followed by apoptosis. On glucose treatment, both p42/p44 mitogen-activated protein (MAP) kinases and the downstream signaling intermediate NF-κB were phosphorylated and translocated to the nucleus. Pretreatment of cells with MAP kinase and NF-κB-specific inhibitors abolished glucose-induced proliferation. However, these inhibitors were ineffective in preventing glucose-induced apoptosis. Interestingly, conditioned medium from cells exposed to high-glucose concentrations inhibited proliferation and concomitantly induced apoptosis in normal cells, suggesting that the inhibitory effect of glucose occurs through secretion of a secondary factor(s). In parallel to apoptosis, we observed an increased production of reactive oxygen species (ROS). Pretreatment of cells with the antioxidant N-acetyl cysteine reversed glucose-mediated ROS production and apoptosis, suggesting that ROS is involved in apoptosis. Our study demonstrates for the first time that a single high-glucose exposure for 10 min alone is sufficient to elicit proliferation and apoptosis in hPTEC and suggests that episodes of transient increase in glucose may contribute to cell damage leading to epithelial cell dysfunction.
Deep-breath frequency in bronchoconstricted monkeys (Macaca fascicularis)
Authors: Dybas Joseph M. , Andresen Catharine J. , Schelegle Edward S. , McCue Ryan W. , Callender Natasha N. , Jackson Andrew C.
Published: February 2006

Deep-breath frequency has been shown to increase in spontaneously obstructed asthmatic subjects. Furthermore, deep breaths are known to be regulated by lung rapidly adapting receptors, yet the mechanism by which these receptors are stimulated is unclear. This study tested the hypothesis that deep-breath frequency increases during experimentally induced bronchoconstriction, and the magnitude of the increased deep-breath frequency is dependent on the method by which bronchoconstriction is induced. Nine cynomolgus monkeys ( Macaca fascicularis) were challenged with methacholine (MCh), Ascaris suum (AS), histamine, or an external mechanical resistance. Baseline (BL) and challenge deep-breath frequency were calculated from the number of deep breaths per trial period. Airway resistance (Raw) and tissue compliance (Cti), as well as tidal volume, respiratory rate, and minute ventilation, were analyzed for BL and challenged conditions. Transfer impedance measurements were fit with the DuBois model to determine the respiratory parameters (Raw and Cti). The flow at the airway opening was measured and analyzed on a breath-by-breath basis to obtain the ventilatory parameters (tidal volume, respiratory rate, and minute ventilation). Deep-breath frequency resulting from AS and histamine challenges [0.370 (SD 0.186) and 0.467 breaths/min (SD 0.216), respectively] was significantly increased compared with BL, MCh, or external resistance challenges [0.61 (SD 0.046), 0.156 (SD 0.173), and 0.117 breaths/min (SD 0.082), respectively]. MCh and external resistance challenges resulted in insignificant changes in deep-breath frequency compared with BL. All four modalities produced similar levels of bronchoconstriction, as assessed through changes in Raw and Cti, and had similar effects on the ventilatory parameters except that non-deep-breath tidal volume was decreased in AS and histamine. We propose that increased deep-breath frequency during AS and histamine challenge is the result of increased vascular permeability, which acts to increase rapidly adapting receptor activity.
Growth hormone responses to repeated bouts of aerobic exercise with different recovery intervals
Authors: Sartorio Alessandro , Agosti Fiorenza , Marinone Pier Giulio , Proietti Marco , Lafortuna Claudio L. , Maffiuletti Nicola A.
Published: February 2006

This study examined the growth hormone (GH) response to repeated bouts of sprint cycling. Eight healthy men completed three trials consisting of two 30-s sprints on a cycle ergometer separated by either 60 min ( Trial A) or 240 min ( Trial B) of recovery and a single 30-s sprint carried out the day after Trial B ( Trial C). Trials A and B were separated by at least 7 days. Blood samples were obtained at rest and during recovery from each sprint. In Trial A, GH was elevated immediately before sprint 2, and there was no further increase in GH following the second sprint [area under the curve: 460 (SD 348) vs. 226 min·μg−1·l−1 (SD 182), P = 0.05]. Free insulin-like growth factor I tended to be lower immediately before sprint 2 than sprint 1 ( P = 0.06). Serum free fatty acids were not different immediately before each of the sprints. In Trial B, there was a trend for a smaller GH response to the second sprint [GH area under the curve: 512 (SD 396) vs. 242 min·μg−1·l−1 (SD 190), P = 0.09]. Free insulin-like growth factor I tended to be lower ( P = 0.06), and serum free fatty acids were higher ( P = 0.01) immediately before sprint 2 than sprint 1. There was no difference in the GH response to sprinting on consecutive days ( Trials B and C). In conclusion, repeated bouts of sprint cycling on the same day result in an attenuation or even ablation of the exercise-induced increase in GH, depending on the recovery interval between sprints.
Task Switching as a Two-Stage Decision Process
Authors: Sinha N. , Brown J.T.G. , Carpenter R.H.S.
Published: February 2006

