bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimizing the “priming” effect: influence of prior exercise intensity and recovery duration on O2 uptake kinetics and severe-intensity exercise tolerance
Authors: Bailey Stephen J. , Vanhatalo Anni , Wilkerson Daryl P. , DiMenna Fred J. , Jones Andrew M.
Published: October 2009

It has been suggested that a prior bout of high-intensity exercise has the potential to enhance performance during subsequent high-intensity exercise by accelerating the O2 uptake (V̇o2) on-response. However, the optimal combination of prior exercise intensity and subsequent recovery duration required to elicit this effect is presently unclear. Eight male participants, aged 18–24 yr, completed step cycle ergometer exercise tests to 80% of the difference between the preestablished gas exchange threshold and maximal V̇o2 (i.e., 80%Δ) after no prior exercise (control) and after six different combinations of prior exercise intensity and recovery duration: 40%Δ with 3 min (40-3-80), 9 min (40-9-80), and 20 min (40-20-80) of recovery and 70%Δ with 3 min (70-3-80), 9 min (70-9-80), and 20 min (70-20-80) of recovery. Overall V̇o2 kinetics were accelerated relative to control in all conditions except for 40-9-80 and 40-20-80 conditions as a consequence of a reduction in the V̇o2 slow component amplitude; the phase II time constant was not significantly altered with any prior exercise/recovery combination. Exercise tolerance at 80%Δ was improved by 15% and 30% above control in the 70-9-80 and 70-20-80 conditions, respectively, but was impaired by 16% in the 70-3-80 condition. Prior exercise at 40%Δ did not significantly influence exercise tolerance regardless of the recovery duration. These data demonstrate that prior high-intensity exercise (∼70%Δ) can enhance the tolerance to subsequent high-intensity exercise provided that it is coupled with adequate recovery duration (≥9 min). This combination presumably optimizes the balance between preserving the effects of prior exercise on V̇o2 kinetics and providing sufficient time for muscle homeostasis (e.g., muscle phosphocreatine and H+ concentrations) to be restored.
Aging blunts the dynamics of vasodilation in isolated skeletal muscle resistance vessels
Authors: Behnke Bradley J. , Delp Michael D.
Published: October 2009

Aging is associated with an altered ability to match oxygen delivery (Qo2) to consumption (V̇o2) in skeletal muscle and differences in the temporal profile of vasodilation may provide a mechanistic basis for the Qo2-to-V̇o2mismatching during the rest-to-exercise transition. Therefore, we tested the hypothesis that the speed of vasodilation will be blunted in skeletal muscle first-order arterioles from old vs. young rats. Arterioles from the soleus and the red portion of the gastrocnemius (GastRed) muscles were isolated from young (Y, 6 mo; n = 9) and old (O, 24 mo; n = 9) Fischer 344 rats and studied in vitro. Vessels were exposed to acetylcholine (ACh; 10−6M), sodium nitroprusside (SNP; 10−4M), and increased intraluminal flow, and the subsequent vasodilation was recorded at 30 frames/s. The data were fit to a monoexponential model and the dynamics of vasodilation [i.e., time delay, time constant (tau), and rate of change (delta/tau)] were calculated. With old age, the rate of vasodilation was significantly blunted in resistance vessels from the soleus to ACh (Y, 27.9 ± 3.6; O, 8.8 ± 2.6 μm/s) and flow (Y, 12.8 ± 2.1; O, 3.1 ± 0.9 μm/s). In the GastRedthe old age-associated impairment of endothelium-dependent vasodilator dynamics was even greater than that of the soleus. With SNP neither the magnitude nor time constant of vasodilation was affected by age in either muscle. The results indicate that aging impairs the dynamics of vasodilation in resistance vessels from the soleus and GastRedmuscles mediated, in part, through the endothelium. Thus the old age-associated slower rate and magnitude of vasodilation could inhibit the delivery of O2during the critical transition from rest to exercise in moderate to highly oxidative skeletal muscle.
Relationship between Sirt1 expression and mitochondrial proteins during conditions of chronic muscle use and disuse
Authors: Chabi Beatrice , Adhihetty Peter J. , O'Leary Michael F. N. , Menzies Keir J. , Hood David A.
Published: October 2009

Sirt1 is a NAD+-dependent histone deacetylase that interacts with the regulatory protein of mitochondrial biogenesis PGC-1α and is sensitive to metabolic alterations. We assessed whether a strict relationship between the expression of Sirt1, mitochondrial proteins, and PGC-1α existed across tissues possessing a wide range of oxidative capabilities, as well as in skeletal muscle subject to chronic use (voluntary wheel running or electrical stimulation for 7 days, 10 Hz; 3 h/day) or disuse (denervation for up to 21 days) in which organelle biogenesis is altered. PGC-1α levels were not closely associated with the expression of Sirt1, measured using immunoblotting or via enzymatic deacetylase activity. The mitochondrial protein cytochrome c increased by 70–90% in soleus and plantaris muscles of running animals, whereas Sirt1 activity remained unchanged. In chronically stimulated muscle, cytochrome c was increased by 30% compared with nonstimulated muscle, whereas Sirt1 activity was increased modestly by 20–25%. In contrast, in denervated muscle, these markers of mitochondrial content were decreased by 30–50% compared with the control muscle, whereas Sirt1 activity was increased by 75–80%. Our data suggest that Sirt1 and PGC-1α expression are independently regulated and that, although Sirt1 activity may be involved in mitochondrial biogenesis, its expression is not closely correlated to changes in mitochondrial proteins during conditions of chronic muscle use and disuse.
Prevention of Amyloidosis in Familial Mediterranean Fever with Colchicine: A Case-Control Study in Armenia
Authors: Sevoyan Maria K. , Sarkisian Tamara F. , Beglaryan Ara A. , Shahsuvaryan Gohar R. , Armenian Haroutune K.
Published: October 2009

