bluuebunny/crossref_metadata_2025 huggingface dataset:
Nitrogen Metabolism in Streptomyces coelicolor: Transcriptional and Post-Translational Regulation
Authors: Reuther Jens , Wohlleben Wolfgang
Published: December 2006

Glutamine synthetases (GS) are key enzymes of nitrogen metabolism. Most bacteria contain only one type of GS enzyme encoded by glnA. Streptomyces coelicolor, the model organism for Gram-positive streptomycetes, however is characterized by two functional GS (glnA, glnII) involved in nitrogen assimilation. In addition, three GS-like genes were identified which do not exhibit GS enzyme activity. The control of nitrogen assimilation and metabolism is mediated by transcriptional and post-translational regulation systems. The OmpR-like regulators GlnR and GlnRII are involved in transcriptional control of important nitrogen metabolism genes (glnA, glnII, amtB, glnK, glnD). Although GlnR and GlnRII share identical binding regions, their physiological impact is different. GSI activity is modulated post-translationally by the adenylyltransferase GlnE in response to the nitrogen concentration whereas no post-translational modifications of GSII are known. The PII/GlnD system also responds to changes in nitrogen conditions. The adenylyltransferase GlnD, which resembles the uridylyltransferase of Enterobacteriaceae, modifies PII under low-nitrogen conditions. Furthermore, PII is processed at its N-terminus in response to an ammonium shock. Apparently the function of the PII protein of S. coelicolor is different from that of the PII proteins of Enterobacteriaceae.
Helicobacter pylori: An Underestimated Factor in Acute Anterior Uveitis and Spondyloarthropathies?
Authors: Otasevic Ljiljana , Zlatanovic Gordana , Stanojevic-Paovic Anka , Miljkovic-Selimovic Biljana , Dinic Marina , Djordjevic-Jocic Jasmina , Stankovic Aleksandra
Published: December 2006

Acute anterior uveitis (AAU) is the most common form of intraocular inflammation, but its aetiology is still unclear. Fifty percent of AAU patients are HLA-B27-positive, and half of these also have spondyloarthropathies (SpA). Numerous serological studies have shown elevated levels of serum antibodies to various Gram-negative bacteria in HLA-B27-positive AAU and SpA patients. Antigenic similarities between these bacteria and host components (HLA-B27) have already been shown. Still, the mechanism underlying these diseases has not been clarified. Among the Gram-negative bacteria, Helicobacter pylori has not been screened in AAU patients. The purpose of our study was to see if this common human pathogen somehow interferes with AAU. In addition Chlamydia trachomatis, Yersinia enterocolitica 03 and 09, Salmonella sp. and Proteus OX19 were also examined. A total of 60 patients consisting of 4 groups (15 patients with AAU, 15 with SpA, 15 with AAU+SpA and 15 healthy control persons) were examined. A high percentage of the serological results of all investigated bacteria was positive: 80% in the AAU, 93.3% in the SpA and 100% in the AAU+SpA group, while it amounted to 66.7% in the control group (p < 0.05). H. pylori showed the highest percentage of positivity in all 3 patient groups (66.7% in the AAU, 73.3% in the SpA and 80% in the AAU+SpA group). In contrast, 26.7% of the controls were anti-H.-pylori-positive, thus showing a statistically significant difference between the patients and the control group (p < 0.05). HLA-B27/B7-CREG positivity was detected in 53.3% of the AAU, 66.7% of the SpA and 93.3% of the AAU+SpA patients and in none of the controls. Our results suggest that H. pylori might be a candidate participating in the development of AAU and SpA. They also support the theory of genetic (HLA-B27) and exogenous factors (Gram-negative bacteria) as probable background of these diseases.
Topical Mitomycin C for the Treatment of Conjunctival Tumor
Authors: Ozcan Altan Atakan , Sizmaz Selcuk , Yagmur Meltem
Published: December 2006

Background: To evaluate the efficacy of topical mitomycin C (MMC) for the treatment of conjunctival tumor in a prospective design. Methods: Nine patients (nine eyes) with conjunctival tumor were studied. The patients received topical MMC 0.04% four times daily by one to six courses. Each course consisted of medication for consecutive 7 days followed by 1 week without medication. Follow-up was conducted on patients for control of disease, and side effects. Results: In 7 patients, the tumor completely disappeared during the mean follow-up period of 24.57 ± 5.94 months (range 18–35 months) with no recurrence. In 1 patient, there was no regression of the tumor, and in 1 patient cessation of the treatment was needed because of an adverse effect of the drug. Conclusion: Topical MMC is effective for the treatment of conjunctival tumor. Longer follow-up and large series are needed to assess the duration of tumor control.
Visual Outcomes and Associated Risk Factors of Cataract Surgeries in Highly Myopic Taiwanese
Authors: Tsai Ching-Yao , Chang Ting-Jia , Kuo Li-Lin , Chou Pesus , Woung Lin-Chung
Published: December 2006