Saccades represent decisions, and the study of their latency has led to a neurally plausible model of the underlying mechanisms, LATER (Linear Approach to Threshold with Ergodic Rate), that can successfully predict reaction time behavior in simple decision tasks, with fixed instructions. However, if the instructions abruptly change, we have a more complex situation, known as task switching. Psychologists' explanations of the phenomena of task switching have so far tended to be qualitative rather than quantitative, and not intended to relate particularly clearly to existing models of decision making or to likely neural implementations. Here, we investigated task switching using a novel saccadic task: we presented the instructions by stimulus elements identical to those of the task itself, allowing us to compare decisions about instructions with decisions in the actual task. Our results support a relatively simple model consisting of two distinct LATER processes in series: the first detects the instruction, the second implements it.
Timing and Communicative Functions of Pitch Contours
Authors: Kohler K.
Published: February 2006

A new research paradigm is applied to F0 synchronization with articulation, inpeak and valley contours, under four principles: (a) Timing of F0 contours enters thedefinitions of the pitch categories. (b) These phonetic exponents are linked to com-municativefunctions. (c) The listener plays a pivotal role. (d) Contextualization oftest stimuli is essential for pitch data collection. Data are presented and interpretedfrom an experimental investigation of the substance-function relationship in theperception of peak and valley shift series by German listeners, using the semanticdifferential technique. The findings of the substance-function relationship areexplained with reference to the frequency codeand to auditory enhancement,i.e.syntagmatic contrast of high-low or low-high pitch trajectories in synchronizationwith articulatory landmarks of accented syllables.
Exploring the Influence of Vocal Emotion Expression on Communicative Effectiveness
Authors: Biersack S. , Kempe V.
Published: February 2006

This study explores whether speaker emotion influences communicative effectiveness. Two hundred participants rated their current emotional state and gave a description of a route on a simple map. The quality of the linguistic content of the descriptions was assessed using Latent Semantic Analysis. Six hundred participants provided route drawings based on the map descriptions. Median route deviation served as a measure of communicative effectiveness. Eighty addi-tional participants rated invariant parts of the descriptions for perceived speaker happiness. Path analysis revealed that while speaker emotion did not affect the linguistic content of the descriptions, it had an effect on communicative effective-ness both through the effects of vocal cues directly as well as mediated by per-ceived happiness of speech. Specifically, higher first formants were associated with higher reported and perceived happiness as well as higher communicative effectiveness. Jitter, on the other hand, was negatively related to the perception of happiness and positively related to communicative effectiveness. These findings suggest that mood-related modulation of phonation and articulation can influence the effectiveness of communication in addition to message content.
From Words to Actions: The Phonetics of Eigenlijk in Two Communicative Contexts
Authors: Plug L.
Published: February 2006

This paper presents the results of an investigation into the distribution of phonetic variants of the Dutch discourse marker eigenlijk, combining phonetic and conversation analytic methods. The paper shows that the phonetic form of eigenlijkdepends to some extent on the sequential environment in which the item is used; moreover, it shows that in the case of two such environments, the forms of eigenlijk are representative of tempo and reduction patterns spanning entire turns or turn-constructional units. These patterns can be related to the interactive function of the turns; thus, the findings presented here contribute to our as yet limited knowledge of the phonetic correlates of communicative actions.
Acoustic Patterns and Communicative Functions of Phrase-Final F0 Rises in German: Activating and Restricting Contours
Authors: Dombrowski E. , Niebuhr O.
Published: February 2006

Acoustic features and communicative functions of phrase-final F0 rises startingbefore an accented-vowel onset are analysed in a corpus of German unscriptedspeech. Two conversational conditions are examined: turn-yielding and turn-holding.The most important feature distinguishing rises in these two conditions is therange proportion, which differentiates between two patterns as follows: (1) raisedpitch on the accented syllable and restrained pitch movement in the tail of thecontour, (2) lowered pitch on the accented syllable and extended pitch movementin the tail. The first pattern is seen as a restrictivegesture, e.g. preventing the dia-loguepartner from turn taking. The second one is viewed as an activatinggesture,inviting the coparticipant to contribute.
Exploring Prosody in Interaction Control
Authors: Edlund J. , Heldner M.
Published: February 2006