Objective: To determine whether or not the use of colchicine decreases the risk of amyloidosis among Armenian patients with familial Mediterranean fever (FMF). Subjects and Methods: The study included 99 Armenian patients from the Center of Medical Genetics database with genetically ascertained FMF; 33 had renal amyloidosis and 66 were randomly selected control patients without renal amyloidosis. Self- reported colchicine use was assessed by interviewer-based questionnaire. Results: The patients with incident amyloidosis were more likely to be older men, but younger at the time of disease onset, and more likely to have had a family history of amyloidosis and M694F mutation in the MEFV gene compared to patients without amyloidosis. The risk of amyloidosis decreased with adequate colchicine use rather than nonadequate use (adjusted odds ratio, OR, 0.48, 95% confidence interval, CI, 0.16–1.43), continuous colchicine use rather than interrupted use (adjusted OR 0.15, 95% CI 0.04–0.53), earlier rather than later initiation age of colchicine treatment (adjusted OR 0.95, 95% CI 0.90–1.01), current colchicine rather than ever/never colchicine use (adjusted OR 0.20, 95% CI 0.05–0.89). Conclusion: The study demonstrated that colchicine treatment is effective in preventing amyloidosis among Armenian patients with FMF and that earlier initiation and continuous therapy at an adequate dose of 1.2–1.8 mg/day may be associated with a decreased amyloidosis risk among Armenian patients with FMF.
Prevalence of Dental Anxiety in 7- to 11-Year-Old Children and Its Relationship to Dental Caries
Authors: Akbay Oba Aylin , Dülgergil Çoruh Türksel , Şaroğlu Sönmez Işıl
Published: October 2009

Objectives: The aims of this cross-sectional study were to evaluate the level of fear of dental procedures among schoolchildren and assess the relationship between caries experience and fear of dental procedures. Subjects and Methods: 275 children aged 7–11 years were recruited for the study. Before conducting a dental examination, each subject was asked to independently complete a Children’s Fear Survey Schedule – Dental Subscale (CFSS-DS) questionnaire. Children having a score of ≥38 were included in the group ‘with dental fear’ while those scoring <38 were placed in the ‘without dental fear’ group. All dental examinations were performed on the school premises according to WHO criteria. Results: Mean CFSS-DS value was 28.1, and the number of children who experienced dental fear was 40 (14.5%). It was found that Decayed, Missing and Filled Surface Index (DMFS-dfs) increased significantly with increasing CFSS-DS values. Fear scores were highest for ‘Choking’ (3.3), ‘Injections’ (2.6) and ‘Having somebody put instruments in their mouth’ (2.6). No significant differences in fear scores between boys and girls were found in this study. Conclusions: The data showed prevalence of dental fear in the 7–11-year-old children of this study. Dental fear scores decreased with increasing age.
Habitual Snoring in Primary School Children: Prevalence and Association with Sleep-Related Disorders and School Performance
Authors: Sahin Unal , Ozturk Onder , Ozturk Mustafa , Songur Necla , Bircan Ahmet , Akkaya Ahmet
Published: October 2009

Objectives: To determine the prevalence of habitual snoring (HS) and its association with both day- and nighttime symptoms, school performance and behavioral disturbances in a sample of primary school children. Subjects and Methods: A cross-sectional study was performed on 1,605 children (819 boys and 786 girls) aged 7–13 years from 9 randomly selected primary schools located within the city limits of Isparta, Turkey. HS and sleep problems were assessed using a 55-item multiple-choice questionnaire. Results: Of the 1,605 questionnaires, 1,164 were fully completed and returned, giving a response rate of 72.5%. The overall prevalence of snoring was 38.9%, while HS accounted for 3.5%. The prevalence of HS among boys (25, 3.0%) was higher than among girls (16, 2.0%; χ2 for trend: p < 0.001, OR: 1.92, 95% CI: 1.01–3.66). There was an association between younger age and HS, as children aged 7–8 years had the highest prevalence (χ2 for trend: 0.054, OR: 1.85, 95% CI: 0.81–4.22). Habitual snorers had more daytime and nighttime symptoms. Allergic symptoms, daytime mouth breathing, shaking the child for apnea, restless sleep and hyperactivity were significant and independent risk factors and sleep-related symptoms for HS. A significant and independent association was found between poor school performance and hyperactivity, nocturnal enuresis, tooth grinding and low parental/maternal education in multivariate analysis. Conclusion: Children with HS were more likely to have sleep-related daytime and nighttime symptoms. No significant associ- ation was determined between HS and poor school performance.
Intracellular Localization of 99mTc-d,l-HMPAO in Rat Blood
Authors: Al-Saeedi Fatma J. , Gopinath Sati
Published: October 2009

