bluuebunny/crossref_metadata_2025 huggingface dataset:
Symptom-Triggered versus Standard Chlormethiazole Treatment of Inpatient Alcohol Withdrawal: Clinical Implications from a Chart Analysis
Authors: Lange-Asschenfeldt Christian , Müller Matthias J. , Szegedi Armin , Anghelescu Ion , Klawe Christoph , Wetzel Hermann
Published: April 2003

To evaluate clinical effectiveness and safety of 2 different detoxification treatment protocols, a chart analysis of hospital inpatients consecutively admitted for alcohol withdrawal during one year was undertaken. Records of 33 patients receiving symptom-triggered treatment (using a modified version of the revised Clinical Institute Withdrawal Assessment for Alcohol Scale) were compared with those of patients treated by applying a fixed-dose regimen (n = 32). Patients (45.3 ± 9.8 years, 21% female) of both groups were comparable regarding illness severity, epidemiologic parameters as well as complications during the observed treatment period. Under symptom-triggered therapy, chlormethiazole (CMZ) treatment duration (4.2 ± 3.5 vs. 7.5 ± 3.3 days, Mann-Whitney U test: p = 0.0003) and cumulative CMZ dosage (4,352 ± 4,589 vs. 9,921 ± 6,599 mg, Mann-Whitney U test: p = 0.0004) were significantly reduced. The daily CMZ dose was significantly lower at days 1–5 in the group receiving symptom-triggered treatment. There was no influence of age on the outcome parameters of either treatment group. In conclusion, an individualized symptom-triggered treatment of alcohol withdrawal with CMZ seems to be equally safe but more efficient than a scheduled regimen.
Regulating Peptidergic Modulation of Rhythmically Active Neural Circuits
Authors: Nusbaum Michael P.
Published: April 2003

The ability of neuropeptides to modulate neural circuit activity is well established, but little is known regarding how the actions of neurally-released peptides are regulated. This issue is being studied in the isolated stomatogastric nervous system (STNS) of decapod crustaceans. The STNS is a small neural system that contains the rhythmically active gastric mill (chewing) and pyloric (filtering of chewed food) motor circuits within the stomatogastric ganglion (STG). These circuits are influenced by a set of modulatory projection neurons in the neighboring commissural and oesophageal ganglia. This system includes three different projection neurons that contain the peptide transmitter proctolin among an overlapping complement of cotransmitters. Despite their shared proctolinergic phenotype, when these projection neurons are activated individually each of them has distinct actions on the gastric mill and pyloric circuits. These distinct actions result only partly from the presence of different cotransmitters in these projection neurons. Also contributing to these distinct actions are differences in the pattern of transmitter release as well as a differential, peptidase-mediated sculpting of the actions of the proctolin released from each projection neuron. There is also a convergence of peptide cotransmitter actions, at the level of the target ion channel, which might limit the effectiveness of each individual cotransmitter. One lesson already learned from this small neural system is that there is a diverse collection of regulatory mechanisms for controlling the actions of neurally-released peptides on rhythmically active neural circuits.
The Role of Growth Hormone in the Regulation of Protein Metabolism with Particular Reference to Conditions of Fasting
Authors: Møller Niels , Nørrelund Helene
Published: April 2003

Growth hormone (GH) has potent protein anabolic actions, as evidenced by a significant decrease in lean body mass and muscle mass in chronic GH deficiency, and vice versa in patients with acromegaly. Depending on the prevailing physiological conditions and on which tissues and which proteins are under examination, the mechanisms involved include both stimulation of protein synthesis and restriction of protein breakdown. Apart from the possible direct effects of GH on protein dynamics, a number of additional anabolic agents, such as insulin, insulin-like growth factor-I and free fatty acids (FFA), are activated. Some of the most recent studies in the field have demonstrated a decisive role of stimulation of lipolysis and high circulating levels of FFA in orchestrating the maintenance of the protein pool of the body.
Type 2 Diabetes in Childhood: The American Perspective
Authors: Libman Ingrid , Arslanian Silva
Published: April 2003