Aims: The purposes of this study are to describe the visual outcome of highly myopic eyes undergoing cataract surgery, to investigate associated risk factors for poor postoperative vision and to assess the postoperative complication frequency among the myopic Taiwanese population. Methods: We conducted a retrospective, noncomparative case series study at the Department of Ophthalmology, Zhongxing Branch, Taipei City Hospital, Taiwan. High myopia was defined as axial length ≧26.0 mm. The main study outcomes were visual acuity for the initial 6-month postoperative period (including visual acuities and improvement of postoperative vision) and postoperative complications (including subsequent cataract formation and postoperative retinal detachment). Results: Fifty-two highly myopic eyes were enrolled between January 2002 and December 2004. The mean follow-up interval was 43.3 ± 20.2 weeks (range 25–103). Thirty-two eyes (61.5%) had good postoperative visual improvement (≧4 lines of Snellen chart). Thirty-seven eyes (71.2%) achieved good postoperative vision (20/40 or better). Fifteen eyes (28.8%) demonstrated poor postoperative vision. Pre-existing maculopathy was an independent risk factor for failure to achieve good postoperative vision [odds ratio (OR): 6.84, 95% confidence interval (CI): 1.12–41.8] and improvement (OR: 16.1, 95% CI: 2.2–119.9). Diabetic history was considered another independent risk factor for poor postoperative vision (OR: 15.6, 95% CI: 0.97–267.6). Six eyes (11.5%) developed subsequent posterior capsular opacification requiring Nd:YAG laser capsulotomy. Two eyes (3.8%) developed retinal detachment during follow-up. Conclusions: Most highly myopic eyes achieved good visual improvement and good postoperative visual acuity after cataract surgery. Pre-existing maculopathy was an independent risk factor of postoperative visual improvement and status. It is crucial to examine retinal status prior to cataract surgery to prevent poor vision improvement, poor postoperative vision or retinal complications.
Collagen Shields as a Drug Delivery System for the Fourth-Generation Fluoroquinolones
Authors: Kleinmann Guy , Larson Scott , Hunter Brian , Stevens Scott , Mamalis Nick , Olson Randall J.
Published: December 2006

Purpose: To evaluate the penetration of commercially available gatifloxacin and moxifloxacin into the anterior chamber of a rabbit eye using collagen shields presoaked in the antibiotics as a drug delivery system. Methods: Collagen shields, presoaked for 10 min in commercially available solutions of gatifloxacin (diluted intravenous Tequin®) or moxifloxacin (VigamoxTM) with the same concentration, were placed on the surface of each of the corneas of 12 rabbits for a total of 24 eyes (12 in each group). Aqueous humor samples were taken 3 and 6 h later. Results:The concentrations of both antibiotics were high after 3 h (3.1 ± 1.3 µg/ml for moxifloxacin and 2.3 ± 0.8 µg/ml for gatifloxacin, p = 0.22). The concentration of gatifloxacin after 6 h was statistically significantly higher than for moxifloxacin (0.76 ± 0.33 µg/ml vs. 0.29 + 0.14 µg/ml, respectively, p = 0.03). Conclusion: Our results suggest that collagen shields can be effective as a drug delivery system for the fourth-generation fluoroquinolones with a longer effect for gatifloxacin.
Case Reports of Three Patients Showing Optic Nerve Head Melanocytoma and Systemic Hypertension
Authors: Kaliaperumal Subashini , Gupta Arvind , Nongrum Benjamin , Rao Vasudev Anand , Srinivasan Renuka
Published: December 2006

Purpose: To report the association of optic disk melanocytoma with systemic hypertension. Cases: Ocular examination of 3 asymptomatic hypertensive patients revealed a pigmented lesion over the optic disk. After clinical examination and radiological evaluation a diagnosis of optic disk melanocytoma was made. One patient had a mild decrease in visual acuity associated with an increase in size of the lesion during the follow-up. Systemic evaluation revealed increased urinary vanillylmandelic acid in all the patients. MRI showed diffuse adrenal hyperplasia while a 131I-MIBG scan showed increased uptake in 1 case. Conclusions: Optic disk melanocytoma is a benign tumor though the lesion may increase in size with the resultant decrease in visual acuity over few years. It may be associated with systemic hypertension secondary to increased levels of catecholamines in the body, which is related to the common neural crest origin of melanocytes, adrenal medullary cells and chromaffin cells.
Incidence of Word Finding Deficits in Normal Aging
Authors: Strauss Hough Monica
Published: December 2006

The incidence and pattern of word finding deficits was investigated in a group of 50 non-neurologically-impaired older adults, ranging in age from 54 to 75. The Test of Adolescent/Adult Word Finding (TAWF; German, 1990) was administered to all individuals. Overall, 28% of the adults exhibited abnormal word finding standard scores on the TAWF. Specifically, 3 word finding profiles were observed: (1) normal psychometric scores and normal word retrieval performance across all subtests; (2) normal psychometric performance with selective impairment on picture naming of nouns, and (3) abnormal word finding standard scores with impaired performance on more than 1 subtest, which included picture naming of nouns as well as category naming. The most frequently occurring error type on picture naming of nouns was productions that were semantically related to the target. The results are discussed relative to the representation of information in semantic memory and its interaction with the lexicon.
Objective Voice Analysis in Dysphonic Patients: New Data Including Nonlinear Measurements
Authors: Yu Ping , Garrel Renaud , Nicollas Richard , Ouaknine Maurice , Giovanni Antoine
Published: December 2006

