bluuebunny/crossref_metadata_2025 huggingface dataset:
Prescription Practice for LH-RH Analogs and Androgen Receptor Antagonists in the Treatment of Advanced Prostate Cancer in Germany (1993–2003)
Authors: Rohde Volker , Diemer Thorsten , Hauck Ekkehard , Bestmann Beate , Miller Jörg , Schröder Helmut , Weidner Wolfgang , Katalinic Alexander
Published: November 2006

Introduction: Nearly 80% of the patients suffering from advanced stages of prostate cancer in Germany are treated currently with luteinizing hormone-releasing hormone (LH-RH) analogs alone or in combination with androgen receptor antagonists. The aim of this study was to assess whether the prescription practice for LH-RH analogs and direct antiandrogens between 1993 and 2003 parallels the rise in the incidence rates for prostate cancer associated with the proportional rise in daily doses. Methods: Between 1993 and 2000 a yearly randomly selected number of receipts has been evaluated from official pharmacies in Germany which have been billed to public health insurance companies. Data concerning drug use, number of daily doses, and total cost of the respective drugs have been calculated by the Research Institute of the AOK (Wissenschaftliches Institut der AOK, WIdO). These prescription data have been related to incidence and mortality rates of patients with prostate cancer. Results: Between 1993 and 2003 the age-standardized incidence rate of carcinomas of the prostate has risen by 180%, while the disease-specific mortality practically has remained nearly at the same level. The daily prescribed doses of LH-RH analogs have risen by a factor of 8.5 from 3.9 to 33.5 million daily doses during this time. In contrast, the daily doses of androgen receptor antagonists have remained unchanged between 1997 and 2001, followed by a rise of 50% between 2001 and 2003. Conclusions: The first analysis of the prescription practice of antiandrogens in the treatment of prostate cancer with respect to the incidence rates in Germany could only be facilitated by the fact that these medications are in exclusive use for this indication in Germany. The rise in prescriptions may be explained by the therapy shift from surgery to LH-RH application until the year 2000; the reasons for a further rise since 2000 remain speculative. In conclusion, only prevalence data would allow the exact calculation of medication needs among prostate cancer patients.
Impact of Percutaneous Access Point Number and Location on Complication and Success Rates in Percutaneous Nephrolithotomy
Authors: Muslumanoglu Ahmet Yaser , Tefekli Ahmet , Karadag Mert Ali , Tok Adem , Sari Erhan , Berberoglu Yalcin
Published: November 2006

Objectives: Percutaneous nephrolithotomy (PNL) is sometimes associated with complications, especially in patients with complex stones. Herein, we review our experience with PNL to determine the impact of percutaneous access number and location on success and complication rates. Patients and Methods: During a 2-year period, a total of 275 patients with a mean age of 42.3 ± 14.8 (range: 13–75) years underwent PNL. Stones were classified as simple in 51.6%, and complex (staghorn calculi or renal pelvis stones coexisting with caliceal stones) in 48.4%. Percutaneous access was done under C-armed fluoroscopy and the tract was formed with a high-pressure balloon dilation system. One single percutaneous access was sufficient in 210 (76.4%), while 2 accesses were utilized in 44 (16%), and ≧3 accesses in 21 cases (7.6%). Supracostal access was performed in 23 (8.4%) patients. Results: An overall success rate of 94.9% was achieved. Stone location, but not the access point location, was the major determinant for success, which was 99.3 and 90.2% in patients with simple and complex stones, respectively (p < 0.01). Significant complications included bleeding necessitating blood transfusion in 28 (10.2%), and hydropneumothorax in 2 (0.7%) patients. Bleeding was observed in 39.1 and 7.5% of patients managed with supracostal access, and subcostal access, respectively (p < 0.01). An increased number of access points significantly augmented the risk for bleeding. Bleeding was encountered in 7.6% of patients managed with 1 percutaneous access point, and in 18.5% of cases managed with ≧2 access points (p < 0.05). Hydropneumothorax occurred in patients with supracostal access. Conclusion: Supracostal access as well as multiple punctures may be needed especially in the management of complex stones, and the need for multiple access points and supracostal access significantly increases complication rates.
Endourological Re-Establishment of a Disrupted Infundibulum after Renal Laceration
Authors: Yamamoto Naoki , Takeuchi Toshimi , Hayashi Hideji , Gotoh Takahiro , Miwa Kousei , Sakai Shunsuke
Published: November 2006

We report a case of severe urinary extravasation after renal contusion and its successful management by endoscopic creation of a neoinfundibulum. When the stenotic infundibulum cannot be traversed with a guide wire, creation of a new infundibulum will offer a secure alternative for accessing the collecting system.
Recurrent Arteriovenous Malformation of the Scrotum Secondary to Pelvic Trauma
Authors: Agrawal Vineet , Dangle Pankaj , Minhas Suks , Ralph David , Christopher Nim
Published: November 2006

We describe a case of recurrent scrotal arteriovenous malformation (AVM) in a young man secondary to pelvic fracture sustained during a road traffic accident. This was diagnosed as a lipoma on the ultrasound and clinical examination. To our knowledge, this is the first reported case of recurrent scrotal AVM secondary to trauma.
Giant Urethral Diverticulum – Unusual Complication following Ventral Buccal Mucosa Onlay Graft Urethroplasty
Authors: Miller Jörg , Hauck Ekkehard W. , Rohde Volker , Weidner Wolfgang
Published: November 2006