This paper investigates prosodic aspects of turn-taking in conversation with aview to improving the efficiency of identifying relevant places at which a machinecan legitimately begin to talk to a human interlocutor. It examines the relationshipbetween interaction control, the communicative function of which is to regulatethe flow of information between interlocutors, and its phonetic manifestation.Specifically, the listener’s perception of such interaction control phenomena ismodelled. Algorithms for automatic online extraction of prosodic phenomenaliable to be relevant for interaction control, such as silent pauses and intonationpatterns, are presented and evaluated in experiments using Swedish map taskdata. We show that the automatically extracted prosodic features can be used toavoid many of the places where current dialogue systems run the risk of interrupt-ingtheir users, as well as to identify suitable places to take the turn.
A Re-Evaluation of the Nature of Speech Errors in Normal and Disordered Speakers
Authors: Pouplier M. , Hardcastle W.
Published: February 2006

It is well known that speech errors in normal and aphasic speakers share cer-tain key characteristics. Traditionally, many of these errors are regarded as serial misorderings of abstract phonological segments, which maintain the phonetic well-formedness of the utterance. The current paper brings together the results of several articulatory studies undertaken independently for both subject popula-tions. These show that, in an error, instead of one segment substituting for another, two segments are often produced simultaneously even though only one segment may be heard. Such data pose problems for current models of speech production by suggesting that the commonly assumed dichotomous distinction between phonological and phonetic errors may not be tenable in the current form or may even be altogether redundant.
On-Line Haemodiafiltration versus Haemodialysis: Stable Haematocrit with Less Erythropoietin and Improvement of Other Relevant Blood Parameters
Authors: Vaslaki Lajos , Major Lajos , Berta Klara , Karatson Andras , Misz Mihay , Pethoe Ferenc , Ladanyi Erzsebet , Fodor Bertalan , Stein Günter , Pischetsrieder Monika , Zima Thomas , Wojke Ralf , Gauly Adelheid , Passlick-Deetjen Jutta
Published: February 2006

Background: Controlled randomised studies to prove improved cardiovascular stability and improved anaemia management during on-line haemodiafiltration (oHDF) are scarce. Methods: 70 patients were treated with both haemodialysis (HD) and oHDF in a cross-over design during 2 × 24 weeks at a dialysis dose of eKt/V≧1.2. Patients randomised into group A started on HD and switched over to oHDF, whereas patients in group B began with oHDF and were treated with HD afterwards. Intradialytic morbid events (IME), such as symptomatic hypotension or muscle cramps, were noted in case of appearance. Blood parameters reflecting anaemic status, phosphate status, lipid metabolism, oxidative stress, and accumulation of advanced glycation end products were recorded either monthly or at the end of each study phase. Results: The mean incidence of IME was 0.15 IME per treatment, and there was no statistical difference between oHDF and HD. A higher haematocrit (oHDF 31.5% vs. HD 30.5%, p < 0.01) at a lower erythropoietin dose (oHDF 4,913 vs. HD 5,492 IU/week, p = 0.02) was found during oHDF, when the sequence of HD and oHDF had not been taken into account. For the study groups, the results were less distinct: in group A, a higher haematocrit (HD 30.4% vs. oHDF 32.0%, p < 0.01) at a comparable erythropoietin dose (HD 5,421 vs. oHDF 5,187 IU/week, ns) was observed during oHDF, whereas in group B an identical haematocrit (oHDF 30.8% vs. HD 30.7%, ns) was achieved at a reduced erythropoietin dose (oHDF 4,622 vs. HD 5,568 IU/week, p < 0.01). During oHDF, lower levels of free and protein-bound pentosidine and of serum phosphate were found. Conclusion: In contrast to other studies, no benefit regarding cardiovascular stability for oHDF was found, but oHDF could well offer a potential benefit regarding anaemia correction, inflammation, oxidative stress, lipid profiles, and calcium-phosphate product.
Hallucinations, Cognitive Decline, and Death in Alzheimer’s Disease
Authors: Wilson R.S. , Tang Y. , Aggarwal N.T. , Gilley D.W. , McCann J.J. , Bienias J.L. , Evans D.A.
Published: February 2006