Objectives/Hypothesis: This report describes a comparative study of objective voice evaluation using a multiparametric protocol including aerodynamic parameters and linear and nonlinear acoustic parameters recorded on an EVA® workstation and perceptual voice analysis by a jury. Study Design: A total of 449 samples were retrospectively selected including 391 patients with pathological voices (308 women and 141 men) and 58 controls with normal voices (38 women and 20 men). A prospective complementary study concerning 43 female patients and 3 controls is presented. Methods: Objective measures included fundamental frequency (Fo), intensity, jitter, signal-to-noise ratio (SNR), Lyapunov coefficient (Lya), oral airflow (OAF), estimated subglottic pressure (ESGP), maximum phonatory time (MPT) and vocal range. A jury of 4 experienced listeners was instructed to classify voice samples (continuous speech) according to the G (overall dysphonia) component of the GRBAS score on a Visual Analogue Scale (VAS) secondarily transformed in a scale ranging from 0 for normal to 3 for severe dysphonia. Results: It was shown that a nonlinear combination of only 7 parameters in women (vocal range, Lya, ESGP, MPT, OAF, SNR, and Fo) and 6 parameters in men (vocal range, Lya, OAF, ESGP, Fo, SNR) allowed classification of 81% voice samples in the same grade as the jury in women and 84% in men. In the prospective study, 80.5% were correctly classified with the same set of objective measurements. Discussion: The relative importance of the different objective parameters in this type of discriminant analysis is dealt with. Special emphasis is placed on Lya.
Decreased Serum Tryptophan Concentration Predicts Poor Prognosis in Malignant Melanoma Patients
Authors: Weinlich Georg , Murr Christian , Richardsen Laura , Winkler Christiana , Fuchs Dietmar
Published: December 2006

Background: Indoleamine (2,3)-dioxygenase (IDO) catalyses the initial, rate-limiting step in the degradation of the essential amino acid tryptophan. Via tryptophan deprivation, IDO activity suppresses T cell proliferation and differentiation and is thought to be a fundamental immune escape mechanism for tumor cells. Objective and Methods: To investigate the potential role of tryptophan degradation as a prognostic marker, serum tryptophan and kynurenine concentrations and the kynurenine-to-tryptophan ratio (kyn/trp) in 87 patients with malignant melanoma were compared to the course of the disease and to concentrations of the immune activation marker neopterin. Results: Compared to 49 healthy volunteers, the melanoma patients presented with lower tryptophan levels due to accelerated degradation. This was especially true for the subgroups of patients with distant metastases (p = 0.01), though not in patients with lymph node metastases or in patients who had not yet progressed. There existed a positive correlation between kyn/trp and neopterin concentrations (rs = 0.587, p <0.001). In patients who died due to dissemination of the tumor, median tryptophan concentrations were significantly decreased (p = 0.006) and kyn/trp (p = 0.03) and neopterin concentrations (p = 0.002) were higher compared to survivors. In addition, lower tryptophan concentrations as well as higher kyn/trp and neopterin concentrations predicted a shorter survival. Conclusion: Decreased serum tryptophan concentrations and elevated serum neopterin levels can be used as predictive markers for the future course in melanoma patients. Moreover, our data support previous speculations that a higher degree of IDO expression could play a crucial role for tumor progression.
Multiple Large Solar Lentigos on the Upper Back as Clinical Markers of Past Severe Sunburn: A Case-Control Study
Authors: Derancourt C. , Bourdon-Lanoy E. , Grob J.-J. , Guillaume J.-C. , Bernard P. , Bastuji-Garin S.
Published: December 2006

Background: Multiple solar lentigos commonly seen on the upper back and shoulders of adults are classically considered as a sign of photodamage, although epidemiological studies are scarce. Aim: To assess whether these lesions are clinical markers of past severe sunburn. Methods: A case-control study in two outpatient dermatology clinics in French university hospitals. Past episodes of moderate and severe sunburn were compared between 145 adult patients with multiple solar lentigos on the upper back and 145 matched controls. Results: In multivariate analysis adjusted for potential confounders, recalled episodes of sunburn during childhood, adolescence and adulthood were independently associated with the presence of multiple solar lentigos (adjusted odds ratios, 95% confidence intervals: 2.3 (1.1–5.2) and 28.1 (10.4–75.6) for moderate and severe sunburn, respectively). Conclusion: Multiple solar lentigos on the upper back and shoulders of adults are potential clinical markers of past severe sunburn which may thus be used to identify a population at higher risk of developing cutaneous malignant melanoma.
Pregnancy and Pregnancy Outcome among Women with Inflammatory Skin Diseases
Authors: Seeger John D. , Lanza Lee L. , West William A. , Fernandez Carlos , Rivero Elena
Published: December 2006

Background/Aims: The effect of inflammatory skin diseases on pregnancy has been incompletely characterized. We sought to estimate the incidence of pregnancy and pregnancy outcomes among women with inflammatory skin diseases. Methods: Cohort study of women with atopic dermatitis (AD), psoriasis, other inflammatory skin diseases, and comparison group, followed for pregnancies and pregnancy outcomes. Results: There were 3,131 pregnancies among 64,773 woman-years (4.8/100) in women with skin diseases, and 2,592 pregnancies among 59,826 woman-years (4.3/100) in the comparison group. The age-standardized incidence of pregnancy was similar to the comparison group [rate ratio (RR) = 1.2, 95% confidence interval (CI) 1.0–1.4 for AD, RR = 1.1, 95% CI 1.0–1.2 for psoriasis, and RR = 1.1, 95% CI 1.0–1.1 for other]. Spontaneous abortion was also similar to the comparison group (RR = 1.2 for AD, 95% CI 1.0–1.4, RR = 1.1, 95% CI 1.0–1.2 for psoriasis, and RR = 1.1, 95% CI 1.0–1.1 for other). Conclusions: Our results suggest little effect of skin disease on incidence or outcome of pregnancy.
Recurrent Erysipelas: 47 Cases
Authors: Leclerc S. , Teixeira A. , Mahé E. , Descamps V. , Crickx B. , Chosidow O.
Published: December 2006