Objective: The objective of this study was to investigate the intracellular localization of technetium 99m-hexamethylpropylene amine oxime (99mTc-d,l-HMPAO) in rat red blood cells (RBCs) and plasma. Materials and Methods: Sprague-Dawley rats (n = 36) were injected with 129.5 MBq 99mTc-d,l-HMPAO. Using a heparinized syringe, 2-ml blood samples were withdrawn from the rats 10, 20, 30, 40, 50 and 60 min after 99mTc-d,l-HMPAO injection. Blood was centrifuged for 10 min at 2,240 rpm to separate RBCs from plasma. A chloroform/methanol/distilled water mixture was added to the RBCs and plasma in separate tubes to extract 99mTc-d,l- HMPAO into aqueous (Aq) and lipid (Lp) phases. The 99mTc-d,l-HMPAO activities in Aq and Lp phases were measured separately using a dose calibrator. The data were analyzed using Student’s t test and a one-way ANOVA. Results: More than 70% of the injected dose of 99mTc-d,l-HMPAO was retained in the RBCs for up to 60 min, compared to less than 20% in plasma. The uptakes in the Aq for plasma were 88.77 ± 1.04, 94.23 ± 2.42, 90.15 ± 1.88, 98.59 ± 0.89, 96.42 ± 1.50 and 97.59 ± 1.92% at 10, 20, 30, 40, 50 and 60 min after injection, respectively. The corresponding uptakes in the Lp phases were: 11.23 ± 0.04, 5.77 ± 0.07, 9.85 ± 0.06, 1.41 ± 0.08, 3.58 ± 0.04 and 2.41 ± 0.06, respectively. Similar values (% ± SE) and trends were obtained in the Aq and Lp phases for RBCs. A highly significant difference between the Aq and Lp phases at each time point studied was observed (p < 0.0001). There was no statistically significant difference between the time points in the Aq phase, but there was a significant difference (p < 0.001) between time points in the Lp phase. Conclusion: This study demonstrated that most of the intracellular localization of 99mTc-d,l-HMPAO was in the Aq phase compared to Lp phase in both RBCs and plasma up to 60 min.
Bone Loss in Ankylosing Spondylitis: Does Syndesmophyte Formation Have an Influence on Bone Density Changes?
Authors: Kaya Arzu , Ozgocmen Salih , Kamanli Ayhan , Ardicoglu Ozge
Published: October 2009

Objective: The aim of this study was to assess bone mineral density (BMD) using dual-energy X-ray absorptiometry (DXA) in a group of patients with ankylosing spondylitis (AS) and the factors which have an impact on bone mass. Also, a subgroup of patients not treated with anti-osteoporotic or disease-modifying anti-rheumatic drugs was followed for 24 months to assess potential influencing factors on BMD changes. Subjects and Methods: Fifty-five patients (42 males, 13 females) with AS were enrolled in the study. Clinical examinations were performed. BMD was measured using DXA at lumbar spine (L2–L4) and proximal femur (femur neck BMD and total femur BMD). Lumbar spine radiographs were scored using the Stoke Ankylosing Spondylitis Spine Score (SASSS). Twenty-one of 55 patients who completed 24 months of follow-up without using the aforementioned medications were reassessed. Results: Active patients (Bath Ankylosing Spondylitis Disease Activity Index >4, n = 22) had significantly lower femur neck and total BMD compared to inactive patients (n = 33), whereas spinal BMD was not different. Follow-up data revealed a 3.4% increase in spinal BMD but 0.9% and 0.25% decreases in femur neck BMD and total femur BMD, respectively. Percent changes in BMD measurements and SASSS scores were not significantly different between active (n = 10) and inactive (n = 11) patients. Conclusion: Significant increase in spinal BMD in parallel with increased SASSS revealed that spinal involvement prominent with new bone formation, sclerosis and syndesmophytes may influence spinal BMD measurements using DXA methods in AS. Proximal femur measurements seem to be less affected from disease-related new bone formation.
49,XXXXY Syndrome with Autoimmune Diabetes and Ocular Manifestations
Authors: Pamuk Baris Onder , Torun Ayse Nur , Kulaksizoglu Mustafa , Algan Cengiz , Ertugrul Derun Taner , Yilmaz Zerrin , Tutuncu Neslihan Bascil , Demirag Nilgun Guvener
Published: October 2009

Objective: We report a rare case of 49,XXXXY syndrome with autoimmune diabetes (requiring insulin therapy), bilateral cataracts and unilateral glaucoma. Clinical Presentation and Intervention: A 25-year-old man with mental retardation presented with multiple skeletal abnormalities, polyuria and polydipsia. He had high glucose concentrations, without ketonuria, and hypergonadotropic hypogonadism. Ophthalmic examination revealed a polar cataract in both eyes and increased intraocular pressure in the left eye. The anti-islet cell antibody test was positive, and anti-glutamic acid decarboxylase autoantibody levels were elevated. Karyotype analysis revealed 49,XXXXY. Intensive insulin therapy and testosterone replacements were started. Conclusion: The autoimmune nature of diabetes that we observed in our patient seems to be predisposed by hypogonadism. Cataract and glaucoma in this case seem to be the result of diabetes, and an association of these ocular manifestations with the syndrome 49,XXXXY seems unlikely.
Concurrent Renal Cell Carcinoma and Central Nervous System Lymphoma in a Patient with Autosomal Dominant Polycystic Kidney Disease
Authors: Chang Ming-Yang , Chen Yu-Ming , Chen Yung-Cheng , Tian Ya-Chung , Fang Ji-Tseng , Yang Chih-Wei
Published: October 2009