The relation of psychotic symptoms to cognitive decline and mortality in Alzheimer’s disease (AD) was examined during a mean of 2.2 years in 478 persons selected from clinical settings. Psychotic symptoms were ascertained at baseline and cognition was assessed semiannually with nine tests from which a global measure was formed. In analyses that controlled for age, sex, race, and education, hallucinations (29.6%), especially visual ones, were associated with more rapid global cognitive decline and increased mortality, even after controlling for baseline level of cognition and use of antipsychotic medication, and the association with mortality increased with higher level of education. Delusions and misperceptions were not strongly related to cognitive decline or mortality. The results suggest that hallucinations in Alzheimer’s disease, particularly visual ones, are associated with more rapid progression.
Relationship between Lifetime Smoking, Smoking Status at Older Age and Human Cognitive Function
Authors: Stewart Marlene C.W. , Deary Ian J. , Fowkes F. Gerald R. , Price Jacqueline F.
Published: February 2006

Cigarette smoking is a major risk factor for clinical cardiovascular disease and may also be associated with poorer cognitive functioning in older age. We measured lifetime cigarette smoking, smoking status and cognitive function in over 2,000 men and women from the general population aged over 50 years with subclinical atherosclerosis (ankle brachial pressure index ≤0.95 but no history of clinical cardiovascular disease). In this population, an association was found between greater lifetime smoking and poorer cognitive function in men and between smoking cessation and better cognitive function in women. The former relationship appeared to reflect an association between smoking habit and prior cognitive function (in early life), whereas the latter remained significant after adjustment for tests of crystallised cognitive function, suggesting a relationship between continuing to smoke (as opposed to quitting) and age-related cognitive decline. Both relationships were inde pendent of the degree of atherosclerosis (as measured using the ankle brachial pressure index), suggesting alternative underlying mechanisms for the association between smoking and human adult cognitive function.
Spinal N-Methyl-D-Aspartate Receptors May Mediate the Analgesic Effects of Emulsified Halogenated Anesthetics
Authors: Hang Li-Hua , Dai Ti-Jun , Zeng Yin-Ming
Published: February 2006

The present study was designed to investigate the relationship between spinal cord N-methyl-D-aspartate (NMDA) receptors and the analgesic effects of emulsified halogenated anesthetics. After having established the mouse model of analgesia by intraperitoneally or subcutaneously injecting appropriate doses of emulsified enflurane, isoflurane or sevoflurane, we intrathecally injected different doses of NMDA and then observed the effects on the pain threshold using the hot-plate test and the acetic acid-induced writhing test. The results showed that intrathecal injection of NMDA (2.5, 5 and 10 ng) did not affect the pain threshold on the hot-plate test or the writhing times in conscious mice (p > 0.05); in contrast, NMDA (2.5, 5 and 10 ng intrathecally) can significantly and dose dependently decrease the pain threshold on the hot-plate test (p < 0.05 or p < 0.01) and increase the writhing times (p < 0.05 or p < 0.01) in the mice treated with emulsified anesthetics. These results suggest that spinal NMDA receptors may be important targets for the analgesic effects of emulsified enflurane, isoflurane and sevoflurane.
Upbeat Nystagmus due to a Small Pontine Lesion: Evidence for the Existence of a Crossing Ventral Tegmental Tract
Authors: Pierrot-Deseilligny C. , Milea D. , Sirmai J. , Papeix C. , Rivaud-Péchoux S.
Published: February 2006

We report a patient with an isolated large upbeat nystagmus (UBN) in the primary position of gaze. Eye movements were filmed and recorded using electro-oculography. The upward vestibulo-ocular reflex gain, evaluated by pitching the head forward, was markedly reduced compared to when pitching the head back. The lesion was a probable lacunar infarction located in the paramedian and posterior part of the basis pontis, at the upper pons level. This UBN case, with one of the smallest brainstem lesions reported so far, supports the existence in humans of the crossing ventral tegmental tract, described in the cat and transmitting excitatory upward vestibular signals to the third nerve nucleus. It is also suggested that the decussation of this tract lies at the same upper pons level as in the cat but in a slightly more ventral location, i.e. in the posterior basis pontis.
Reliability Study on the Japanese Version of the Clinician’s Interview-Based Impression of Change
Authors: Homma Akira , Nakamura Yu , Kobune Shinichi , Haraguchi Hirofumi , Kodani Nobuyoshi , Takami Isao , Matsuoka Joe , Matsuda Hiroaki , Kusunoki Tadashi
Published: February 2006