The incidence of type 2 diabetes mellitus is steadily escalating throughout the world in people from a wide range of ethnic groups and all social and economic levels. Type 2 diabetes is no longer a disease only of adults: parallel with the global epidemic of type 2 diabetes in adults, an ‘emerging epidemic’ of type 2 diabetes has been observed in youth over the last decade. Research and clinical experience in adults have established that insulin resistance is a major risk factor for type 2 diabetes. However, insulin resistance alone is not sufficient to cause diabetes, which will develop only when insulin secretion by the β-cells fails. This review discusses the recent emergence of type 2 diabetes in children and adolescents, its risk factors, pathophysiologic mechanisms and treatment modalities.
Williams-Beuren Syndrome: A Model of Recurrent Genomic Mutation
Authors: Pérez Jurado Luis Alberto
Published: April 2003

Williams-Beuren syndrome is a segmental aneusomy syndrome with manifestations affecting the vascular, connective tissue, endocrine and central nervous systems. Most patients show a similar heterozygous ∼1.5 Mb deletion at 7q11.23 that contains a number of reported genes. Deletion mapping in the few atypical patients with smaller deletions suggested that additive effects of haploinsufficiency for two or more genes might be necessary for the phenotype. Vascular stenoses are caused by haploinsufficiency at the elastin gene, while the genes responsible for the cognitive deficits are likely located at the telomeric edge of the deletion, including CYLN2 and GTF2I. Large region-specific segmental duplications predispose to misalignment and inter- or intrachromosomal unequal crossing-over causing the deletions. Atypical alleles at 7q11.23 such as inversions and deletions/insertions of large repeats, also generated through aberrant recombination between the local segmental duplications, are found in ∼35% of transmitting parents. Genomic instability at 7q11.23 is directly related to the genomic structure of the region.
Born Small for Gestational Age: Increased Risk of Type 2 Diabetes, Hypertension and Hyperlipidaemia in Adulthood
Authors: Jaquet Delphine , Czernichow Paul
Published: April 2003

The metabolic and cardiovascular complications associated with reduced fetal growth have been identified in the past 10 years. These include cardiovascular disease and the insulin resistance syndrome, comprising dyslipidaemia and impaired glucose tolerance or type 2 diabetes, and they appear to result from the initial development of insulin resistance. Although the mechanism underlying the development of insulin resistance associated with reduced fetal growth remains unclear, there is some evidence that adipose tissue plays a key role. Over the past decade, several hypotheses have been proposed to explain this unexpected association. Each points to either a detrimental fetal environment, genetic susceptibility or an interaction between the two. Although yet to be confirmed, the hypothesis suggesting that the association could be the consequence of genetic-environmental interactions is at present the most attractive.
Integrated Vascular Access Management
Authors: Beathard Gerald A.
Published: April 2003

Nephrologists need to deal with the problem of vascular access management in the same manner as the other major problems that affect our dialysis patients. We need to become experts in vascular access and we need to occupy a pivotal position in directing the decisions that are made that affect dialysis patient welfare. An integrated vascular access management strategy is required. Optimally, there should be four components to this strategy – evidence-based policies and procedures, a dedicated vascular access facility, committed vascular access surgeons and the availability of committed vascular access interventionalists. In many respects this is the approach that offers the best in quality of patient care and is also the most economic to deliver.
Gentamicin-Induced Cytotoxicity Involves Protein Kinase C Activation, Glutathione Extrusion and Malondialdehyde Production in an Immortalized Cell Line from the Organ of Corti
Authors: Bertolaso Lucia , Bindini Debora , Previati Maurizio , Falgione Daniela , Lanzoni Irene , Parmeggiani Alina , Vitali Cristina , Corbacella Elisa , Capitani Silvano , Martini Alessandro
Published: April 2003