Background:Recurrence is a common complication of erysipelas (cellulitis). Objectives:Todescribe the characteristics of patients with recurrent erysipelas and thereby, identify potential risk factors and evaluate prophylaxis efficacy. Methods:Data were retrospectively recorded from the files of 47 patients admitted to hospital between 1995 and 2003 for erysipelas recurrence. Studied variables included: general condition, regional and local factors, e.g. broken cutaneous barrier. Patient characteristics were used to construct tree-based models according to the classification and regression tree methodology. Results: Our patients suffered a mean of 4.1 recurrences. Cutaneous barrier disruption was observed in 81%, mainly intertrigo (60%). Antibiotic prophylaxis was taken by 68% of the patients for 30.6 months. After 1 and 2 years, 84 and 72% of the patients, respectively, were recurrence-free. Conclusion: Our results showed that erysipelas recurrence has the same risk factors as single episodes and underlines the potential benefit of oral or parenteral antibiotic prophylaxis to prevent recurrences.
The Steroid-Sparing Effect of an Emollient Therapy in Infants with Atopic Dermatitis: A Randomized Controlled Study
Authors: Grimalt Ramon , Mengeaud Valérie , Cambazard Frédéric
Published: December 2006

Background: No study has clearly demonstrated the steroid-sparing effect of emollients in the treatment of atopic dermatitis (AD). Aim: Evaluating the effect of an emollient containing oat extracts on the amount of topical corticosteroids used in infants with moderate to severe AD. Study Design: During 6 weeks, 173 infants under 12 months old treated for inflammatory lesions by moderate- and/or high-potency topical corticosteroids randomly received the emollient or not (control group). Methods: Evaluation of corticosteroid consumption by weighing the tubes, disease severity by the Scoring Atopic Dermatitis Index (SCORAD), and infants’ and parents’ quality of life by Infant’s Dermatitis Quality of Life Index and Dermatitis Family Impact scores at D0, D21 and D42. Results: Compared to the control group, the amount of moderate- and high-potency corticosteroids used in 6 weeks decreased by 7.5% (not significant) and 42% (p < 0.05), respectively, in the emollient group. The SCORAD index, and infants’ and parents’ quality of life significantly improved (p < 0.0001) in both groups. Conclusion: The emollient treatment significantly reduced the high-potency topical corticosteroid consumption in infants with AD.
Anti-SSA/Ro Antibody as a Risk Factor for Fluorouracil-Induced Drug Eruptions Showing Acral Erythema and Discoid-Lupus-Erythematosus-Like Lesions
Authors: Adachi Atsuko , Nagai Hiroshi , Horikawa Tatsuya
Published: December 2006

Background: It is well known that fluorouracil (FU) agents frequently induce discoid-lupus-erythematosus (DLE)-like eruptions and acral erythema in Japan. However, the etiology of these drug eruptions caused by FU agents has not been clarified yet. Objective: To determine if the existence of anti-SSA/Ro antibody may be a risk factor for FU-agent-induced DLE-like eruptions and acral erythema. Patients and Methods: Six patients with FU-agent-induced drug eruptions showing DLE-like lesions and acral erythema were enrolled in this study. The titers of anti-SSA/Ro antibody in the sera and the histopathology of the skin lesions were examined. Results: Biopsy specimens from DLE-like eruptions and all 5 examined acral erythema cases showed lichenoid change of the basal keratinocytes. Direct immunofluorescence studies revealed deposition of immunoglobulins along the basement membrane zone in the lesions of both DLE-like eruptions and acral erythema. Further, all 6 cases had high titers of serum anti-SSA/Ro antibody, which did not decline within 6 months after cessation of the causative drug. Conclusion: We propose that anti-SSA/Ro antibody may be a risk factor for FU-agent-induced drug eruptions showing acral erythema and DLE-like eruptions.
Recurrent Flexural Exanthema (SDRIFE or Baboon Syndrome) after Administration of Two Different Iodinated Radio Contrast Media
Authors: Arnold A.W. , Häusermann P. , Bach S. , Bircher A.J.
Published: December 2006

In 1984, the baboon syndrome was described as a particular form of systemic contact dermatitis that occurred after the administration of a contact allergen in individuals previously sensitized by topical exposure to the same allergen. Its clinical picture presents as an erythema of the buttocks and upper inner thighs resembling the red bottom of baboons. This specific reaction was originally observed with mercury, nickel and ampicillin. Since then over 100 cases have been described, most of them without known prior sensitization to the causative agent. In 2004, our group proposed the acronym SDRIFE specifically for cases associated with systemic drugs; it stands for symmetrical drug-related intertriginous and flexural exanthema, as a distinct reaction pattern related to systemic drugs. Here we describe a case of SDRIFE after administration of the iodinated radio contrast medium (RCM) iomeprol (Iomeron®), accidentally reproduced by the RCM iopromide (Ultravist®). Positive delayed skin tests with both drugs were observed indicating that the pathomechanism of SDRIFE is likely a cell-mediated type IV allergy. Oral potassium iodide and a skin-test-negative RCM were administered and both tolerated, indicating that the antigen is related to the molecules and not to iodine itself. Therefore, in our case skin tests had a good positive and negative predictive value.
Leg Muscles Differ in Spatial Activation Patterns with Differing Levels of Voluntary Plantarflexion Activity in Humans
Authors: Giordano S.B. , Segal R.L.
Published: December 2006