The Japanese version of the Clinician’s Interview-Based Impression of Change (CIBIC-plus J) is a semistructured interview format including a 7-point Likert type scale for the Clinician’s Global Impression of Change. It comprises subscales of DAD for ADL, Behave-AD for behavioral and psychiatric symptoms and MENFIS for cognitive and emotional impairment. DAD and Behave-AD are used for caregivers and MENFIS for both caregivers and patients. The objective of this study was to examine the interrater reliability of the CIBIC-plus J by the videotape method. Twenty videotaped patients including 13 real and 7 virtual patients were independently assessed by 11 raters. The kappa coefficient from the full set of data of 20 patients and 11 raters was 0.453, and from the limited data of 13 real patients, 0.383. By permitting one-point disagreements on the 7-point scale or by collapsing it into the 3-point scale (improved, no change, or worsened), kappa improved to 0.894 and 0.731, or 0.734 and 0.504, respectively. From these results, it was concluded that the reliability of a 7-point Clinician’s Global Impression of Change was halfway, i.e., neither sufficient nor insufficient. However, if one-point disagreements or collapsing into 3-point scale are allowable, the CIBIC-plus J will be sufficiently reliable.
The Effects of L-Arginine on Neurological Function, Histopathology, and Expression of Hypoxia-Inducible Factor-1 Alpha following Spinal Cord Ischemia in Rats
Authors: Tuncer M. Cudi , Hatipoglu E. Savas , Ozturk H. , Kervancioglu P. , Buyukbayram H.
Published: February 2006

The aim of this study was to investigate the effects of L-arginine (L-Arg) on neurological function, histopathology, and expression of hypoxia-inducible factor-1 alpha (HIF-1α) following spinal cord ischemia in rats, and the interaction between therapy with the nitric oxide donor L-Arg and up-regulation of the expression of HIF-1α. Thirty Wistar rats weighing between 200 and 250 g were divided into three groups, each containing 10 rats: group 1, sham operation; group 2, untreated ischemia-reperfusion (I-R); group 3, I-R plus L-Arg treatment. Spinal cord ischemia was applied for 20 min. There were no significant differences in mean arterial pressures, temperatures, and blood gas levels among the groups. In group 2, malondialdehyde values were significantly increased compared with groups 1 and 3. The rats with aortic occlusion in group 2 had paraplegia or paraparesis. In group 3, all animals were neurologically intact. In group 3, spinal motor neurons did not decrease significantly, and little proliferation of microglia was observed compared with those in group 2. In group 2, spinal motor neurons in ventral gray matter decreased significantly compared with those in groups 1 and 3. HIF-1α-positive immunostaining was mildly detected in group 2 animals. The expression of immunoreactive cells was intensely increased in spinal cord tissue from I-R/L-Arg rats. In conclusion, our findings suggest that HIF-1α-positive immunostaining may be critical factors in the pathophysiology of inflammatory spinal cord injury induced by I-R. Nitric oxide may play an important role in the immunohistochemical expression of these molecules, and the neuroprotective benefit of L-Arg may be attributed to preventing neural cell necrosis.
Mild Hypothermia Ameliorates Lung Ischemia Reperfusion Injury in an ex vivo Rat Lung Model
Authors: Shoji T. , Omasa M. , Nakamura T. , Yoshimura T. , Yoshida H. , Ikeyama K. , Fukuse T. , Wada H.
Published: February 2006

Background: Ischemia reperfusion (I-R) injury of the lung frequently occurs after cardiopulmonary bypass, pulmonary thromboendarterectomy, lung transplantation, and major pulmonary resection with vascular reconstruction. Mild hypothermia ameliorates ischemia reperfusion injury of the brain and the liver. However, the effect of mild hypothermia on I-R injury of the lung has not been investigated. Methods: The lungs of Lewis rats underwent 80 min of ischemia followed by 60 min of reperfusion in an ex vivo perfusion model. The ambient temperature was maintained at either normothermia (38°C, n = 6) or mild hypothermia (35°C, n = 6) during the ischemia and reperfusion. Results: Pulmonary shunt fraction, peak inspiratory pressure, mean pulmonary arterial pressure during reperfusion, and the wet/dry weight ratio of the lung tissue at the end of reperfusion in the mild hypothermia group were significantly (p < 0.05) lower than those in the normothermia group. Total adenine nucleotide, adenosine triphosphate, adenosine diphosphate, and adenosine monophosphate after reperfusion in the mild hypothermia group were significantly (p < 0.05) higher than those in the normothermia group. Conclusion: Mild hypothermia attenuates I-R injury of the lung with maintained levels of intrapulmonary high-energy phosphate compounds after reperfusion, suggesting its beneficial effect on warm lung I-R in clinical settings.
Relation between Severity of Injury and the Early Activation of Interleukins in Multiple-Injured Patients
Authors: Yagmur Y. , Ozturk H. , Unaldi M. , Gedik E.
Published: February 2006