The objective of the present study was to investigate the biochemical mechanisms underlying gentamicin cytotoxicity in OC-k3 cells derived from an immortalized cell line developed from the organ of Corti of transgenic mice. Administration of 50 µM gentamicin significantly reduced cell proliferation and viability, as well as initiating morphological changes associated with apoptosis. Protein kinase C (PKC) α activity was increased in gentamicin-treated cells, peaking 15 min after dosing (+138.2%). This PKCα increase was followed by a rise of glutathione (GSH) efflux and a concomitant 29% decrease in intracellular GSH levels at 30 min. PKCα-specific inhibitors blocked these cytotoxic effects. Gentamicin also increased malondialdehyde levels, while N-acetylcysteine, GSH and ascorbic acid prevented gentamicin-induced cell death. These findings suggest that gentamicin cytotoxicity involves a production of intracellular reactive oxygen species and a concomitant PKC-dependent fall of intracellular scavenging abilities (GSH), events that together drive cells to undergo apoptosis.
T Cell Response to Human Papillomavirus 16 E7 in Mice: Comparison of Cr Release Assay, Intracellular IFN-γ Production, ELISPOT and Tetramer Staining
Authors: Michel Nico , Öhlschläger Peter , Osen Wolfram , Freyschmidt Eva-Jasmin , Guthöhrlein Heidrun , Kaufmann Andreas M. , Müller Martin , Gissmann Lutz
Published: April 2003

Successful vaccination against infections by high-risk papillomaviruses aiming at the prevention of cervical cancer most likely requires the induction of neutralizing antibodies and human papillomavirus (HPV)-specific T cells directed against early viral proteins such as E7. Whereas the technology for detection of antibodies is well established, measurement of T cells is more cumbersome and standardization of assays is difficult. By using chromium release assay, ELISPOT, tetramer staining and intracellular IFN-γ assay, we compared the levels of HPV 16 E7-specific T cells obtained after immunization of C57BL/6 mice with different DNA expression vectors. We found that all four assays gave highly comparable results. ELISPOT can be recommended for future studies as it indicates the presence of activated (i.e. IFN-γ-secreting) T cells in a quantitative manner and combines high sensitivity with relatively low T cell demand.
Using Health Belief Models to Understand the Efficacy-Effectiveness Gap for Mood Stabilizer Treatments
Authors: Scott Jan
Published: April 2003

Objective: This study explored the utility of Health Belief Models (HBM) in explaining medication adherence in subjects with severe affective disorders. Method: Well-established measuring instruments, with confirmed reliability and validity, were used to assess each component of two HBMs and adherence to mood-stabilising medication in 98 subjects with either bipolar (805 subjects) or unipolar disorders. Results: About 30% of subjects met criteria for partial adherence to medication. Demographic and diagnostic variables did not predict adherence status. Subjects’ beliefs about themselves and their control over the disorder were more important than side-effects in predicting medication adherence. Self-reported assessments were predictive of admission to hospital in the year after the interview. Conclusion: Although the study has a number of methodological limitations, the results suggest that clinical assessment of components of HBMs may improve the detection of patients at risk of non-adherence to mood-stabilising medication.
Feticide during Second- and Third-Trimester Termination of Pregnancy: Opinions of Health Care Professionals
Authors: Dommergues Marc , Cahen Françoise , Garel Micheline , Mahieu-Caputo Dominique , Dumez Yves
Published: April 2003

Objective: To study the opinions of professionals on feticide being performed as the first step of late termination of pregnancy (TOP). Setting: Tertiary care obstetrical unit with policy of routine feticide in late TOP. Method: Questionnaire survey. Results: 101/109 professionals responded (23 midwives, 22 doctors, 24 nurses, 21 auxiliaries, 9 others). 90 had heard of feticide, 83 knew about how and 38 about when the procedure was done. When asked about what the goals of feticide were, 94 respondents quoted, ‘preventing parents from facing neonatal agony’, 73 ‘avoiding fetal pain’, 85 ‘preventing labor ward staff from facing neonatal agony’, and 60 ‘complying with legal rules’. 54 respondents thought feticide was beneficial to their patients or improved their own professional practice, and 71 declared the procedure was emotionally positive, yet stressful. 48 respondents declared lacking information on feticide. Respondents who had attended to feticide at least once (n = 59) knew more on feticide, and were more positive on the impact feticide had on their practice than those who had never attended a feticide (n = 42). Conclusions: In a highly specialized center, professionals had positive opinions on feticide, expecting it would avoid fetal or neonatal agony and pain.
Analysis of Saturation Binding and Saturation Infection for Dengue Serotypes 1 and 2 in Liver Cells
Authors: Suksanpaisan Lukkana , Smith Duncan R.
Published: April 2003