Background/Aims: The purpose of this study was to investigate the differential activity between and within individual muscles commonly grouped as plantarflexors. Much of the previous information gathered on plantarflexor activity has been attained using electromyographic recordings. In this study, we used magnetic resonance imaging which allowed us to look at spatial differences in activation. Methods: Twenty-two human subjects exercised under four different conditions – combinations of loads of 25 or 65% of maximum voluntary contraction (MVC) and the direction of plantarflexion at a sagittal and off-sagittal angle. Before and after each exercise condition, T2-weighted magnetic resonance images were collected. Regions of interest were drawn around the lateral gastrocnemius (LG), medial gastrocnemius (MG), soleus (SOL), peroneus longus (PER) and tibialis anterior (TA) muscles and analyzed for differences. Results: Significant increases in T2 relaxation times during 25% MVC conditions were found for PER and, during the 65% MVC, for all four muscles considered plantarflexors (LG, MG, SOL, PER). No significant differences were found between sagittal and off-sagittal conditions. Within LG and MG, greater increases in T2 times with exercise were found in proximal regions compared with distal regions. Conclusion: These results are consistent with suggestions that individual members of muscle groups are capable of differential activity and that for at least some muscles, such differential activity may exist within subvolumes of individual muscles.
Is Vowel Normalization Independent of Lexical Processing?
Authors: Mitterer Holger
Published: December 2006

Vowel normalization in speech perception was investigated in three experiments.The range of the second formant in a carrier phrase was manipulated and thisaffected the perception of a target vowel in a compensatory fashion: A low F2 rangein the carrier phrase made it more likely that the target vowel was perceived as afront vowel, that is, with a high F2. Recent experiments indicated that this effectmight be moderated by the lexical status of the constituents of the carrier phrase.Manipulation of the lexical status in the present experiments, however, did notaffect vowel normalization. In contrast, the range of vowels in the carrier phrase didinfluence vowel normalization. If the carrier phrase consisted of mid-to-high frontvowels only, vowel categories shifted only for mid-to-high front vowels. It is arguedthat these results are a challenge for episodic models of word recognition.
Primary Spinal Primitive Neuroectodermal Tumor: Case Series and Review of the Literature
Authors: Kumar Raj , Reddy S.J. , Wani A.A. , Pal L.
Published: December 2006

Primary spinal primitive neuroectodermal tumor (PSPNET) is extremely rare and only 25 cases have been reported in the world literature so far. Three patients of 8, 9 and 18 years of age, who presented with variable grades of neurological deficit were diagnosed as having a dorsal intramedullary lesion, a holocord lesion and cervical extradural tumor with extraspinal extension, respectively, and were operated at our institute. The histopathology of all 3 children revealed PNET. The clinical course, image characteristics and outcome of the 3 children are described, and the relevant literature is reviewed. The following conclusions were drawn from the present study and review of the literature. PNET may manifest itself as a primary lesion of the spine unlike the more common drop metastases from an intracranial lesion. PSPNET may be intramedullary, intradural and extradural with variable extraspinal extension. PSPNET may present as holocord intramedullary lesion, an entity which has not been described earlier. These lesions have a short history, significant neurological deficits and rapid course of illness. PSPNET, though an established entity, did not find a place in the WHO 2000 classification of CNS tumors. Hence its status has to be defined.
Chronic Subdural Hematoma of the Neonate: Report of Two Cases and Literature Review
Authors: Powers Ciaran J. , Fuchs Herbert E. , George Timothy M.
Published: December 2006

We report the cases of 2 infants who were born with macrocephaly and bulging fontanelles and were subsequently found to have chronic subdural hematomas on imaging studies. The etiology of 1 infant was likely due to an inherent coagulopathy, while no etiology could be found for the other. The subdural hematomas were managed by craniotomy in 1 infant and serial subdural taps in the other. There are currently only 8 other case reports of chronic subdural hematoma of the neonate in the literature. Our cases and a brief review of the literature are presented.
Radiation-Induced Meningioma following Prophylactic Radiotherapy for Acute Lymphoblastic Leukemia in Childhood
Authors: Kawahara Ichiro , Masui Kenta , Horie Nobutaka , Matsuo Takayuki , Kitagawa Naoki , Tsutsumi Keisuke , Nagata Izumi , Morikawa Minoru , Hayashi Tomayoshi
Published: December 2006

Background: Acute lymphoblastic leukemia (ALL) is the most common childhood malignancy. Although it was considered to be a poor prognostic disease, modern treatment protocols (aggressive chemotherapy and prophylactic cranial irradiation) have resulted in dramatically improved survival rates. In a group of low-risk ALL patients, the 5-year survival rate is estimated to be 85%. However, ALL patients who undergo this treatment are at risk of developing secondary neoplasms related to treatment, which has become an increasingly recognized problem. Case Description: A 3-year-old boy with ALL was successfully treated with chemotherapy (vincristine, prednisolone, mercaptopurine and methotrexate) and prophylactic cranial irradiation (total 18 Gy). At the age of 23, he was admitted to our hospital for weakness in the right leg. Computed tomography and magnetic resonance imaging revealed a parasagittal tumor of the left frontoparietal lobe with perifocal edema. The tumor was completely removed surgically and pathohistologically diagnosed as atypical meningioma. Conclusion: Long-term survivors who received radiotherapy for ALL in childhood are at risk for late complications, including radiation-induced meningioma. Therefore, careful follow-up neurological examinations, for example magnetic resonance imaging, are indicated in these patients. In addition, late complications should be taken into account during the initial planning of prophylactic radiotheraphy dosage, which has implications for informed consent of the patient.
Moyamoya Disease Associated with Midaortic Syndrome
Authors: Korematsu Kojiro , Yoshioka Susumu , Maruyama Takashi , Nagai Yasuyuki , Inoue Kazuhiko , Yukaya Naoko , Baba Haruhisa , Kuratsu Jun-ichi
Published: December 2006