The aim of this study was to evaluate the relation between severity of injury and the early activation of interleukins in multiple-injured patients. Ninety-nine patients with multiple injuries were included in this prospective study. Plasma levels of interleukin (IL)-1, IL-2, IL-6, IL-8 and TNF-α were measured. Injury Severity Score (ISS), Revised Trauma Score (RTS), Glasgow Coma Score (GCS) and the Acute Physiology and Chronic Health Evaluation II (APACHE-II) were all recorded. Of the 99 patients, 82 were male and 17 were female. The mean age was 26.6 ± 20.7 years. The mortality rate for this series was 17%. Patients who died from trauma exhibited a significant increase for IL-2, IL-6 and IL-8 in comparison with patients who survived. Significant differences for ISS, RTS and GCS were found between survivors and non-survivors. Values in all patients with ISS >16 were increased and these increases were significant for IL-6 and IL-2. These data show that the initial increase of IL-2, IL-6 and IL-8 might predict the patients with a high possibility of mortality and a significant increase of IL-2 and IL-6 in patients with ISS >16 might be used in a new developed trauma score combined with ISS as an indicator for the injury severity.
Extended Liver Resection and Hepatic Ischemia in Pigs: A New, Potentially ReversibleModel to Induce Acute Liver Failure and Study Artificial Liver Support Systems
Authors: Ladurner R. , Hochleitner B. , Schneeberger S. , Barnas U. , Krismer A. , Kleinsasser A. , Offner F. , Königsrainer I. , Margreiter R. , Königsrainer A.
Published: February 2006

Background: Extended hepatectomy is a valid model for the study of acute liver failure. Since the porcine liver is comparable in size, morphology and anatomy to the human liver, we describe a technique employing hepatic ischemia and extended liver resection to induce acute liver failure in a porcine model as a means of studying bioartificial liver support. Method: A subtotal (75–80% resection) extended left hepatectomy was performed in 7 pigs after 60 min warm ischemia of the future remnant liver. After resection, the animals were given the best supportive care and observed until death. Results: All animals died within 18–48 h, none as a result of surgical complications. Gross appearance of the liver showed severe steatosis of the right lateral lobe, and histology revealed severe coagulative necrosis of the whole lobule. Conclusion: This technique of extended liver resection after hepatic ischemia in the porcine model may be useful for studies of potentially reversible acute liver failure and experimental bioartificial support.
Intraoperative Portable 0.12-Tesla MRI in Pediatric Neurosurgery
Authors: Roth Jonathan , Beni Adani Liana , Biyani Naresh , Constantini Shlomi
Published: February 2006

Objectives: Intraoperative MRI (iMRI) is used mainly in the adult neurosurgical population. The main indications for iMRI usage are resection control and updated intraoperative navigation capabilities. In this paper we present our experience using this technique in children. Specific advantages of iMRI for this age group are discussed. Methods and Results: We retrospectively reviewed 31 pediatric neurosurgical procedures in which a portable iMRI system was used. The indications for iMRI usage were preoperative navigation, resection control during tumor removal, shunt placements, and needle biopsy. In 7 children the use of the iMRI changed the course of the surgical procedure. Operative morbidity and mortality were not increased with use of the iMRI. Conclusions: iMRI systems have advantages for the pediatric neurosurgical population, including both real-time basic navigation and improved resection control.
Risk of Ventriculoperitoneal Shunt Infections due to Gastrostomy Feeding Tube Insertion in Pediatric Patients with Brain Tumors
Authors: Gassas A. , Kennedy J. , Green G. , Connolly B. , Cohen J. , Dag-Ellams U. , Kulkarni A. , Bouffet E.
Published: February 2006