During the past 10 years, buccal mucosa grafting for urethroplasty has gained widespread acceptance. In general the reported success rates are 80% and higher. Typical complications are recurrent strictures, fistula, and, especially when the technique of ventral onlay urethroplasty has been used, sacculations that are of little clinical significance in most cases. The development of large diverticula has not been described yet. We report on the case of a 63-year-old man who developed a giant diverticulum of the urethra 1 year after a ventral buccal mucosa onlay graft urethroplasty for recurrent bulbar urethral strictures had been worked out.
Voluminous Fetal Chylous Ascites: A Case of Complete Spontaneous Prenatal Regression
Authors: Chéreau Elisabeth , Lejeune Véronique , Gonzales Marie , Carbonne Bruno
Published: November 2006

We report a case of isolated voluminous fetal ascites discovered during a routine fetal ultrasound at 22 weeks’ gestation. Analysis of the fluid showed it to be chyliform and ruled out other causes of fetal ascites. Regular bimonthly ultrasound scans monitored its progressive diminution and then its disappearance. Examination showed the child to be normal at birth. Though the literature indicates that prognosis is usually favorable for infants with isolated fetal chylous ascites, spontaneous regression during pregnancy is an uncommon finding.
Hypothetical Role of Prostaglandins in the Onset of Preterm Labor after Fetal Surgery
Authors: Pomini Francesco , Noia Giuseppe , Mancuso Salvatore
Published: November 2006

Preterm labor is one of the most important factors limiting the advancement of fetal surgery programs. While prostaglandins (PGs) have long been indicated as the key factor in the initiation of labor in humans, there is significant evidence showing that the chorionic membrane acts as a powerful barrier between the decidua/myometrium and amniotic PGs during normal pregnancy. After either open or endoscopic fetal surgery the imperfect, non-hermetical closure of the chorion permits leakage of PGs from the amnionic sac, allowing them to reach the decidua and myometrium. The surgical wound in the chorionic barrier could be the major factor involved in preterm labor and delivery after human fetal surgery.
T2 Quantifications of Lungs in the Fetal Lamb with Experimentally-Induced Congenital Diaphragmatic Hernia
Authors: Breysem Luc , Bosmans Hilde , Jani Jacques , Roubliova Xenia , Cannie Mieke , Deprest Jan , Smet Maria Helena
Published: November 2006

Objective: As an aid to evaluate lung hypoplasia, we investigated the difference between T2 value in fetal lungs of lambs with surgically-induced left-sided diaphragmatic hernia (DH) and gestational age (GA)-matched control littermates (normal [NL]). Methods: Lungs were divided into two groups: DH (n = 4) and NL (n = 6). DH was induced at 65–75 days GA (term = 145 days). Fetal MRI was performed (mean GA: 120 days) with half-Fourier acquisition single-shot turbo spin-echo (TE: 60 ms) and rapid acquisition with relaxation enhancement (TE: 350 ms) in the same location (1.5-T Philips, Gyroscan, Best, The Netherlands). T2 of each lung was calculated for multiple regions of interest by taking natural logarithm of signal-to-noise ratio. Mean T2 was compared between DH and NL (unpaired analysis for entire group). Paired comparison between left/right lung was made within DH and NL. Results: Unpaired analysis showed significantly lower T2 of left respectively right lungs in DH (p = 0.02 [respectively] 0.05]) compared to NL (n = 6), as well as between the T2 of all DH versus NL (p = 0.001). In DH, calculated T2 appeared to be lower in left than in right lungs (difference ranged from –2 to +49%). In NL, left and right lungs showed comparable T2. Conclusion: Measurement of T2 signal intensity in DH lungs is feasible and show lower T2 in comparison to NL lungs. Left lungs from lambs with DH show lower T2 than right lungs.
The Relationship between Birth Weight Leptin and Bone Mineral Status in Newborn Infants
Authors: Akcakus Mustafa , Kurtoglu Selim , Koklu Esad , Kula Mustafa , Koklu Selmin
Published: November 2006

Background: The positive relationship between fat mass, bone mass and leptin has been shown in fetal mouse cartilage/bone. It has been shown that umbilical venous leptin predicts both the size of the neonatal skeleton and its estimated volumetric mineral density. Aims: This study investigates how birth weight and bone mineralization correlate with leptin levels. In addition, we aimed to determine the predictive value of anthropometrics measurements and gender on variability in bone mineral status. Methods: Umbilical cord venous blood samples were obtained at the delivery from 100 term newborn infants. Forty of the newborn infants had birth weights appropriate for gestational age (AGA), 30 were small for gestational age (SGA) and 30 were large for gestational age (LGA). Data were acquired using the whole body dual energy X-ray obsorptiometry scanner in the first 24 h after birth. Results: Leptin concentrations were higher in LGA (36.6 ±12.0 ng/ml; p < 0.0001), but lower in SGA (11.7 ± 5.6 ng/ml; p < 0.001) than in AGA infants (20.3 ± 7.6 ng/ml). Whole body bone mineral density and whole body bone mineral content were higher in LGA babies (0.442 ± 0.025 g/cm2, 71.6 ± 9.0 g, p < 0.01, p < 0.001, respectively) but lower in SGA (0.381 ± 0.027 g/cm2, 29.1 ± 9.1 g, p < 0.001, p < 0.001, respectively) than in AGA babies (0.426 ± 0.022 g/cm2, 53.7 ± 9.6 g, respectively). The percentage of whole body bone mineral content was lower in SGA (1.3 ± 0.3) than in AGA (1.6 ± 0.2, p < 0.001) and LGA (1.7 ± 0.2, p < 0.001). In stepwise linear regression analyses models; leptin is not found related to the bone indices. Conclusion: Our study does not provide support for the hypothesis that leptin may play a major role in the regulation of bone metabolism in the developing skeleton.
Interleukin-8 and Monocyte Chemotactic Protein-1 mRNA Expression in Perinatally Infected and Asphyxiated Preterm Neonates
Authors: Petrakou E. , Mouchtouri A. , Levi E. , Lipsou N. , Xanthou M. , Fotopoulos S.
Published: November 2006