Objective: The liver has been increasingly recognized as a significant target organ in the pathogenesis of dengue virus infection. However, only two contradictory studies have examined the binding of the dengue virus to liver cells. This study therefore sought to investigate the binding of the dengue virus to HepG2 cells. Methods: Radiolabeled dengue virus serotypes 1 and 2 were prepared through viral propagation in Vero cells. Increasing amounts of virus were then incubated with HepG2 cells to determine the ability of the virus to achieve saturation of binding on HepG2 cells. Results: Results indicated that it was not possible to reach saturation of binding under experimentally achievable conditions. We then sought to determine whether it was possible to reach a state of saturation of infection, by using increasingly high titers of virus on a constant number of cells. Dengue serotype 1 showed no evidence of saturation of infection, even at titers of 5,000 viruses per cell. In contrast, dengue serotype 2 became saturated at levels of approximately 3,000 viruses per cell. Conclusions: These results are consistent with proposals that dengue virus binding to cells is mediated initially through a low-affinity interaction with an abundant molecule on the surface of the cell and secondly through interaction with a less commonly expressed molecule, which is required for viral internalization.
Patient Satisfaction with Three Dental Speciality Services: A Centre-Based Study
Authors: Al-Mudaf Buthaina A. , Moussa Mohamed A.A. , Al-Terky Maha A. , Al-Dakhil Ghaneema D. , El-Farargy Alaa E. , Al-Ouzairi Sadad S.
Published: April 2003

Objective: To assess the level of patient satisfaction with three dental speciality services: oral surgery, periodontics, and fixed prosthodontics. Subjects and Methods: A sample of 1,242 patients, aged 16 years and over who received dental care at least twice at the main dental centre, Al-Amiri, Kuwait, were interviewed during May–August 1998 by independent researchers concerning their experience of previous visits. Patients reported their level of satisfaction on a 5-point Likert scale for the items in the questionnaire, which focused on four areas: access, dentist’s communication, staff helpfulness, and structural aspects of the practice. Results: On average 49.4% (25.9–89.6%) of participating patients rated the level of care received as excellent. Areas rated poorest included waiting time for an appointment and waiting time in the clinic to access the dentist. Participants were less satisfied with doctor’s explanation of illness, dental treatment and confidentiality of medical records. The areas that received excellent ratings by patients included: (a) communication (listening and understanding complaints 40.0% and courteous treatment 57.8%), and (b) structural aspects (availability of infection control and safety measures 89.6% and packed sterilized instruments 78.9%). Conclusion: Findings indicate that the level of patient satisfaction was reasonably high. Areas identified as needing improvement included: dentist-patient communication skills, medical records, appointment systems, and shortening of the waiting time to access the dentist.
Lymphoscintigraphy in the Sentinel Lymph Node Technique for Breast Tumor: Value of Early and Late Images for the Learning Curve
Authors: Rousseau C. , Campion L. , Curtet C. , Classe J.M. , Dravet F. , Fiche M. , Sagan C. , Chatal J.F. , Resche I.
Published: April 2003

As the performance of early (H+1 to H+4) and late (D1) lymphoscintigraphic images raises organizational problems in outpatient surgery for breast cancer, only early images are generally obtained. The present study evaluated whether two series of images are better than one and defined the advantages of both methodologies. One hundred and eighteen patients with infiltrating breast carcinoma (T0, T1 and T2) were included in the study: 87 in group A (early and late images) and 31 in group B (only early images). All patients received two peritumoral injections of 99mTc-sulfur colloid, 15–18 MBq (group A) and <15 MBq (group B). During the operation, the patent blue bye technique was associated with radioactivity detection. The two groups were comparable for histological type and tumor size and localization. Successful localization of sentinel nodes on early lymphoscintigraphic images was significantly greater for group B. The identification of a sentinel node focus on early lymphoscintigraphy increased by 10% during the study. Sentinel node detection by the isotopic method alone, or the two methods combined, was comparable for both groups. In radioactivity detection, the count rate for sentinel nodes versus background (contralateral breast) was similar for the two groups. During the learning phase, two series of images gave a definite advantage. Subsequently, lymphoscintigraphy performed at +2 h was sufficient (the results for the two groups became indistinguishable).
Stroke Services in Scotland
Authors: Dennis Martin
Published: April 2003