Objective: To determine the risk of ventriculoperitoneal (VP) shunt infections after percutaneous retrograde gastrostomy feeding tube (GT) placement in children with brain tumors. Patients and Methods: All children (age 0–18 years) with primary brain tumors diagnosed and treated at the Hospital for Sick Children, Toronto, Canada, were subjected to a retrospective analysis. Two groups were identified: the study group included children with a VP shunt and a GT; the control group included children with VP shunts only. Each study patient was matched with 2 controls to compare the rate of infections (cohort comparative study). Results: There were 1,167 children diagnosed and treated with primary brain tumors during the study period (1988–2003); 174 (15%) had a VP shunt and 23 (2%) children had both, a VP shunt and a GT. In the study group (n = 17), GTs were inserted at a median time of 80 days (range 6–204 days) after VP shunts. VP shunt infection rate was 23.5% (4/17) compared to 8.8% (3/34) in the control group (OR 3.18; 95% CI 0.622–16.54, p = 0.16). Three (75%) of the infection episodes in the study group presented with an ascending VP shunt infection directly related to the GT insertion or manipulation in the first 6 weeks. These GTs were inserted at 13, 47 and 49 days after VP shunt insertion. Conclusion: Placement of percutaneous retrograde GTs, in the acute phase, in children with brain tumors and VP shunts may increase the risk of ascending meningitis especially if there are early GT-related complications.
Case Report of Optic Atrophy in Pansynostosis: An Unusual Presentation of Scalp Edema from Hair Braiding
Authors: O’Hara Catherine M. , Izadi Keyoumars , Albright Leland , Bradley James P.
Published: February 2006

Pansynostosis (fusion of all cranial sutures) and optic atrophy were found as incidental CT scan and ophthalmological findings in an 8-year-old who presented to the emergency room with scalp edema from tight ‘cornrow’ hair braiding. Cranial vault expansion was successfully performed. Ophthalmological problems have stabilized but have not reversed. Late presentation of craniosynostosis and the pathophysiology of secondary optic atrophy are discussed.
Endoscopic Resection of an Intraventricular Dysembryoplastic Neuroepithelial Tumor of the Septum Pellucidum
Authors: Harter David H. , Omeis Ibrahim , Forman Scott , Braun Alex
Published: February 2006

Tumors located in the region of the foramen of Monro often present with signs and symptoms of obstructive hydrocephalus. Various types of lesions occur in this location. We describe a case of a dysembryoplastic neuroepithelial tumor of the septum pellucidum presenting with obstructive hydrocephalus and its successful endoscopic excision. The surgical considerations and pathologic findings are discussed.
Syndromic Craniosynostosis with Elbow Joint Contracture
Authors: Akai Takuya , Yamamoto Kenji , Iizuka Hideaki , Kawakami Shigehiko , Yoshida Jun , Kakinuma Hiroaki , Yaguchi Yuuki , Ozawa Tesuo
Published: February 2006

This paper reports a new type of syndromic craniosynostosis that was diagnosed by DNA analysis of the patient’s fibroblast growth factor receptor (FGFR) genes. At birth, a male infant had ocular proptosis, a pseudotail, and obstructed respiration. He developed craniosynostosis, craniofacial dysmorphism, hydrocephalus, and bilateral contracture of his elbow joints. His treatment included fronto-orbital advancements and a ventriculoperitoneal shunt. Genetic analysis revealed that he was heterozygous for a missense mutation in exon 9 of the FGFR2 gene that resulted in an amino acid substitution of cysteine for serine at residue 351 (Ser351Cys). Seven cases with this mutation had previously been reported. All had severe craniosynostosis with midface hypoplasia, elbow joint contracture, developmental retardation, and early death.
Complete Recovery of Spinal Cord Injury without Radiographic Abnormality and Traumatic Brachial Plexopathy in a Young Infant Falling from a 30-Feet-High Window
Authors: Lee Chien-Chang , Lee Sie-Huei , Yo Chia-Hung , Lee Wang-Tso , Chen Shyr-Chyr
Published: February 2006

The laxity and elasticity of the infant or child spine may predispose him to cervical spine injury without bony disruption. The term ‘SCIWORA’ syndrome (Spinal Cord Injury Without Radiographic Abnormalities) is commonly used to characterize this condition. We report a 14-month-old infant who fell from a fourth-story window, with delayed onset of SCIWORA and brachial plexopathy. The infant initially presented with complete limb paralysis, but had a full recovery 6 months later. In contrast to the classical grave prognosis of these two conditions, our case represents one of the few exceptions in the literature with excellent recovery. Corresponding to previous reports, we suggest that the initial normal appearance of the spinal cord and nerve roots on magnetic resonance image may serve as a good prognosticator, regardless of the severity of initial neuroelectrophysiological studies or clinical manifestations.
Spontaneous Acute Subdural Hematoma following Contralateral Calcified Chronic Subdural Hematoma Surgery: An Unusual Case
Authors: Tatli M. , Guzel A. , Altinors N.
Published: February 2006