Objective: To report an unusual case of synchronous renal cell carcinoma and CNS lymphoma in a patient with autosomal dominant polycystic kidney disease (ADPKD). Case Presentation and Intervention: A 58-year-old woman presented with progressive right hemiparesis of 2 months’ duration. A brain CT scan revealed multiple enhanced lesions in the basal ganglia and the right occipital lobe. CNS lymphoma was confirmed by a stereotactic biopsy. Polycystic kidneys and a right renal mass were found incidentally. It was decided to treat the patient with cranial radiotherapy and chemotherapy first. The patient achieved complete remission of CNS lymphoma after 3 months, but the renal mass remained unchanged. A needle biopsy of the renal mass revealed renal cell carcinoma and unilateral nephrectomy was performed successfully. The patient remained in complete remission at 6-year follow-up. Conclusion: The patient was treated successfully with a combination of chemotherapy, radiotherapy, and unilateral nephrectomy. This report highlights the need for clinicians to remain alert to the possibility of double malignancies while caring for ADPKD patients, especially when multiple unexplained manifestations exist.
The Natural History of Untreated Sarcomatoid Renal Cell Carcinoma: An Autopsy Report
Authors: Nakagawa Tatsuo
Published: October 2009

Objective: To report a case of an autopsy that disclosed an untreated sarcomatoid renal cell carcinoma (RCC) with a 9-year natural history. Clinical Presentation and Intervention: An 86-year-old woman presented with acute cystitis. Ultrasonography revealed an incidental left renal mass measuring 2 × 3 cm. After 8.9 years, multiple liver metastases were detected on ultrasound. After 9.0 years, the tumor had increased by 3.5 cm from the initial size, and multiple lung metastases were also detected. After 9.1 years, the patient developed multiple metastases and died from progressive disease at the age of 95. On autopsy, metastases were found in both lungs, bilateral hilar lymph nodes of the lung, the liver, both adrenal glands and the bone marrow. Conclusion: This case showed a probable slow transition from typical RCC to sarcomatous elements that remained untreated for 9 years before the patient died.
Management and Outcome of Pregnancies with Parvovirus B19 Infection over Seven Years in a Tertiary Fetal Medicine Unit
Authors: Simms R.A. , Liebling R.E. , Patel R.R. , Denbow M.L. , Abdel-Fattah S.A. , Soothill P.W. , Overton T.G.
Published: October 2009

Objectives: To determine rates of fetal anaemia and pregnancy outcome in susceptible pregnant women infected with human parvovirus B19 infection in a tertiary fetal medicine department over a 7-year period. Additional features enabling identification of fetuses that progress to severe anaemia were also investigated. Methods: Forty-seven susceptible, pregnant women with confirmed parvovirus infection referred to a regional fetal medicine unit, over a 7-year period (1999–2006), were identified. Where possible maternal serum AFP measurements were obtained from second-trimester serum screening and the presence or absence of echogenic bowel noted. Results: Of the 47 cases, one was excluded. Of the remaining 46 cases, 34 (74%) showed no signs of fetal anaemia and delivered at term. The remaining 12 (26%) showed signs of fetal anaemia. Eight of the 12 developed hydrops and underwent fetal blood sampling and transfusion (median pretransfusion Hb 3.6 g/dl). Seven of the 8 transfused fetuses were thrombocytopenic with a platelet count <150 × 109/l, with 2 fetuses having platelet counts <50 × 109/l. The median gestation age at transfusion was 22 weeks (range 18–27 weeks). The median number of weeks between seroconversion and transfusion was 6 (range 3–12). The signs of anaemia resolved after one transfusion in 5 of the 8 transfused fetuses and they subsequently delivered at term. There were 2 fetal deaths during or shortly after transfusion and one neonatal death following delivery at 28 weeks gestation due to severe pre-eclampsia, 5 days after successful transfusion. Conclusions: Following parvovirus seroconversion, the incidence of significant fetal anaemia requiring transfusion was 17%. Seroconversion after 21 weeks did not result in severe fetal anaemia. Significant anaemia requiring intervention did not occur 12 weeks after maternal seroconversion. We did not demonstrate a correlation with either maternal serum AFP or the presence of fetal echogenic bowel and the development of severe fetal anaemia. Because of the association between fetal anaemia and severe thrombocytopenia, it may be prudent to have compatible platelets available at the time of fetal blood sampling.
Reference Range of Fetal Renal Volume by Three-Dimensional Ultrasonography Using the Vocal Method
Authors: Darahem Tedesco Giselle , de Silva Bussamra Luiz Cláudio , Araujo Júnior Edward , Schwach Werneck Britto Ingrid , Marcondes Machado Nardozza Luciano , Fernandes Moron Antonio , Aoki Tsutomu
Published: October 2009

Objective: To establish reference values for fetal renal volume by three-dimensional sonography using the VOCAL (Virtual Organ Computer-Aided Analysis) method. Methods: This prospective longitudinal study involved 57 healthy pregnant women who were examined between 24 and 34 weeks of pregnancy. Each fetal kidney was evaluated separately using the VOCAL method with a 30° rotation angle. For each gestational age, the following measures were obtained for the right and left kidneys: mean, standard deviation, minimum and maximum values, and the 5th, 10th, 25th, 50th, 75th and 90th percentiles. Polynomial regression models were constructed to assess the relationship between renal volume and gestational age, adjusted by the determination coefficient (R2). The Wilcoxon test was used to evaluate the concordance between the right and left renal volumes. Bland-Altman graphs were used to assess intra- and inter-observer variability. Results: The right renal volume increased from 4.5 ± 1.3 cm3 at 24 weeks to 12.1 ± 1.5 cm3 at 34 weeks. The left renal volume increased from 4.6 ± 0.8 cm3 at 24 weeks to 11.9 ± 1.1 cm3 at 34 weeks. There was a strong correlation between both the right and left renal volumes and gestational age (R2 = 0.975 and 0.970, respectively). There were no significant differences between the right and left renal volumes. The mean difference between repeated measures by the same examiner was –0.07 cm3 (–0.88 to 0.75) for the right kidney and –0.21 cm3 (–0.95 to 0.75) for the left kidney. The mean difference between repeated measures obtained by two different examiners was –0.07 cm3 (–1.25 to 1.12) for the right kidney and 0 cm3 (–1.53 to 1.53) for the left kidney. Conclusion: Reference values were generated for fetal renal volume assessed by three-dimensional ultrasonography using the VOCAL method.
Monozygotic Dichorionic Twins Heterokaryotypic for Duplication Chromosome 2q13-q23.3
Authors: Leung W.C. , Choi H. , Lau W.L. , Ng L.K. , Lau E.T. , Lo F.M. , Choy K.W. , Lau T.K. , Tang M.H.Y. , Chin R.
Published: October 2009