Stroke services are developing rapidly in Scotland. Most of the 33 hospitals which admit stroke patients from the community have a stroke unit and access to brain imaging. However, acute stroke units are few and many of the 10,000 patients each year still do not access a stroke unit bed. A recently introduced National Strategy aims to ensure that all patients have access to early stroke unit care, brain imaging and appropriate specialist rehabilitation and secondary prevention. A national system to monitor the progress of the strategy is being developed.
Synergy of Binary Poly(Oxypropylene-Oxyethylene) Copolymers in Reducing Retention of Streptococcus sanguis to Hydroxyapatite
Authors: Guan Y.H. , Lilley T.H. , Lath D.L. , Marlow I. , Brook A.H.
Published: April 2003

Binary poly(oxypropylene-oxyethylene) block copolymer systems have been investigated as a non-bactericidal approach to reduce the retention of an oral bacterium, Streptococcus sanguis. Using a previously validated hydroxyapatite-coated microtitre model to simulate the tooth, the performance of copolymer pairs was measured experimentally. A synergy index and an efficacy index were defined to describe the reduction of bacterial retention by the binary systems that comprise the copolymer pairs. Relationships between the synergy and efficacy indices and their associated compositions are given. The results obtained have been rationalised using a previously developed theoretical approach in conjunction with the binding energetics of species to surfaces.
Host-Derived Proteinases and Degradation of Dentine Collagen in situ
Authors: van Strijp A.J.P. , Jansen D.C. , DeGroot J. , ten Cate J.M. , Everts V.
Published: April 2003

Dentine root caries is a process of demineralization and degradation of the organic matrix by proteinases. In this in situ study, the presence and activity of the matrix metalloproteinases 1, 2 and 9 (MMP-1, MMP-2, MMP-9) in saliva and in completely demineralized dentine specimens were investigated. Furthermore, the activity of cathepsin B was determined in saliva. A correlation between these enzymes and the level of degraded collagen was investigated. Demineralized dentine specimens were mounted in the partial prosthesis of 17 volunteers. Saliva samples were taken at 0, 2 and 4 weeks. After 4 weeks, the enzymes were extracted from the dentine specimens and the collagen loss was assessed. The collagen loss varied between 0 and 40.3%. Zymography of the saliva and the dentine extract samples showed that (pro-)MMP-2 and (pro-)MMP-9 were present. The levels of active MMPs were assessed, using fluorogenic MMP-specific substrates. All but 3 of the 51 saliva samples showed MMP-1 activity ranging from 1.5 to 101.1 relative fluorescence units (RFU)/s. Forty-eight saliva samples showed gelatinolytic MMP-2/MMP-9 activity (1.7–141.1 RFU/s). MMP-1 activity was shown in all dentine extracts varying between 3.5 and 295.0 RFU/s. From the dentine extracts, 15 showed MMP-2/MMP-9 activity (0.2–13.7 RFU/s). The MMP activity from both saliva and dentine extracts did not correlate with the collagen loss. The activity of salivary cathepsin B varied from 4.8 to 42.2 arbitrary units/min. A positive correlation was found between salivary MMP activity and cathepsin B activity. This study revealed that gelatinolytic enzyme activity was present both in saliva and dentine collagen. No correlation could be observed, however, between the level of enzyme activity and the collagen loss of the dentine specimens.
Intracranial Invasion from Primary Adenocarcinoma Arising in the External and Middle Ear
Authors: Marioni Gino , de Filippis Cosimo , Stramare Roberto , Puggina Stefano , Marino Filippo , Ferran-Bennström Enrique , Staffieri Alberto
Published: April 2003