Calcified chronic subdural hematoma (CCSDH) is a well-known disease to many neurosurgeons but only few cases have been reported regarding its surgical complications. We report a spontaneous acute subdural hematoma following contralateral CCSDH surgery in a 16-year-old boy and discuss its possible mechanisms. The first few days of the postoperative period, especially for the cerebral atrophy cases, should be monitored carefully and a control computerized tomography scan should be performed early for possible complications. To our knowledge, spontaneous acute subdural hematoma following contralateral CCSDH surgery has not been reported previously.
Hemoperfusion with an Immobilized Polymyxin B Column Reduces the Blood Level of Neutrophil Elastase
Authors: Kushi Hidehiko , Miki Takahiro , Nakahara Jun , Okamoto Kazuhiko , Saito Takeshi , Tanjoh Katsuhisa
Published: February 2006

Background: We investigated whether direct hemoperfusion with an immobilized polymyxin B column (DHP with PMX) could reduce the blood level of neutrophil elastase. Methods: 20 sepsis patients were enrolled in the study. DHP with PMX was performed twice within a 24-hour period. Neutrophil elastase was measured 7 times. Results: Neutrophil elastase was 468 ± 75.1 µg/l, while it was 1,531 ± 201.7 µg/l immediately after the first session, declined to 351 ± 73.9 µg/l before the second session of DHP with PMX, and increased again to 599.3 ± 112.7 µg/l immediately after the second session, 328 ± 73.7 µg/l at 24 h, 264 ± 39.3 µg/l at 48 h, and 230 ± 36.1 µg/l at 72 h after DHP with PMX. The levels from 48 h onwards were significantly lower compared with that before treatment. Conclusion: DHP with PMX has an overall effect that reduces circulating neutrophil elastase levels.
Seasonal Variation of Sexual Abuse in Santiago de Chile
Authors: Téllez Carlos , Galleguillos Tamara , Aliaga Alvaro , Silva Claudio
Published: February 2006

Background: Seasonal variations of sexual crime have been seldom studied in the world. Santiago, a city situated at 33° south latitude with a well defined four season climate, has a reliable forensic registry, providing a good opportunity for the assessment of seasonality in this type of crime. Materials and Methods: After studying monthly records of sexual abuse from the registry of the Servicio Médico Legal of Santiago between 1990 and 2001, a ratio of observed to expected monthly frequency was obtained, allowing the assessment of the seasonal character of the phenomenon. Results: A total number of 11,844 cases of sexual abuse were recorded during 12 years of the study. Statistically significant differences could be demonstrated between spring and autumn, with a peak in November and a nadir in June. Conclusions: A distinct seasonal pattern can be set forth for sexual abuse in Santiago, Chile.
Seasonal Variation in Suicidal Deaths in Chile: Its Relationship to Latitude
Authors: Heerlein Andrés , Valeria Claudio , Medina Bárbara
Published: February 2006

Background: Studies in the northern and southern hemispheres consistently identified seasonal influences on monthly and semester suicide distribution. The variations of sunlight exposure in zones of increasing latitude has been suggested as one of the most plausible explanations for this phenomenon. Some recent studies in the northern hemisphere could not find seasonal asymmetries of suicides. The current study examines the monthly, seasonal and semester distribution of suicidal deaths in Chile and the influence of seasons in zones of low latitude as compared with regions of high or very high latitude, trying to determine if a seasonal pattern still exists in a country of the southern hemisphere. Methods: Monthly, seasonal and semester suicidal data over the period 1995–1999 were examined for the whole sample and for gender-specific subgroups in Chile. Four different latitudinal zones were analyzed separately, in order to investigate the effect of the photoperiod on suicide distribution. Results were analyzed by χ2 tests for multinomials, as an overall measure of deviation. Results: We found a significant unimodal springtime peak for both genders in the global territory. Among the 4,710 male and 829 female suicides reported in this period there were no gender differences in the seasonal pattern of suicidal deaths. When divided into four different latitudinal zones, the regions with low latitude (north of the country) showed no significant differences, while central and southern zones (higher latitude) show a significant springtime pattern. In the extreme south of the country, no significant differences were found, probably due to the very small number of cases. Conclusion: The study confirms the existence of a unimodal springtime peak of suicides in Chile, but not in the zone of low latitude. Results support the notion that the seasonal impact on suicidal distribution is a function of photoperiod.