We present an evaluation of the diagnosis, management and outcome of a pair of heterokaryotypic monozygotic dichorionic twins. The heterokaryotype was an incidental finding from an amniocentesis performed for prenatal diagnosis of β-thalassaemia major in a pair of dichorionic twins. Monozygocity was revealed by QF-PCR showing identical short tandem repeat markers on chromosomes 21, 18, 13, X and Y. The twins were heterokaryotypic for duplication chromosome 2q13-q23.3, as shown by array comparative genomic hybridization. Selective foeticide was performed. This case demonstrates that heterokaryotypic monozygotic dichorionic twins are a genetic possibility that does occur.
Conservative Management of Placenta Previa-Accreta by Prophylactic Uterine Arteries Ligation and Uterine Tamponade
Authors: Ferrazzani Sergio , Guariglia Lorenzo , Triunfo Stefania , Caforio Leonardo , Caruso Alessandro
Published: October 2009

Background: Placenta previa-accreta is associated with severe hemorrhage occurring while separating the placenta during cesarean delivery and hysterectomy is considered the treatment of choice. Conservative management has recently been proposed. Case: A 26-year-old woman had pregnancy complicated by placenta previa with suspected accreta. During elective cesarean section a prophylactic double bilateral ligation of uterine arteries was performed before removal of the placenta; subsequently, the continuous small bleeding from the placental bed was stopped by tamponade with a balloon catheter filled with saline solution. The patient was discharged 5 days later. An ultrasonographic color Doppler follow-up demonstrated a renewed uterine vascularization. Conclusion: Double bilateral ligation of uterine arteries can be used as a prophylactic surgical treatment when a severe bleeding because of placenta previa-accreta is expected, in order to avoid hysterectomy.
Gastroschisis Associated with an Intra-Abdominal Umbilical Vein Varix: A Report of 2 Cases
Authors: Fung Tak Yuen , Chan Lin Wai , Leung Tak Yeung , Lau Tze Kin
Published: October 2009

We describe 2 cases of gastroschisis which were found to be associated with an intra-abdominal umbilical vein varix.
Therapy for Foetal Pericardial Tumours: Survival following in utero Shunting, and Literature Review
Authors: Devlieger R. , Hindryckx A. , Van Mieghem T. , Debeer A. , De Catte L. , Gewillig M. , Gucciardo L. , Deprest J. , Meyns B.
Published: October 2009

We report the first case of foetal pericardial teratoma, treated successfully in utero by pericardio-amniotic shunting, and review the relevant literature. Foetal treatment improves survival in case of hydrops. Foetal pericardio-amniotic shunting could possibly be an alternative to serial pericardiocentesis.
Risk Factors for Central Pontine and Extrapontine Myelinolysis following Orthotopic Liver Transplantation
Authors: Lee Eun Mi , Kang Joong Koo , Yun Sung-Cheol , Kim Ki-Hun , Kim Sang Joon , Hwang Kyu-Sam , Lee Sung-Gyu
Published: October 2009

Background: Central pontine myelinolysis (CPM)/extrapontine myelinolysis (EPM) is one of the most serious neurological complications that can occur after orthotopic liver transplantation (OLT). We analyzed the risk factors for CPM/EPM in OLT patients. Methods: We retrospectively reviewed the records of 1,247 patients who underwent OLT between 1992 and 2005. We compared demographic, clinical and biological parameters of patients with CPM/EPM with those of age-, sex- and operation date-matched patients without CPM/EPM (controls). Results: Of 1,247 patients, 11 (0.88%) were diagnosed with CPM/EPM based on neuroimaging findings. A higher Model for End-Stage Liver Disease-Na score, preoperative hyponatremia and hypocholesterolemia, as well as greater changes in electrolytes, especially sodium, during surgery, were observed in the CPM/EPM group (p < 0.05). Conclusion: CPM/EPM after OLT is more likely to occur in patients with more severe preoperative liver dysfunction and greater changes in electrolyte imbalance, especially sodium, during surgery.
Labor Induction with 25-μg Misoprostol Vaginal Capsules
Authors: Santo Susana , Lourenço Regina , Centeno Mónica , Pargana Luísa , Clode Nuno , Ferreira Helena , da Graça Luís M.
Published: October 2009

Aim: To evaluate the success rate and the safety profile of labor induction with a new misoprostol formulation – vaginal capsules of 25 μg of misoprostol. Methods: Labor induction was performed in 250 singleton term pregnancies; 149 (59.6%) were nulliparous. Vaginal capsules of 25 μg of misoprostol were placed in the posterior vaginal fornix every 6 h. Success rate, contractility and fetal heart rate abnormalities and fetal outcomes were evaluated. Results: The success rate of labor induction was 97.6%. The average number of vaginal administrations was 1.5. The mean interval between induction and active labor was 10 h and 20 min and the average length of labor was 15 h and 35 min. The cesarean section rate was 18.8%. There were 15 cases of tachysystole, 3 cases of hypertonus and 1 case of hyperstimulation syndrome. There were no adverse neonatal outcomes. Conclusions: This study allowed to conclude that labor induction with vaginal capsules of 25 μg of misoprostol is associated with an excellent success rate and safety profile.
Olfactory Dysfunction in Allergic Rhinitis
Authors: Guss Joel , Doghramji Laurel , Reger Christine , Chiu Alexander G.
Published: October 2009