Objective: Primary middle ear and external ear adenocarcinoma is extremely rare. Involvement of the antrum, mastoid, petrous bone and parotid gland has been described. Intracranial invasion has been rarely reported. Patient: The authors present a new case of primary adenocarcinoma of the middle ear, external canal, mastoid, petrous part of the temporal bone with intracranial invasion. Conclusions: Diagnostic (in particular differential diagnosis from endolymphatic sac tumours) and therapeutic problems are discussed. Computerized tomography is useful in detecting bone involvement beyond the external canal, giving a direct representation of the markedly destructive pathological process. Magnetic resonance has better soft tissue contrast, permitting more accurate evaluation of the cartilaginous portion of the external auditory canal, surrounding soft tissues, intracranial extension, and vascular encasement. The limited number of cases reported in the literature recommend radical surgery and postoperative radiotherapy on initial presentation.
Effect of Smoking on the Outcome of Functional Endoscopic Sinus Surgery
Authors: Khalil Hisham Saleh
Published: April 2003

A number of factors are thought to affect the outcome of functional endoscopic sinus surgery, including the presence of systemic illness, nature and severity of pathology, history of previous surgery and gastro-oesophageal reflux. The aim of this prospective case-control study was to determine whether long-term smokers undergoing functional endoscopic sinus surgery had poorer outcomes compared to non-smokers. Thirty-two smokers and 30 non-smokers with chronic rhinosinusitis undergoing functional endoscopic sinus surgery were followed prospectively for 6 months. Staging of disease and scoring of operative data was performed using the Lund and Mackay system. There was no significant difference between both groups in the staging and surgical score. Improvement in most of pre-operative symptoms and healing of the osteomeatal unit was significantly less amongst smokers. Poorer outcomes are to be expected in smokers undergoing functional endoscopic sinus surgery.
Evaluation of the Barostat for Recordings of Gastrointestinal Motility
Authors: Kreis M.E. , Kasparek M.S. , Starlinger M.J. , Becker H.D. , Zittel T.T. , Jehle E.-C.
Published: April 2003

Background: The barostat has been used to investigate gastrointestinal motility. No detailed technical evaluation to characterize the properties of this device for motility recordings has been reported. We, therefore, aimed to test the barostat in vitrounder standardized conditions. Methods: Barostat and manometry recordings were performed using a combined catheter in a pressure chamber. Some of the experiments were made in pig sigmoid colon in order to mimic recordings in a hollow organ. Data are mean ± SD. Results: Baseline changes of the bag volume under constant conditions were 3.9 ± 2.0%. The bag volume increased by 4.5 ± 1.1% with a temperature increase from 22 to 37°C (p < 0.05). At external pressures above the bag operating pressure, the barostat bag collapsed, while only minimal volume reductions occurred at external pressures below the bag pressure. Barostat recordings of pressure events were delayed when compared with manometry and not linearly related to the pressure increases. Conclusion: The influence of temperature changes on barostat recordings is small. The volume decrease in the barostat bag is not linearly related to the external pressure increase and influenced by the operating pressure in the bag. This experimental study provides insight and caveats for those planning to use the barostat device for motility recordings of the gastrointestinal tract.
Inhibition of Intestinal Bacterial Translocation with Rifaximin Modulates Lamina propria Monocytic Cells Reactivity and Protects against Inflammation in a Rodent Model of Colitis
Authors: Fiorucci Stefano , Distrutti Eleonora , Mencarelli Andrea , Barbanti Miriam , Palazzini Ernesto , Morelli Antonio
Published: April 2003