Background: Inflammation due to perinatal infection (PI) and perinatal asphyxia (PA) may cause damage to various tissues and very often to the immature brain of the fetus and the newborn. Previously, we have shown that the neonatal immune system has the ability to produce increased chemokine protein levels in the serum during the inflammatory response caused by PI and PA. Aim: The aim of our present study was to investigate mRNA levels of the proinflammatory chemokines interleukin-8 (IL-8) and monocyte chemotactic protein-1 (MCP-1) in peripheral blood leukocytes from infected and asphyxiated neonates. Methods: Forty-two premature neonates were studied; 11 with PI, 16 with PA and 15 without PA and PI, were used as controls. IL-8 and MCP-1 mRNA levels were investigated in whole blood and in phytohemagglutinin-activated lymphocytes using semi-quantitative polymerase chain reaction and real-time polymerase chain reaction, respectively. Results: IL-8 mRNA levels were significantly increased in whole blood both during PA and PI, while MCP-1 mRNA levels were not. In vitro activated lymphocytes expressed significantly increased IL-8 mRNA levels during PI, whereas no increase was observed during PA. MCP-1 mRNA levels were significantly increased in activated lymphocytes during PA, while no increase was observed during PI. Conclusions: Our data show that chemokine mRNA levels expressed by activated lymphocytes during inflammation caused by PIs are different to those expressed during PAs. These findings might have important implications during the administration of specific chemokine antagonists in order to prevent or reduce tissue damage caused by inflammation.
Near-Infrared Spectroscopy as a Screening Tool for Patent Ductus Arteriosus in Extremely Low Birth Weight Infants
Authors: Underwood Mark A. , Milstein Jay M. , Sherman Michael P.
Published: November 2006

Background: Patent ductus arteriosus (PDA) is frequent and potentially pathologic in preterm infants. A simple bedside tool to screen for ductal patency would assist in the care of extremely low birth weight (ELBW) infants. Objective: To investigate the utility of near-infrared spectroscopy (NIRS) in identifying ELBW infants who would benefit from early echocardiography. Methods: Tissue oxygen saturation (StO2) was measured by NIRS in the lungs, brain, skeletal muscle and kidney of 20 ELBW infants. Comparisons were made between the StO2 in these organs and the need for intervention for a PDA. All studies were performed within the first 4 days of life. Similar measurements were performed following treatment with indomethacin in nine of the patients. Results: The StO2 of skeletal muscle (left deltoid) and kidney differed between the infants who were treated for PDA and those who were not (p = 0.01 for both). As a screen for a PDA requiring intervention, deltoid StO2 had sensitivity 77% and specificity 83%, and kidney StO2 had sensitivity 85% and specificity 83%. Following treatment with indomethacin, the low StO2 in the deltoid and kidney increased toward the range seen in patients who did not require treatment of a PDA. Inter- and intra-observer variability ranged from minimal to high. Conclusion: This pilot study of a portable NIRS device shows encouraging efficacy in identifying ELBW infants who were likely to benefit from early echocardiography and subsequent intervention to close a PDA. Further study is warranted.
Role of Ammonia and Nitric Oxide in the Decrease in Plasma Prolactin Levels in Prehepatic Portal Hypertensive Male Rats
Authors: Scorticati Camila , Perazzo Juan C. , Rettori Valeria , McCann Samuel M. , De Laurentiis Andrea
Published: November 2006

Objectives: Since very little is known about neuroendocrine changes that occur in portal-systemic hepatic encephalopathy, we studied plasma prolactin (PRL) levels and the involvement of hyperammonemia, nitric oxide (NO) and dopaminergic and adrenergic systems in the control of this hormone secretion in a male rat model of prehepatic portal hypertension (PH). Methods: We conducted in vivo studies to determine plasma ammonia and PRL levels. Dopamine (DA), dihydroxyphenylacetic acid (DOPAC), epinephrine and norepinephrine content in medial basal hypothalamus (MBH) and anterior pituitary (AP) were measured. In addition, NO synthase (NOS) activity and protein expression were evaluated in APs. In in vitro studies, the APs from intact rats were incubated with different doses of ammonia and PRL secretion was determined. In ex vivo studies, the APs from normal and PH rats were incubated in the presence of ammonia and/or a NOS inhibitor, NG-nitro-L-arginine-methyl ester (L-NAME) and PRL secretion was determined. Results: PH rats had a significant increase in plasma ammonia levels (p < 0.001) and a decrease in plasma PRL levels (p < 0.05). Neither DA nor DOPAC content or DOPAC/DA ratios were modified in both MBH and APs; however, we observed a significant increase in norepinephrine content in both MBH and AP (p < 0.001 and p < 0.05, respectively) and a significant increase in epinephrine in APs (p < 0.001). Moreover, PH produced an increase in NOS activity (p < 0.01) and NOS protein expression (p < 0.0001) in APs. The ammonia (100 µM) significantly reduced PRL secretion from APs in vitro (p < 0.05). The presence of L-NAME, an inhibitor of NOS, abrogated the inhibitory effect of ammonia on PRL secretion from APs from control and PH rats. Conclusions: We found that plasma PRL levels were decreased in PH rats probably due to the high ammonia levels. The central noradrenergic system could also mediate this decrease. Also, the increase in NOS activity and/or content in AP induced NO production that directly inhibited PRL secretion from the AP, without the participation of the dopaminergic system.
Stability of Neurocognitive Impairment in Different Subtypes of Mild Cognitive Impairment
Authors: Loewenstein David A. , Acevedo Amarilis , Agron Joscelyn , Duara Ranjan
Published: November 2006