Background: Olfactory dysfunction in patients with allergic rhinitis has long been thought to be secondary to coexisting chronic rhinosinusitis and polyposis with obstruction of airflow over the olfactory epithelium. Recent evidence suggests that the allergic inflammatory infiltrate may itself affect olfaction in the absence of mucosal hypertrophy. Objective: We undertook a study to determine olfactory function in patients with allergic rhinitis in the presence and absence of chronic sinusitis. Methods: Fifty-one subjects with symptoms of rhinitis who presented for allergy testing were administered the University of Pennsylvania Smell Identification Test. In addition each patient underwent computed tomography (CT) scanning of the sinuses. Results: Eighty percent of subjects were allergic. Subjects with allergic rhinitis and no evidence of sinusitis scored on average in the 30th percentile (95% CI 20–40th percentile) on objective olfactory testing compared to age- and gender-specific norms. Half the allergic patients were classified as normosmic, while half had some degree of hyposmia. Conclusions: Our study demonstrates that even in the absence of mucosal disease on CT scan, a significant subset of patients with allergic rhinitis will exhibit hyposmia, mostly to a mild or moderate degree. The pathophysiology and potential treatments for olfactory loss in these patients should be further explored.
Semantic Markers in the Diagnosis of Neurodegenerative Dementias
Authors: Cuetos Fernando , Rodríguez-Ferreiro Javier , Menéndez Manuel
Published: October 2009

Background: The search for early cognitive markers of Alzheimer’s disease (AD) has focused on episodic memory and spatiotemporal orientation. However, recent research suggests that semantic memory is also impaired in the preclinical stages of AD. Methods: Age- and education-matched groups of participants with AD, mild cognitive impairment, and subjective memory complaints and healthy controls were assessed with 16 cognitive tests encompassing attention, orientation, episodic and semantic memory, and language tasks. Results: The battery correctly distinguished AD patients from healthy seniors in 92% of the cases. Three semantic memory-based tasks turned out to be particularly powerful for this purpose. Conclusion: Our results suggest that semantic memory tasks should be included in the battery of tests for the evaluation of cognitively impaired patients.
Case-Control Studies – An Efficient Observational Study Design
Authors: van Stralen Karlijn J. , Dekker Friedo W. , Zoccali Carmine , Jager Kitty J.
Published: October 2009

Case-control studies are an efficient research method for investigating risk factors of a disease. The method involves the comparison of the odds of exposure in a patient group with that of the odds of exposure in a control group. As only a minority of the population is included in the study, less time can be devoted to those who remain free of the disease of interest. The design of a case-control study can be complex due to the selection of the appropriate cases and controls. Cases can be identified in a prospective and retrospective manner from various sources. Controls can be obtained via the patient, random digit dialing or in a hospital and all at different points in the time period of the study. All options have their own advantages and disadvantages. Furthermore, different forms of bias, such as recall bias and selection bias, can occur. When appropriately designed, case-control studies can provide the same information as in a cohort study, in a more rapid and efficient manner.
Elevated Homocysteine Is a Predictor of All-Cause Mortality in a Prospective Cohort of Renal Transplant Recipients
Authors: Connolly Grainne M. , Cunningham Ronan , McNamee Peter T. , Young Ian S. , Maxwell Alexander P.
Published: October 2009

Background: In patients with chronic kidney disease, an elevated homocysteine concentration is associated with an increased incidence of cardiovascular events. Aim: The aim of this study was to investigate the relationship between homocysteine concentration and all-cause mortality during prospective follow-up of a renal transplant cohort. Methods: A total of 378 renal transplant recipients were recruited between June 2000 and December 2002. Homocysteine was measured at baseline and mortality data was collected at a median of 2,441 days after enrolment. Results: In univariate analysis, homocysteine was a significant predictor of mortality (p < 0.001). In multivariate analysis, homocysteine remained a significant independent predictor of mortality following adjustment for traditional cardiovascular risk factors (p = 0.01), vitamin B12 and folate (p < 0.001) and estimated glomerular filtration rate (p = 0.03). Conclusions: In the renal transplant recipients enrolled in this study, homocysteine concentration was a significant predictor of mortality in univariate survival analysis and in multivariate survival analysis following adjustment for traditional cardiovascular risk factors and following adjustment for renal function. Assessing the effect of lowering homocysteine concentration on the survival of patients with a renal transplant is therefore worthy of further study.
High Incidence of Osteoporosis and Fractures in an Aging Post-Polio Population
Authors: Mohammad Ausaf F. , Khan Khalid Ali , Galvin Leo , Hardiman Orla , O’Connell Paul G.
Published: October 2009