Background: A modification of the intestinal flora and an increased bacterial translocation is a common finding in patients with inflammatory bowel disease as well as in animal model of colitis. Rifaximin, a non-absorbable derivative of rifamycin, is an effective antibiotic that acts by inhibiting bacterial ribonucleic acid synthesis. Aims: In the present study, we investigated the effect of the administration of rifaximin (10, 30 and 50 mg/kg/day) or prednisolone (10 mg/kg/day) in 2,4,6-trinitrobenzene sulfonic acid (TNBS)-induced colitis in mice. Methods: Colitis was induced in mice by intrarectal administration of TNBS (1.5 mg/mouse in 50% ethanol) and disease severity assessed clinically and by histologic scoring of colon damage, determination of interleukin (IL)-2, IL-12, interferon (IFN)-γ and tumor necrosis factor (TNF)-α (protein and mRNA and myeloperoxidase (MPO) activity in the colon. Cytokines production by the lamina propria mononuclear cells (LPMC) and luminal bacteria were also measured. Results: Rifaximin administration (30 or 50 mg/kg/day) increased survival rates of colitic mice and reduced colitis severity as demonstrated by improvement of wasting syndrome, histologic scores, decrease in colon IL-2, IL-12, IFN-γ and TNF-α (protein and mRNA) levels, and diminished colon MPO activity. Rifaximin administration caused a significant reduction of colon bacterial translocation towards mesenteric lymph nodes. LPMC obtained from rifaximin-treated mice released significantly lower amount of IFN-γ in response to ex vivo stimulation with agonistic anti-CD3 and anti-CD28 antibodies. Rifaximin (50 mg/kg/day) significantly accelerates recovery in mice with established colitis. Conclusions: Luminal bacterial microflora plays a role in the pathogenesis of TNBS-induced colitis in mice. Rifaximin administration reduces the development of colitis and accelerates healing of established disease by preventing bacterial translocation.
Repeated Thoracentesis: An Important Risk Factor for Eosinophilic Pleural Effusion?
Authors: Martínez García M.A. , Cases Viedma E. , Perpiñá Tordera M. , Sanchis-Aldás J.L.
Published: April 2003

Background: Eosinophilic pleural effusion (EPE) is a relatively rare clinical condition. Repeated thoracenteses (RTs) are normally considered a frequent cause of EPE. Yet, to our knowledge, there is no firm evidence (apart from anecdotal case reports) supporting such a statement. Objective: To investigate potential relationships between the number, type (with or without pleural biopsy) and time elapsed between RTs and the number of eosinophils present in pleural fluid samples. Methods: We reviewed retrospectively 273 pleural fluid samples belonging to 120 patients (79 males, 41 females), attended in our institution from 1992 to 2000, whose clinical mangement had required RTs. Apart from the anthropometric and clinical data of each patient, we included the following variables in the analysis: number of thoracenteses performed in each individual, number of pleural biopsies carried out at each thoracentesis and time between consecutive thoracenteses. We also recorded the total (and differential) leukocyte count, red blood cell count, as well as the main biochemical, microbiological and histological data of both the pleural fluid and peripheral blood samples. Results: We did not observe any significant change in the percentage of eosinophils in relation to the number of thoracenteses performed per patient. This lack of relationship was also observed in the subgroup of patients who required one (or more) pleural biopsies (n = 111) (regardless of the number of biopsies). Our results suggest that RTs are not an important risk factor for the development of EPE, regardless of the time elapsed between two thoracenteses. Conclusion: We believe, therefore, that multiple punctures should not longer be considered a prevalent cause of pleural eosinophilia.
Primary Endobronchial Actinomycosis Associated with Broncholithiasis
Authors: Seo Joon Beom , Lee Jae Woong , Ha Seung Yeon , Park Jeong Woong , Jeong Seong Hwan , Park Gye Young
Published: April 2003

Primary endobronchial actinomycosis is an extremely rare disease that presents with endobronchial mass. We report 2 cases of primary endobronchial actinomycosis associated with broncholithiasis. There was no foreign body material, suggesting that these broncholiths were formed endogenously. Even though it is very rare, endobronchial actinomycosis should be included in the differential diagnosis of calcified endobronchial mass, especially when there is no clinical or radiological evidence of a granulomatous infection, such as tuberculosis, and the yellowish materials obstructing the bronchi are seen during bronchoscopy.
Cerebrospinal Fluid Beta-Amyloid 42 Is Reduced before the Onset of Sporadic Dementia: A Population-Based Study in 85-Year-Olds
Authors: Skoog I. , Davidsson P. , Aevarsson Ó. , Vanderstichele H. , Vanmechelen E. , Blennow K.
Published: April 2003