There has been increasing interest in delineating different cognitive subtypes of mild cognitive impairment (MCI). It remains unclear, however, the extent to which neuropsychological impairment associated with amnestic, nonamnestic, and amnestic+ subtypes of MCI remains stable over time. In this study, 70 persons meeting the criteria for MCI and 38 cognitively normal elderly subjects received a baseline neuropsychological evaluation and were reevaluated 1 year later. Our results indicated that 84.6% of the persons initially classified as amnestic, 75% of those classified as nonamnestic, and 80% of the persons classified as MCI+ evidenced stable or more pronounced neuropsychological impairment across the follow-up period. Less than 7% of the amnestic and amnestic+ cases had nonimpaired neuropsychological profiles at their reevaluation at 12 months, and 16.7% of the nonamnestic cases had nonimpaired neuropsychological test profiles at follow-up. Approximately 87% of the cognitively normal subjects at baseline continued to have unimpaired neuropsychological performance at follow-up. These results indicate that the presence of neuropsychological impairment is relatively stable over a 12-month follow-up period among different cognitive subtypes of MCI, although 15–25% of the cases did not exhibit the specific cognitive deficits that characterized their performance at baseline.
Norepinephrine Transporter Gene (NET) Polymorphism in Patients with Type 2 Diabetes
Authors: Ksiazek Piotr , Buraczynska Kinga , Buraczynska Monika
Published: November 2006

Background: Norepinephrine transporter (NET) is involved in the regulation of norepinephrine (NE) turnover and metabolism. Neuronal NE reuptake may be impaired in individuals with renal disease and/or hypertension due to dysfunction of the NE transporter. A silent G1287A nucleotide substitution in exon 9 of the NET gene was studied in human conditions involving hypertension. We investigated its effect in patients with type 2 diabetes. Methods: The study involved 215 type 2 diabetes patients with nephropathy, 95 patients with diabetes duration ≧10 years, free of nephropathy, and 360 healthy subjects. All individuals were genotyped for the NET-8 gene polymorphism with the PCR-RFLP method. Genotype and allele frequencies were compared between the groups. NE was measured by high-performance liquid chromatography and electrochemical detection. Results: We genotyped 310 patients and 360 controls for the NET gene polymorphism. Genotype distribution in both groups was in accordance with the Hardy-Weinberg equilibrium. There were no significant differences in the frequency of genotypes and alleles between patients and controls (p = 0.43). The frequencies were also similar for patients with nephropathy and those without. After dividing the patient group into hypertensive (n = 208) and normotensive (n = 102) subjects, there was a significant increase in the frequency of the AA genotype in patients with hypertension compared to normotensives (19 vs. 10%, p < 0.05). Conclusion: No association was found between G1287A polymorphism in the NET gene and diabetes. Our results suggest that this polymorphism has a possible role in increased susceptibility to hypertension in patients with type 2 diabetes.
Elevated Soluble ADAM8 in Bronchoalveolar Lavage Fluid in Patients with Eosinophilic Pneumonia
Authors: Matsuno Osamu , Miyazaki Eishi , Nureki Shinichi , Ueno Takuya , Ando Masaru , Ito Kazunobu , Kumamoto Toshihide , Higuchi Yasunori
Published: November 2006

Background: ADAM (a disintegrin and metalloprotease) family members, characterized by a metalloprotease and a disintegrin domain, are membrane-anchored glycoproteins involved in proteolysis and cell adhesion. ADAM8 might have an important role in allergic inflammation. It can cleave a variety of substrates and is a sheddase for VCAM-1 and CD23, the low-affinity IgE receptors. Methods: To evaluate the contribution of ADAM8 to the pathogenesis of eosinophilic pneumonia (EP), we measured the concentrations of soluble ADAM8 (sADAM8) and its substrates, soluble VCAM-1 (sVCAM-1) and soluble CD23 (sCD23), in bronchoalveolar lavage fluid from patients with smoking-induced acute eosinophilic pneumonia (AEP), chronic idiopathic eosinophilic pneumonia (CEP), and drug-induced eosinophilic pneumonia (drug-EP). Results: The sADAM8 and sVCAM-1 concentrations were increased in AEP and CEP. The sCD23 concentration was elevated in AEP. In AEP, but not CEP, the sADAM8 concentration significantly correlated with those of both sVCAM and sCD23. Conclusion: The pathogenesis of AEP, CEP, and drug-EP was distinct with regard to ADAM8. Our results are the first to associate ADAM8 with eosinophilic responses and lung inflammation in humans.
Blood Pressure Recordings within and outside the Clinic and Cardiovascular Events in Chronic Kidney Disease
Authors: Agarwal Rajiv , Andersen Martin J.
Published: November 2006

Background: Blood pressure (BP) measured outside the clinic correlates better with cardiovascular outcomes in patients with essential hypertension. To assess the role of out-of-clinic BP recordings in predicting cardiovascular events in patients with chronic kidney disease (CKD), a prospective cohort study was conducted in 217 veterans with CKD. Methods: BP was measured outside the clinic at home and by 24-hour ambulatory recordings, and in the clinic by ‘routine’ and standardized methods. Patients were followed over a median of 3.4 years to assess the combined end-point of total mortality, myocardial infarction or stroke. Results: Average (±SD) home BP was 147.0 ± 21.4/78.3 ± 11.6 mm Hg, 24-hour ambulatory BP 133.5 ± 16.6/73.1 ± 11.1 mm Hg and in-clinic BPs were 155.2 ± 25.6/84.7 ± 14.2 mm Hg by the standardized method, and 144.5 ± 24.2/75.4 ± 14.7 mm Hg by the ‘routine’ method. A 1 SD increase in systolic BP increased the hazard ratio (HR) of the composite end-point by 1.16 (95% CI 0.89–1.50) for routine BP, 1.57 (95% CI 1.19–2.09) for standardized BP, 1.66 (95% CI 1.27–2.17) for home BP, and 1.42 (95% CI 1.10–1.84) for 24-hour ambulatory BP recording. The HR of the composite end-point was only significant for hypertension defined by 24-hour ambulatory BP monitoring (HR 2.22 (95% CI 1.23–4.01)). Adjusted for the propensity scores, BP measured by the ambulatory technique was not an independent predictor of cardiovascular events. Non-dipping was associated with increased cardiovascular risk, but not when adjusted for other risk factors. Conclusion: Risk factors that differentiate hypertension or non-dipping appear to confer a cardiovascular risk in CKD.
Association of Angiotensin I-Converting Enzyme Gene Insertion/Deletion Polymorphism and IgA Nephropathy: A Meta-Analysis
Authors: Yong Du , Qing Wu Qing , Hua Liang , Kan Jia Jing , Xi Chen Jia , Jin Qin Qiao , Chao Shen Han
Published: November 2006