We report a 1-year-old girl who presented moyamoya disease associated with midaortic syndrome. She had been treated for cardiac failure and severe hypertension due to midaortic syndrome until she suffered seizure and repeated cerebral ischemic attack. Cerebral angiography revealed stenosis of the bilateral internal carotid artery at its terminal portion. She was successfully treated with encephaloduroarteriosynangiosis, and ischemic attack ceased postoperatively. This is the first report of moyamoya disease with midaortic syndrome. Although cerebral ischemic attack has been effectively managed by encephaloduroarteriosynangiosis, renovascular hypertension is still difficult to control.
Prognostic Value of Hyperintense Vessel Signals on Fluid-Attenuated Inversion Recovery Sequences in Acute Cerebral Ischemia
Authors: Girot Marie , Gauvrit Jean-Yves , Cordonnier Charlotte , Pruvo Jean-Pierre , Verdelho Ana , Leys Didier , Leclerc Xavier
Published: December 2006

Background: Fluid-attenuated inversion recovery (FLAIR) sequences may reveal hyperintense vessel signals (HVS) at the acute stage of cerebral ischemia. The aim of this study was to test the hypothesis that HVS are associated with a worse outcome. Methods: We included 30 consecutive patients admitted within 12 h after onset of hemispheric cerebral ischemia. The outcome was assessed with the modified Rankin Scale at month 1. Results: Proximal HVS were present in 9 patients and distal HVS in 16. All patients with proximal occlusions on time-of-flight sequences had distal HVS on FLAIR. Patients with poor outcome at month 1 (modified Rankin Scale 3–6) more frequently had had HVS on MRI (12/13 vs. 4/17; p< 0.001). Conclusion: Distal HVS found on FLAIR sequences within 12 h of acute cerebral ischemia are associated with a worse 1-month outcome.
A New Subtype Classification of Ischemic Stroke Based on Treatment and Etiologic Mechanism
Authors: Han Sang Won , Kim Seo Hyun , Lee Jong Yun , Chu Chong Kyu , Yang Jae Hoon , Shin Ha Young , Nam Hyo Suk , Lee Byung In , Heo Ji Hoe
Published: December 2006

A new subtype classification of ischemic stroke was developed to reflect recent therapeutic strategies as well as evolving concepts of stroke definitions and mechanisms. In 200 consecutive patients with acute ischemic stroke, the inter-rater reliability and proportion of subtypes of the new classification system were assessed and compared with those of the Trial of ORG 10172 in the Acute Stroke Treatment (TOAST) classification. The most frequent subtype of the new classification was atherothrombosis (n = 80, 40%), followed by stroke of undetermined etiology (n = 54, 27%), small artery disease (n = 33, 16.5%), cardioembolism (n = 26, 13%), and stroke of other determined etiology (n = 7, 3.5%). Three raters agreed to the stroke subtype diagnosis in 165 out of 200 cases and the overall ĸ value was excellent (ĸ = 0.82). The new classification system for brain infarction was easy to use and had high inter-rater reliability.
Burton’s Line in Lead Poisoning
Authors: Pearce J.M.S.
Published: December 2006

Lead poisoning in both its acute and chronic forms has been recognised since the second century BCE. Lead colic, anaemia, renal tubulopathies and motor neuropathies are well recognised. This paper sketches the early history and remembers the important contribution of Henry Burton, who described the gums to be bordered by a narrow leaden-blue line, about the one-twentieth part of an inch in width, whilst the substance of the gum apparently retained its ordinary colour and condition. The sign though inconstant, is still a valuable clinical clue.
Synaesthesia
Authors: Pearce J.M.S.
Published: December 2006

Synaesthesia is the intriguing, involuntary experience of feeling one sensation in response to a different sensory stimulus. Recognised since described in 1890 by John Locke and clarified by Galton in the 1880s, it has been analysed in the last 50 years. Grapheme-colour synaesthesia is the commonest form, but many other sensory linkages are reported. Experiments show that it is a genuine immediate perception, not merely a memory or learned association. Many of the mechanisms posited are based on indirect methods, and we know little of the neurophysiological mechanisms.
Protective Effects of Sodium Daidzein Sulfonate on Trabecular Bone in Ovariectomized Rats
Authors: Ren Ping , Ji Hui , Shao Qing , Chen Xiuying , Han Jingchao , Sun Yi
Published: December 2006

The ovariectomized (OVX) rat, as an established animal model of human osteoporosis, was adopted in the present experiment to study the protective effects of sodium daidzein sulfonate (SDS) on trabecular bone. Six-month-oldSprague-Dawley rats were sham-operated or ovariectomized. Five days later, the OVX rats were randomly assigned to one of three experimental groups and treated for 90 days with vehicle, 17β-estradiol (E2) or SDS. Compared with OVX rats, SDS administration (15 mg/kg) prevented OVX-induced decrease in lumbar vertebral and femoral bone mineral density (BMD), and significantly increased bone mechanical strength parameters, including ultimate stress and elastic modulus. In the OVX group, the structure of trabecular plate in the femoral head was absorbed and became progressively thinner or was removed completely, accompanied by enlargement of marrow cavities and amalgamation of two or more marrow cavities. Administration of SDS and E2 prevented the change of trabecular bone microarchitecture induced by OVX, increasing the trabecular bone area and trabecular thickness, while decreasing the trabecular separation. These results indicate that SDS administration prevents OVX-induced decrease in BMD and bone mechanical strength, and has a moderate protective effect on the microarchitecture of trabecular bone in aged Sprague-Dawley rats.
Comparison of Recurrence Rates after Anterior Colporrhaphy for Cystocele Using Three Different Surgical Techniques
Authors: Chen Chi-Hau , Wu Wen-Yih , Sheu Bor-Ching , Chow Song-Nan , Lin Ho-Hsiung
Published: December 2006