Background/Aims: Since the polio epidemic in Ireland in the 1950s, most polio survivors are approaching into the 6th and 7th decade of their lives. There is little data about bone density and risk of fractures in these patients. In 2006, we undertook an audit of post-polio patients attending rheumatology and neurology outpatient clinics in a university teaching hospital. Our aim was to determine the prevalence of osteoporosis (OP), falls and fractures and to evaluate the association of bone density with other potential contributing factors to OP. Methods: Over a 6-month period, 50 post-polio patients attending outpatient clinics completed a questionnaire, and subsequently their medical records were reviewed. Demographic data and details of treatment were extracted. The patients underwent a dual-energy X-ray absorptiometry scanning to quantify bone mineral density. Results: Thirty subjects (60%) were females (26 were postmenopausal). The average age of females was 60 ± 13.4 years and of men 59 ± 16.8 years. Overall, 41 (82%) of the patients had experienced falls in the last 5 years and 32 (64%) in the last 6 months. Nineteen (38%) of the patients had experienced a bone fracture in the last 5 years. Based on the bone mineral density data, 28 (56%) of the patients were diagnosed with OP and 20 (40%) had osteopenia, but only 8 (16%) received anti-resorptive therapy. Of the 19 patients who had a fracture, 14 (74%) had OP and 5 (26%) had osteopenia, of whom only 6 (32%) received anti-resorptive therapy. Eight out of 9 fractures of the neck of femur occurred in the weaker leg. Conclusions: Post-polio patients are a high-risk group for fracture, and thus bone density assessment, review of falls risk and therapeutic intervention should be considered for all patients. Both osteopenia and OP are associated with increased fracture risk.
Plasmids That Insert into the Rhamnose Utilization Locus, rha: A Versatile Tool for Genetic Studies in Sinorhizobium meliloti
Authors: Arango Pinedo Catalina , Gage Daniel J.
Published: October 2009

Described is a suite of plasmids that can be used to deliver DNA into a specific site in the chromosome of Sinorhizobium meliloti with a minimal impact in the physiology of the organism. This allows stable, single-copy, insertions of DNA while maintaining a constant chromosomal context. The plasmids integrate into rhaS, one of a group of genes encoding proteins for rhamnose utilization, enabling a simple screening method for recombinants, while leaving other cellular processes unaffected by the insertion. Construction of plasmids for gfp labeling, mutant complementation, gene expression and protein over-expression studies are outlined. The rha insertion plasmids constitute a flexible and easy to use collection of cloning vectors that can be efficiently delivered by conjugation or transformation, and that could be used in genetic and physiology studies of S. meliloti, and, with minor modifications, in other bacterial species.
Plasmids Derived from Lambdoid Bacteriophages as Models for Studying Replication of Mobile Genetic Elements Responsible for the Production of Shiga Toxins by Pathogenic Escherichia coli Strains
Authors: Nejman Bożena , Łoś Joanna M. , Łoś Marcin , Węgrzyn Grzegorz , Węgrzyn Alicja
Published: October 2009

Background: Genes encoding Shiga toxins in pathogenic Escherichia coli strains (Shiga toxin-producing E. coli, STEC) are located on lambdoid prophages. However, studies on the replication of these phages were not reported to date. Methods: Plasmids derived from Shiga toxin-converting phages were constructed, introduced into wild-type E. coli strain and studied using methods of molecular genetics. Results: The studied replicons behaved similarly to plasmids derived from bacteriophage λ, and DNA sequence analysis revealed their high level of homology to the λ replication region. Nevertheless, contrary to λ and two of six tested plasmids, four tested replicons were able to replicate in the E. colidnaA46 mutant. Specific nucleotide differences, causing amino acid substitutions relative to wild-type λ O and P proteins, appeared to be responsible for this phenotype. Conclusions: We conclude that replicons of phages bearing Shiga toxin genes are functionally similar to that of bacteriophage λ, however, some of them have important differences which influence replication regulation. Furthermore, our results may suggest that there are newly discovered molecular interactions in the DNA replication regulation of λ and lambdoid phages. Hence, plasmids derived from lambdoid phages appear to be convenient models to study the replication of Shiga toxin-converting bacteriophages.
Selective Growth Inhibition of Cancer Cells by L-Methioninase-Containing Fusion Protein Targeted to the Urokinase Receptor
Authors: Palwai Naveen R. , Zang Xiao-Ping , Harrison Roger G. , Benbrook Doris , Pento J.Thomas
Published: October 2009

Background: We have reported the development of a novel fusion protein (FP) consisting of an amino-terminal fragment of urokinase linked to the amino terminus of the enzyme L-methioninase (L-M). The present study compared the effect of this novel FP on the proliferation of human ovarian, skin, breast endometrial and pancreatic cancer cell lines. Methods: The FP, L-M and a mutated FP, with reduced L-M activity, were produced by recombinant methods. The effect of treatment with FP, L-M and mutated FP on the proliferation of the cancer cells was measured in vitro using an MTS assay. Results: The inhibitory effect of the FP was found to be significantly greater than that of L-M alone or the mutated FP. In addition, the FP produced a greater inhibitory effect on an ovarian cancer cell line than on comparable normal, non-cancerous cells. Further, the FP produced a dose-dependent inhibition of the proliferation of pancreatic cancer cell lines. Conclusion: These results suggest that this FP is a potent and selective inhibitor of the proliferation of various cancer cell lines and has potential as a therapeutic agent for the treatment of various methionine-dependent cancers.
Neonatal Handling Reduces Renal Function in Adult Rats
Authors: Donadio Márcio Vinícius Fagundes , Jacobs Silvana , Corezola Kizzy Ludnila , da Silva Melo Denizar Alberto , Dias Henrique Bregolin , Reichel Carlos Luiz , Franci Celso Rodrigues , Jeckel-Neto Emilio Antonio , Lulhier Francisco , Lucion Aldo Bolten , de Oliveira Jarbas Rodrigues , Sanvitto Gilberto Luiz
Published: October 2009