Background/Aims: The angiotensin I-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism has been extensively examined for the association with immunoglobulin A (IgA) nephropathy (IgAN), however, conflicting results have occurred. We performed a meta-analysis to evaluate the association of ACE I/D polymorphism with IgAN in different ethnic groups. Methods: 11 studies testing the association between ACE I/D polymorphism and IgAN susceptibility, and 9 studies testing the association of ACE I/D with IgAN progression were used in this analysis. The overall odds ratio (OR) was estimated by a fixed or random effect model. Results: The overall OR for the risk of susceptibility and progression of IgAN in Asians for the DD genotype is 2.37 (95% CI 1.04–5.41) and 1.75 (95% CI 1.24–2.56). The overall OR for the D allele in Asians also showed a similar magnitude, though without statistical significance (p = 0.09, p = 0.13, respectively). In Caucasians, both the DD genotype and D allele were associated with IgAN progression (OR 1.90, 1.61, respectively), but not IgAN susceptibility (p = 0.30, p = 0.41, respectively). Conclusion: Our findings support the notion that ACE I/D polymorphism is associated with IgAN. Meanwhile, the role of ACE I/D polymorphism in Asians is different from that of Caucasians.
HGF Protects Rat Mesangial Cells from High-Glucose-Mediated Oxidative Stress
Authors: Li Hui , Jiang Tao , Lin Yifeng , Zhao Zhonghua , Zhang Nong
Published: November 2006

Background: Oxidative stress has been considered to be a common pathogenetic factor of diabetic nephropathy. Recent observations suggested that hepatocyte growth factor (HGF) was an antioxidant growth factor; thus, its renoprotective effects in diabetic nephropathy might be related to antioxidant mechanism. The aim of the present study was to evaluate whether HGF could prevent rat mesangial cells (RMC) from high-glucose-mediated oxidative stress and explore its relevant mechanism. Methods: RMC were cultured in 5.6 mM (NG) or 30 mM (HG) glucose in the absence or presence of HGF (20 ng/ml) and c-met inhibitor SU11274 (5 µM) for 24 h. Results: c-met expression in HG was markedly increased. Enhanced oxidative stress was observed in HG as evidenced by elevated reactive oxygen species and malondialdehyde levels and decreased glutathione level, which was markedly attenuated by HGF. HGF also inhibited HG-induced p22phox and aldose reductase upregulation and prevented HG-reduced glutamate-cysteine ligase catalytic subunit (GCLC) expression through inhibiting USF binding to negative regulatory region of GCLC promoter. Reduced glucose-6-phosphate dehydrogenase activity and expression in RMC by HG was rescued by HGF. Conclusion: HGF could function as an antioxidant factor and protect against HG-mediated oxidative stress by enhancing ROS scavenging and suppressing ROS production.
Plasma Homocysteine and Hematological Factors in Patients with Venous Thromboembolic Diseases in Kuwait
Authors: Marouf Rajaa , Mojiminiyi Olusegun , Qurtom Mohammad , Abdella Nabila , Al Wazzan Hanan , Al Humood Salah , Al Mazeedy Madeeha
Published: November 2006

Background: Venous thromboembolic disease (VTE) is a common cause of morbidity in Kuwait, but the risk factors have not been studied. Hyperhomocysteinemia has been suggested as one of the risk factors. We postulate that hyperhomocysteinemia acts synergistically with hematological variables to increase VTE risk. This study evaluates the roles of hyperhomocysteinemia and hematological variables in patients with VTE. Methods: We measured fasting plasma total homocysteine (tHcy), activated protein C resistance, protein C (PC), protein S (PS) and antithrombin (AT) in 201 patients with VTE and 166 healthy controls. We also measured factor VIII, factor II, lupus anticoagulant, anticardiolipin, serum vitamin B12, folate, creatinine, lipid profile, glucose, full blood count and red cell folate. The glomerular filtration rate (GFR) was calculated from creatinine. Results: When patients on warfarin were excluded, 13.1% of patients (18 out of 137) had a deficiency in PC, 16.8% (23 out of 137) had a deficiency in PS, and when patients on heparin were excluded, 8.3% of patients (14 out of 168) had low AT. Spearman’s rank correlation analysis showed that tHcy had significant correlations with age, creatinine and PS, and significant inverse correlations with GFR, high-density lipoprotein cholesterol and serum folate. Partial correlation analysis after correcting for age and sex showed that tHcy retained a significant correlation with creatinine, GFR and serum folate. Binary logistic regression analyses of the determinants of hyperhomocysteinemia included age, creatinine, GFR and serum folate. Multivariate logistic regression analysis showed significant association of tHcy with VTE (OR = 5.6; p < 0.0001) in the presence of known risk factors for VTE. Conclusion: We conclude that elevated tHcy is a significant risk factor for the development of VTE, and therefore, it should be included in the workup for patients at risk of VTE, but the determinants of tHcy should be kept in mind.
Late Relapses in Acute Promyelocytic Leukaemia
Authors: Latagliata Roberto , Carmosino Ida , Breccia Massimo , Minni Antonio , Testi Anna , Iorio Nicol , Lo-Coco Francesco , Avvisati Giuseppe , Petti Maria Concetta , Mandelli Franco , Cimino Giuseppe
Published: November 2006