Aims: To compare the recurrence rates after anterior colporrhaphy for cystocele using three different surgical techniques: standard plicating, purse-string, and rolling anterior colporrhaphy. Methods: A retrospective chart review of women undergoing anterior colporrhaphy for cystocele with or without concomitant operations between 1988 and 2000 was conducted. Women were assessed by vaginal examination pre- and postoperatively at 6 weeks and over 2 years. Grades of cystocele were assessed by Baden-Walker halfway grading system. χ2 tests and ANOVAs were performed for categorical and continuous variables, respectively. Cox regressions were used to calculate recurrent rates. Results: Among the studied 363 women, 296, 33, and 34 underwent standard plicating, purse-string and rolling techniques, respectively. There was no significant difference in age, parity, menopausal status, or mean length of follow-up among the three groups. The purse-string group revealed a significantly higher risk of recurrence than the standard plicating group (hazard ratio: 2.67; 95% CI: 1.05–6.08). The severity of cystocele was another key role of determining the prognosis for recurrences (grades 3 & 4 relative to grade 1, hazard ratio: 3.35; 95% CI: 1.34–8.38). Conclusion: Our study showed that standard plicating and rolling technique provided similar anatomic cure rates. However, the purse-string technique was less effective in restoring vaginal anatomy than standard plicating anterior colporrhaphy.
In vitro Pharmacological Characterization of Mitemcinal (GM-611), the First Acid-Resistant Non-Peptide Motilin Receptor Agonist, in Smooth Muscle of Rabbit Small Intestine
Authors: Takanashi Hisanori , Yogo Kenji , Ozaki Ken-ichi , Koga Hiroshi , Itoh Zen , Ōmura Satoshi
Published: December 2006

The pharmacological properties of mitemcinal (GM-611), the first acid-resistant non-peptide motilin agonist, were investigated in the smooth muscle of the rabbit small intestine and compared with porcine motilin (pMTL), erythromycin A (EMA) and its derivatives (EM-523, EM-574 and ABT-229). Mitemcinal, pMTL, EMA, EM-523, EM-574 and ABT-229 produced concentration-dependent contractions with approximately the same maximum contractions in the isolated rabbit duodenum longitudinal strips. The contractile response to mitemcinal or pMTL was competitively inhibited by a selective motilin antagonist, GM-109. The pA2 values for GM-109 as an antagonist of mitemcinal and pMTL showed approximately the same values. However, the concentration-dependent contractile responses to mitemcinal or pMTL were not affected by pretreatment with atropine, tetrodotoxin, hexamethonium, naloxone or tropisetron. The removal of calcium ions from the medium and pretreatment with verapamil greatly suppressed the contractions induced by mitemcinal and pMTL. The contractile response to mitemcinal was not affected by preincubation in acidic solutions, while those of EM-523, EM-574 and ABT-229 were strongly diminished in the same condition. Mitemcinal as well as other motilin agonists displaced 125I-pMTL bound to a homogenate of the rabbit duodenum muscle tissue. The displacement curves of all these compounds were parallel. These results indicate that mitemcinal is a selective and full motilin receptor agonist in the smooth muscle of the rabbit small intestine and that this agent has an excellent acid-resistant property.
Inhibitory Effect of Quercetin on Tryptase and MCP-1 Chemokine Release, and Histidine Decarboxylase mRNA Transcription by Human Mast Cell-1 Cell Line
Authors: Castellani Maria Luisa , Kempuraj Duraisamy , Frydas Stavros , Theoharides Theoharis C. , Simeonidou Isaia , Conti Pio , Vecchiet Jacopo
Published: December 2006

Mast cells are important in reactions of allergic disease and are also involved in a variety of neuroinflammatory diseases. Mast cells can be immunologically activated by IgE through their Fc receptors, as well as by neuropeptides and cytokines to secrete mediators. Here we used a human mast cell-1 (HMC-1) cell line cultured and treated with a physiological activator, anti-IgE, and a nonphysiological activator, calcium ionophore A23187, for tryptase and MCP-1 generation and transcription of histidine decarboxylase. We used quercetin, a potent antioxidant, cytoprotective and anti-inflammatory compound capable of inhibiting histamine and some cytokines released from several cell types, as an inhibitor of immunological and nonimmunological stimulus for mast cells. In this study quercetin inhibits, in a dose-response manner, tryptase and MCP-1. Moreover, using RT-PCR quercetin inhibited the transcription of histidine decarboxylase, the rate-limiting enzyme responsible for the generation of histamine from histidine, and MCP-1. Our data suggest that quercetin is an important and good candidate for reducing the release of pro-inflammatory mast cell mediators activated by physiological and nonphysiological stimulators.
Does Renal Function Influence Plasma Levels of Advanced Glycation and Oxidation Protein Products in Patients with Chronic Rheumatic Diseases Complicated by Secondary Amyloidosis?
Authors: Ryšavá Romana , Kalousová Marta , Zima Tomáš , Dostál Ctibor , Merta Miroslav , Tesař Vladimír
Published: December 2006