Background/Aims: To evaluate the effects of neonatal handling on hydroelectrolytic balance in adult rats. Methods: The litters were divided into two groups: nonhandled and handled. The procedure consisted of handling the pups for 1 min/day in the first 10 days postnatally. When adults, animals had their body weight verified and were housed in individual metabolic cages. After a 24-hour period, urine samples were collected and the urinary and water intake volumes measured. Blood samples to determine osmolality, aldosterone, corticosterone, angiotensin II, creatinine, urea, sodium and potassium levels were collected. The kidneys were removed for histological assessment. Urinary osmolality, sodium, urea and creatinine were also measured and the creatinine clearance (CC) calculated. Results: No difference between groups was found in the body weight. Handled animals showed a reduction in the total kidney wet weight, water intake, urinary volume, CC, plasma angiotensin II, corticosterone and aldosterone when compared to the nonhandled and an increase in the urinary osmolality and sodium excretion fraction. No differences in serum potassium and no evidence of structural changes were demonstrated by histological analysis. Conclusion: Neonatal handling induced long-lasting effects decreasing renal function without evidence of kidney structural changes.
Urinary Excretion of Endothelin Receptors ETA and ETB in Hypertensive Patients and Normotensive Subjects
Authors: Karram Tony , Khamaisi Mogher , Bishara Bishara , Ramadan Rawi , Nitecki Samy , Ben-Izhak Ofer , Meretyk Shimon , Winaver Joseph , Heyman Samuel N. , Hoffman Aaron , Abassi Zaid
Published: October 2009

Background/Aims: Endothelin (ET)-1 is produced by most renal cell types. Renal tubular and vascular cells express both the ET receptors ETA and ETB. Since significant amounts of ET-1 of renal origin were detected in human urine, urinary ET-1 has been used as an index for the capacity of renal ET-1 production. Here, we determine the existence of additional components of the intrarenal ET system, namely the ETA and ETB receptor subtypes, in the urine of normal and hypertensive subjects. Methods: ETA and ETB receptors were detected in urine samples that were concentrated by TCA precipitation, Speedvac or ProteoSpin™. Results: Analysis of the human urine extracts revealed the existence of approximately 50 and 55 kDa of immunoreactive proteins, corresponding to ETB and ETA, respectively, indicating that intact ETA and ETB are excreted in the urine of healthy subjects and hypertensive patients. Normotensive and hypertensive subjects had statistically comparable ETB excretion normalized to creatinine (0.58 ± 0.16 vs. 0.83 ± 0.17 μg/mg creatinine, respectively; p = 0.304). In contrast, ETA excretion was higher among hypertensive subjects (0.05 ± 0.01 vs. 0.11 ± 0.02 μg/mg creatinine; p = 0.0451). Immunostaining of ETA and ETB in the human urinary system revealed expression of both receptors, principally in tubular cells (mainly in medullary collecting ducts) and in the bladder urothelium, and ETA expression in the peritubular capillaries and arterioles. Urinary ET receptors closely and inversely correlated with indices of urine concentration, suggesting that their shedding is principally affected by urine flow. Conclusion: ET receptors are present in human urine, conceivably originating within the urinary system. Their excretion is principally affected by urinary concentration. It remains to be determined whether urinary ETA/ETB is of physiological/pathophysiological relevance.
A Unified Framework for Detecting Genetic Association with Multiple SNPs in a Candidate Gene or Region: Contrasting Genotype Scores and LD Patterns between Cases and Controls
Authors: Pan Wei
Published: October 2009

It is critical to develop and apply powerful statistical tests for genetic association studies due to typically weak associations with complex human diseases or phenotypes. For population-based case-control studies with unphased multilocus genotype data, most of the existing methods are based on comparing genotype scores, e.g. allele frequencies, between the case and control groups. Another class of approaches are motivated to contrast linkage disequilibrium (LD) patterns between the two groups. It is expected that no single test can be uniformly most powerful across all situations, and different tests may perform better under different scenarios. A recent effort has been devoted to combining the above two classes of approaches, which however has some potential drawbacks. Here we propose a general and simple framework to unify the above two classes of approaches: it is based on the simple idea to incorporate LD measurements, in addition to genotype scores, as covariates in a logistic regression model, from which various tests can be constructed by taking advantage of the nice properties of the score statistics for the logistic model. It also has an advantage in easily accommodating covariates and other study designs. We use simulated data to show that our proposed tests performed well across several scenarios. In particular, in contrast to either of the two classes of the tests that is only powerful in detecting only one, but not both, of the two types of the distributional differences between cases and controls, our proposed tests are sensitive to both.
Allelic Based Gene-Gene Interaction in Case-Control Studies
Authors: Jung Jeesun , Zhao Yiqiang
Published: October 2009

In case-control studies identifying disease susceptibility loci, it has been shown that the interaction caused by multiple single nucleotide polymorphisms (SNPs) within a gene as well as by SNPs at unlinked genes plays an important role in influencing risk of a disease. A novel statistical approach is proposed to detect gene-gene interactions at the allelic level contributing to a disease trait. With a new allelic score inferred from the observed genotypes at two or more unlinked SNPs, we derive a score test from logistic regression and test for association of the allelic scores with a disease trait. Furthermore, F and likelihood ratio tests are derived from Cochran-Armitage regression. By testing for the association, the interaction can be assessed both in cases where the SNP association can be detected and cannot be detected as a main effect in single SNP approach. The analytical power and type I error rates over 6 two-way interaction models are investigated based on the non-centrality parameter approximation of the score test. Simulation studies demonstrate that (1) the power of the score test is asymptotically equivalent to that of the test statistics by the Cochran-Armitage method and (2) the allelic based method provides higher power than two genotypic based methods.