From January 1988 to December 1997, among 53 acute promyelocytic leukaemia patients in 1st complete remission (CR) after 5 years from diagnosis, we observed 5 late relapses (9.4%) after 60, 61, 71, 101 and 155 months from diagnosis; 3 of those late relapses (7.7%) occurred among 39 patients previously treated with all-trans-retinoic acid. An involvement of the mastoid occurred in 3/5 patients (60%), compared with 2/32 patients (6.3%) at an early relapse (p < 0.02). As to the treatment of the late relapse, 1 patient received all-trans-retinoic acid alone followed by allogeneic transplantation and 4 patients were treated according to the GIMEMA 0191 protocol. All patients achieved a 2nd CR and are still alive: 4 in the 2nd molecular CR after 6, 33, 34 and 115 months; 1 relapsed after 15 months and is now in the 3rd CR. In conclusion, a late relapse occurred in a sizeable fraction of acute promyelocytic leukaemia patients: the high rate of ear involvement might be explained considering the ear as a ‘disease sanctuary’.
Pilot Remission Induction Therapy with Idarubicin, plus an Intensified Dose of Ara-C and Priming with Granulocyte Colony-Stimulating Factor for Acute Myeloid Leukemia
Authors: Baek Jin Ho , Sohn Sang Kyun , Kim Dong Hwan , Kim Jong Gwang , Yang Deok-Hwan , Kim Yoe-Kyeoung , Lee Je-Jung , Kim Hyeoung-Joon
Published: November 2006

Background: The sensitization of leukemic cells with hematopoietic growth factors can enhance the cytotoxicity of chemotherapy in acute myeloid leukemia (AML). Intensified remission induction (RI) therapy can also improve the treatment results for AML. Therefore, the current trial attempted to evaluate the efficacy and toxicity of granulocyte colony-stimulating factor (G-CSF) priming and a dose intensification of Ara-C in RI chemotherapy for AML. Methods: A total of 29 patients with newly diagnosed AML received G-CSF-priming RI chemotherapy consisting of idarubicin (12 mg/m2, days 1–3), G-CSF (150 µg/m2, days 3–8) and Ara-C (500 mg/m2, b.i.d., days 4–8), and the outcomes were compared with those of a historical group treated with a standard regimen consisting of idarubicin (12 mg/m2, days 1–3) and Ara-C (100 mg/m2, days 1–7). Results: There was no difference in sex, age, subtype and cytogenetic risk between the two groups. The complete remission rate and treatment-related mortality were 72 and 17% for the G-CSF-primed group (p = 0.89) and 71 and 10% for the historical group (p = 0.32), respectively. The time to neutrophil recovery (25 vs. 24 days, p = 0.17) and platelet recovery (24 vs. 23 days, p = 0.23) did not differ significantly between the two groups. Similarly, the duration of fever was not significantly different (5 vs. 7 days, p = 0.58). Thirteen patients (45%) experienced fever and 5 patients (17%) manifested skin rashes during the G-CSF priming. After a median follow-up of 336 days, the 1-year overall survival, disease-free survival and event-free survival rates were 72 vs. 63% (p = 0.83), 74 vs. 56% (p = 0.059) and 53 vs. 38% (p = 0.32), respectively. Conclusion: The sensitization of leukemic cells with growth factors and dose intensification seem to be clinically applicable means to enhance the efficacy of RI chemotherapy only in selected patients with AML, thereby warranting further studies focusing on specific subgroups of AML patients.
Aerodynamic and Sound Intensity Measurements in Tracheoesophageal Voice
Authors: Grolman Wilko , Eerenstein Simone E.J. , Tan Frédérique M.L. , Tange Rinze A. , Schouwenburg Paul F.
Published: November 2006

Background: In laryngectomized patients, tracheoesophageal voice generally provides a better voice quality than esophageal voice. Understanding the aerodynamics of voice production in patients with a voice prosthesis is important for optimizing prosthetic designs and successful voice rehabilitation. Objectives: To measure the aerodynamics and sound intensity in tracheoesophageal voice production. Study Design and Methods: We built a special setup, which consisted of a Pentium 200 MHz computer with an AD-DA interface card and Labview 4.01 software. In an oral/nasal mask we constructed several mass flow sensors and a microphone. This measured both the oral airflow and the level of sound. For the measurement of endotracheal pressure, which is the driving force behind the airflow, we used a transducer which was connected to the tracheostoma. The endoesophageal pressure was measured at the level of the prosthesis in the esophagus by a Mikrotip transducer. Using this we could determine how much the voice prosthesis contributes to the overall pressure drop of the phonatory tract. Furthermore, the average airflow rate as a function of the sound pressure levels could be determined. Results: In our population, 6 out of 7 patients showed a positive relationship between trans-source airflow and generated sound intensity. We compared our prosthesis pressure drop values with in vitro data and found that there are some differences, possibly due to difference in age of the prosthesis and physiological circumstances in vivo. The overall contribution of the voice prosthesis to the airway resistance depends on the level of phonation and the type of device. In our patient group it is apparent that the pharyngoesophageal (PE) segment has the greatest share of the total pressure drop, especially at higher airflow rates. We measured a 27% pressure drop in airflow over the voice prosthesis. Different tracheostoma occlusion methods did not have any effect on the aerodynamics and sound intensity. One patient that had had a jejunal graft for reconstruction showed, not unexpectedly, extremely different aerodynamic values. We were unable to define optimal airflow rates or optimal resistance values for sound production in the PE segment. Conclusion: The aerodynamic characteristics of voice production in laryngectomized patients with voice prostheses are determined by both prosthetic factors and PE segment tissue factors. In our patient group the PE segment is responsible for the greatest pressure drop. We found no significant difference in pressure drop and sound intensity for different tracheostoma occlusion methods.
Efficacy and Safety of the eXcelon Transbronchial Aspiration Needle in Mediastinal Lymph Node Enlargement: A Case-Control Study
Authors: Fernández-Villar Alberto , Leiro Virginia , Blanco Monserrat , Represas Cristina , Botana Maribel , González Ana , Piñeiro Luis
Published: November 2006