Background: The aim of the study was to assess the contribution of carbonyl and oxidative stresses to the development of amyloidosis in patients suffering from chronic rheumatic diseases, and the potential influence of renal function to their concentrations was considered. Methods: We investigated 17 patients with chronic rheumatological diseases and histologically proven diagnosis of AA amyloidosis (group AA-RA), 26 patients suffering from rheumatoid arthritis without any signs of AA amyloidosis (group nonAA-RA) and 20 healthy volunteers (Co). In all patients, advanced glycation end products (AGEs), advanced oxidation protein products (AOPP), pregnancy-associated plasma protein A (PAPP-A) and other selected proinflammatory markers were measured. Results: An increase in serum levels of AOPP and AGEs was found in the AA-RA group in comparison with nonAA-RA patients and also with Co (p < 0.001 for all comparisons). AGEs positively correlated with serum creatinine (r = 0.67, p = 0.004) and negatively with glomerular filtration rate (r = –0.54, p = 0.027). We did not find a correlation between AOPP and any other assessed parameters including proteins and renal parameters. PAPP-A levels were not significantly increased in any group of patients (AA-RA, nonAA-RA) in comparison with Co. Conclusions: Increased plasma levels of AGEs and AOPP in the group of patients with AA-RA may have been partly explained by the diminished renal clearance. However, the increase in AOPP levels was higher than what is expected in this degree of renal failure (glomerular filtration rate in the AA-RA group corresponding to chronic kidney disease stage III).
Lupin (Lupinus albus) Protein Isolate (L-ISO) Has Adequate Nutritional Value and Reduces Large Intestinal Weight in Rats after Restricted and ad libitum Feeding
Authors: Caligari Silvia , Chiesa Giulia , Johnson Stuart K. , Camisassi Davide , Gilio Donatella , Marchesi Marta , Parolini Cinzia , Rubio Luis A. , Sirtori Cesare R.
Published: December 2006

Background: A protein isolate from white lupin (Lupinus albus; L-ISO) has potential as a novel human food ingredient, but its nutritional effects are unknown. Methods: We evaluated protein quality and effects on body composition in rats of isoenergic diets of L-ISO, lactalbumin, or casein with both restricted (10-day) and ad libitum (28-day)intake. The diets were equivalent in protein per se, but supplementation was used to balance essential amino acid levels. Results: In both studies, the rats consumed similar amounts of each diet, and no effect of diet on the gain:feed ratio was observed – though gain:N ratio and net protein utilization were slightly lower for the L-ISO diet. Lower large intestinal weights after the L-ISO than after the lactalbumin diet were observed in both studies. The L-ISO diet resulted in lowered body fat percentage in the 10-day study but in an elevated level in the 28-day study. Liver composition (DNA, RNA, glycogen, and fat) and plasma levels of some amino acids (His, Thr, Ala, Pro, Tyr, Val and Met) were affected by diet, but no effects on plasma lipid, glucose, or uric acid were observed. Conclusion: The L-ISO diet did not affect feed intake and has adequate nutritional quality in rats whilst modifying large intestinal weight in a potentially beneficial manner – suggesting potential for this protein in human nutrition.
Creatinine Clearance but Not Serum Creatinine Alone Predicts Long-Term Postoperative Survival after Lower Extremity Revascularization
Authors: Maithel Shishir K. , Pomposelli Frank B. , Williams Mark , Sheahan Malachi G. , Scovell Sherry D. , Campbell David R. , LoGerfo Frank W. , Hamdan Allen D.
Published: December 2006

Background: Renal insufficiency is a well-described risk factor for perioperative morbidity and shortened survival after major vascular procedures. Due to the potential inaccuracy of serum creatinine levels alone in measuring kidney function, our aim was to determine whether estimated creatinine clearance more consistently predicted long-term survival. Methods: A retrospective review of one institution’s vascular registry was performed. Logistic regression analysis was conducted to determine independent predictors of 1-, 2- and 3-year postoperative mortality. Creatinine clearance was estimated as [140 – age (years)] × weight (kg)/72 × serum creatinine (mg/dl), multiplied by 0.85 for women. Results: A total of 252 consecutive patients underwent infrainguinal bypass procedures between August 1999 and May 2000. Demographics included average age 68 years, 65% male, 74% diabetic, 12% dialysis-dependent, 23% history of congestive heart failure, 12% history of stroke and 20% serum creatinine >2 mg/dl. One-year mortality was 16% (n = 40), 2-year mortality was 25% (n = 64), and 3-year mortality was 35% (n = 88). There was no difference in serum creatinine values between survivors and non-survivors at 1 year (1.8 vs. 1.9, p = 0.80), 2 years (1.8 vs. 2.0, p = 0.62) or 3 years (1.8 vs. 2.0, p = 0.24), and creatinine >2 mg/dl did not predict long-term adverse outcomes. In contrast, reduced creatinine clearance (≤60 ml/min) was an independent predictor of mortality regardless of dialysis status (1 year: OR = 2.53, p = 0.014; 2 years: OR = 2.46, p = 0.004; 3 years: OR = 2.45, p = 0.001), and creatinine clearance was higher for survivors versus non-survivors at all 3 time points (1 year: 70.2 vs. 49.5, p = 0.003; 2 years: 72.3 vs. 51.2, p < 0.0001; 3 years: 74.7 vs. 52.6, p < 0.0001). Other independent predictors of mortality included a history of stroke (1 year: OR = 3.28, p = 0.008; 2 years: OR = 2.55, p = 0.025; 3 years: OR = 2.35, p = 0.038) and congestive heart failure (1 year: OR = 2.86, p = 0.006; 2 years: OR = 2.54, p = 0.005; 3 years: OR = 2.13, p = 0.017). Conclusions: Independent of dialysis status, a decreased creatinine clearance, but not elevated serum creatinine alone, is an independent predictor of mortality after lower extremity arterial reconstruction. Determination of creatinine clearance should replace serum creatinine in the preoperative risk evaluations of patients undergoing major vascular surgical procedures.