Background: Several different types of needles for transbronchial needle aspiration (TBNA) exist in the market. Recently, the eXcelon transbronchial needle (Boston Scientific, Boston, Mass., USA) was commercialized, and to our knowledge, no comparative studies with other types of needles have been performed up to date. Objectives: The aim of the present study was to determine the diagnostic yield and safety of the 21-gauge eXcelon transbronchial needle in the diagnosis of mediastinal lesions and to compare it with a 22-gauge Wang cytology needle (Bard-Wang, Billerica, Mass., USA). Methods: A case-control prospective study was conducted. The study group included 42 TBNA of mediastinal nodes performed in 35 patients with the eXcelon 21-gauge needle from January to June 2005. A control group included 110 TBNA carried out in 99 patients that underwent mediastinal lymph node sampling using a MW-122 needle from June 2002 to December 2004. Results: There was no statistical differentiation in the characteristics of the disease, mediastinal lymph nodes or number of passes between cases and controls. Adequate samples were obtained in 30 (71.4%) cases and 81 (73.6%) controls (p = 0.8). Technical complications occurred in 7 (16.6%) cases and 14 (12.7%) controls (p = 0.7). The only clinical complication was bleeding presented in 2 (4.8%) cases and 3 (2.7%) controls (p = 0.3). Conclusion: The eXcelon 21-gauge transbronchial needle is as effective and safe as the MW-122 needle in the diagnosis of mediastinal lymph node enlargement.
Characterization of Dog Allergens Can f 1 and Can f 2. 2. A Comparison of Can f 1 with Can f 2 Regarding Their Biochemical and Immunological Properties
Authors: Kamata Yoichi , Miyanomae Aki , Nakayama Emiko , Miyanomae Takeshi , Tajima Tomoko , Nishimura Keiichiro , Tada Toshiji , Hoshi Hidenobu
Published: November 2006

Background: The major dog allergens, Can f 1 and Can f 2, are members of the lipocalin protein family. The characterization of both dog allergens is still not complete. Their deduced amino acid sequences indicate the presence of three cysteine residues, probably connected with a disulfide bridge. We compared the biochemical and immunological properties of Can f 1 with those of Can f 2 using gel filtration, electrophoresis, and immunological assays. Methods: The rCan f 1, rCan f 2 and dog salivary proteins containing natural Can f 1 and Can f 2 were analyzed by HPLC gel filtration. The recombinant Can f 1 (rCan f 1) and rCan f 2 were analyzed by native and sodium dodecyl sulfate (SDS) polyacrylamide gel electrophoresis (PAGE) with or without reduction. The binding ability of rabbit IgG purified by protein G affinity chromatography from the antiserum against rCan f 1 and rCan f 2 was examined after a reduction in the recombinant allergens. The immunological cross-reaction between rCan f 1 and rCan f 2 was examined by an enzyme-linked immunosorbent assay (ELISA) using the rabbit IgG against rCan f 1 and rCan f 2. The cross-reaction of human IgE in the serum of a patient with dog allergy between rCan f 1 and rCan f 2 was also analyzed by competitive ELISA. Results: The molecular weights of rCan f 1 and of rCan f 2 were 18 and 21 kDa, respectively, using SDS-PAGE under reducing conditions, but the natural Can f 1 and Can f 2 were separated by HPLC gel filtration into fractions containing proteins of 31 and 34 kDa, respectively. rCan f 1 and rCan f 2 migrated as multiple bands (30–100 kDa) in native PAGE in the presence or absence of a reductant. The molecular weights of natural Can f 1 and of Can f 2 were 20 and 23 kDa, respectively, in SDS-PAGE under reducing conditions. The ability of rabbit IgG to bind to rCan f 1 and rCan f 2 increased after the reduction of the recombinant allergens. The rabbit IgG against rCan f 1 bound to rCan f 2. Cross-reaction of human IgE was observed between rCan f 1 and rCan f 2. Conclusions: In the native and recombinant forms, Can f 1 and Can f 2 possessed a dimer structure under natural (non-reduced) condition. The dimers of Can f 1 and of Can f 2 were not built with a disulfide bridge but by non-covalent association. Cleavage of a disulfide bond of rCan f 1 and rCan f 2 increased the ability of binding of rabbit IgG to the allergens. The cross-reactivity of rabbit IgG and human IgE between rCan f 1 and rCan f 2 indicates that the same epitope(s) was present in Can f 1 and Can f 2.
Human Eosinophils Have an Intact Smad Signaling Pathway Leading to a Major Transforming Growth Factor-β Target Gene Expression
Authors: Kanzaki Mirei , Shibagaki Naotaka , Hatsushika Kyosuke , Mitsui Hiroshi , Inozume Takashi , Okamoto Atsushi , Dobashi Yoh , Ogawa Hideoki , Shimada Shinji , Nakao Atsuhito
Published: November 2006

Background: There is a paradoxical finding that eosinophils are frequently accumulated at the sites of allergic inflammation where transforming growth factor (TGF)-β, a negative regulator of eosinophil survival, is upregulated; however, eosinophil accumulation is persistent. We thus hypothesized that eosinophils might have aberrant TGF-β signaling and be unresponsive to TGF-β. To test the hypothesis, we examined the expression and function of Smad proteins, which are central mediators for TGF-β signaling, in human eosinophils. Methods: Eosinophils were isolated from the peripheral blood of normal donors, and the expression and activation of endogenous Smad proteins were examined by reverse transcription polymerase chain reaction and Western blotting. The Smad function in the transcription of the major TGF-β target gene Smad7 was investigated using a dominant negative form of Smad3. The effect of TGF-β on eosinophil survival was then evaluated by a cell viability assay using normal and asthmatic eosinophils. Results: Human eosinophils expressed mRNAs and proteins of TGF-β typeI and type II receptors, Smad2, Smad3 and Smad4. TGF-β induced the phosphorylation of Smad2 in eosinophils, which was blocked by SB431542, an inhibitor of TGF-β type I receptor kinase. A dominant negative Smad3 protein suppressed TGF-β-induced Smad7 mRNA expression in eosinophils. Finally, TGF-β prevented granulocyte macrophage colony-stimulating factor- or interferon-γ-mediated survival of eosinophils obtained from asthmatic patients as well as normal subjects. Conclusion: Human eosinophils have an intact Smad signaling pathway leading to a major TGF-β target gene expression. Thus, eosinophils might become resistant to TGF-β only in in vivo circumstances.
Treatment and Outcomes in Patients with Asthma and Allergic Rhinitis in the United Kingdom
Authors: Zhang Qiaoyi , Thomas Michael , Wisniewski Tami , Sazonov Kocevar Vasilisa , Price David
Published: November 2006

Background: Since allergic rhinitis in asthma patients is associated with worse asthma control, the treatment of the comorbid condition may improve outcomes. Methods: A 1-year retrospective study using the UK Mediplus® database (2001–2004) included asthmatic patients aged 15–55 with allergic rhinitis. Patients starting therapy based on the Global Initiative for Asthma guidelines, defined as an increase in inhaled corticosteroids (high-dose inhaled corticosteroids, hdICS), or the addition of montelukast (ICS+MON) or long-acting β-agonists (ICS+LABA) to ICS, were studied. Univariable and multiple logistic regressions evaluated asthma-related outcomes. Results: Among 2,596 asthma and allergic rhinitis patients, 83.2% initiated ICS+LABA, 12.1% hdICS and 4.7% ICS+MON. The mean age was 34 years and 60% were female. ICS+MON patients had more moderate-severe asthma (p = 0.04). Approximately 84% of the ICS+LABA patients experienced an asthma control failure compared to 50% in the other groups (p < 0.0001). The proportions of patients requiring treatment change were 73.8, 22 and 27.3% in the ICS+LABA, hdICS and ICS+MON groups, respectively (p = 0.001). Asthma-related resource use was similar among all groups. The ICS+MON group received fewer mean prescriptions for oral corticosteroids (p = 0.024) than the other groups (p = 0.026). Conclusions: In asthma and allergic rhinitis, treatment with ICS+MON or hdICS was associated with lower rates of asthma control failure and fewer treatment changes than the ICS+LABA group. MON users also required fewer oral corticosteroids.
North American Passion Plays: “The Greatest Story Ever Told” in the New Millenium
Authors: Chansky Dorothy
Published: November 2006

North American outdoor passion plays are not marginal theatrical sites; focusing critical attention on these faith-based dramas is particularly urgent in the context of the rise of religiosity in U.S. politics. The amateur evangelical shows offer troubling representations of Jews, racial exclusivity, and implicit assumptions of authenticity; yet, as community theatre endeavors, they hold forth possibilities for innovative iconography.
Dancing Around Orientalism
Authors: Dox Donnalee
Published: November 2006

The performance of belly dancing in the West embodies a central paradox: while invoking Orientalist tropes in its appropriation of Middle Eastern dances, it is cast as a celebratory form of women's empowerment that destabilizes Western patriarchy. Exploring these contradictory claims, the author situates the predicaments of gender and interculturalism that surface in discourses about Western belly dance.
Analysis and Design of Echo State Networks
Authors: Ozturk Mustafa C. , Xu Dongming , Príncipe José C.
Published: November 2006

The design of echo state network (ESN) parameters relies on the selection of the maximum eigenvalue of the linearized system around zero (spectral radius). However, this procedure does not quantify in a systematic manner the performance of the ESN in terms of approximation error. This article presents a functional space approximation framework to better understand the operation of ESNs and proposes an information-theoretic metric, the average entropy of echo states, to assess the richness of the ESN dynamics. Furthermore, it provides an interpretation of the ESN dynamics rooted in system theory as families of coupled linearized systems whose poles move according to the input signal dynamics. With this interpretation, a design methodology for functional approximation is put forward where ESNs are designed with uniform pole distributions covering the frequency spectrum to abide by the richness metric, irrespective of the spectral radius. A single bias parameter at the ESN input, adapted with the modeling error, configures the ESN spectral radius to the input-output joint space. Function approximation examples compare the proposed design methodology versus the conventional design.
Linear Multilayer ICA Generating Hierarchical Edge Detectors
Authors: Matsuda Yoshitatsu , Yamaguchi Kazunori
Published: November 2006

In this letter, a new ICA algorithm, linear multilayer ICA (LMICA), is proposed. There are two phases in each layer of LMICA. One is the mapping phase, where a two-dimensional mapping is formed by moving more highly correlated (nonindependent) signals closer with the stochastic multidimensional scaling network. Another is the local-ICA phase, where each neighbor (namely, highly correlated) pair of signals in the mapping is separated by MaxKurt algorithm. Because in LMICA only a small number of highly correlated pairs have to be separated, it can extract edge detectors efficiently from natural scenes. We conducted numerical experiments and verified that LMICA generates hierarchical edge detectors from large-size natural scenes.