Deposition of β-amyloid (Aβ) is an early pathogenic event in Alzheimer’s disease (AD). We measured Aβ42 and Aβ40 in cerebrospinal fluid (CSF) in a population-based sample of 85-year-olds, 27 demented and 35 non-demented. During the following 3 years, 7 of the 35 non-demented individuals had developed dementia, while 28 remained non-demented. Reduced CSF levels of both Aβ42 (p = 0.001) and Aβ40 (p = 0.0001) were found in patients with manifest AD and vascular dementia at the age of 85. Non-demented individuals who developed dementia during follow-up had lower levels of CSF- Aβ42 (p = 0.003), but not CSF-Aβ40 (p = 0.96), than those who remained non-demented. The odds ratio for development of dementia was 8.2 (p = 0.027) for individuals in the lower 50th percentile of CSF-Aβ42, while none of those in the highest 33rd percentile of CSF-Aβ42 developed dementia during follow-up. There were no significant differences between carriers and non-carriers of the apolipoprotein E Ε4 allele regarding CSF-Aβ42or CSF-Aβ40.Our study suggests that low CSF-Aβ42 is found also in an unselected population-based sample of old demented patients and provides the first evidence of a disturbance in the metabolism of Aβ, specifically involving Aβ42, before the onset of clinical symptoms in AD.
Possibility of Progenitor Cell Mobilization during the Hematological Recovery following Peripheral Blood Stem Cell Autograft
Authors: De Propris Maria Stefania , Meloni Giovanna , Cordone Iole , Capria Saveria , Bellucci Roberto , Trisolini Silvia , Simone Francesca , de Fabritiis Paolo
Published: April 2003

Twenty-four patients with hematological malignancies were studied during recovery following autografting in order to establish the proportion of patients that show CD34+ cell mobilization and the kinetics of mobilized CD34-positive cells. The patients showed a peak in peripheral blood (PB) CD34+ cells after a median of 14 days (range 12–20) following reinfusion. According to the number of circulating CD34+ cells, two groups could be clearly distinguished: 17 patients (group A) with <10 PB CD34+ cells/µl (median 1.2, range 0–5) and 7 patients (group B) with >10 CD34+ cells/µl (median 51, range 13–123). Compared to group A, patients of group B showed a faster hematological reconstitution of both polymorphonuclear leukocytes >500/µl (12 vs. 15 days) and platelets >50,000/µl (12 vs. 17 days). The expression of the β1 integrin CD49d was similar in the two groups of patients, while a lower expression of the β2 integrin CD11a and a greater expression of the L-selectin CD62L were observed in the PB CD34+ cells of group B patients. Both in the PB and in the BM, the number of CFU-GEMM, CFU- GM, CFU-E and BFU-E of group B was significantly greater than that of group A. However, when the clonogenic potential of a single CD34+ cell was evaluated, no major differences in the number of colonies produced per CD34+ cell were found between the two groups.
Acute Stroke Trials: The Problems of Local Investigators?
Authors: Toni D. , Sacchetti M.L. , Chamorro A.
Published: April 2003

During stroke trials local investigators have to face many practical problems and time consuming procedures (filling in huge case report forms, performing repeat blood sample drawings for pharmacokinetic studies etc.) which, however, simply require organizational structures which is understood to be necessary to be able to conduct such kind of studies. Other, and most worrisome problems, are indeed to be solved when a sponsored research may rise potential ethical issues, or when academic research proposals clash with the interest of pharmaceutical companies or find difficulties in being funded by public institutions. It is just a greater involvement of these latter, possibly free from bureaucratic laces, which might help a balance to be struck between academic and industrial aims.
Barley chromosome arms longer than half of the spindle axis interfere with nuclear divisions
Authors: Hudakova S. , Künzel G. , Endo T.R. , Schubert I.
Published: April 2003

We have tested the influence of recombinantly-elongated chromosome arms on nuclear divisions in barley and confirmed a rule according to which half the length of the average spindle axis defines the upper tolerance limit for chromosome arm length. A slightly longer chromosome arm caused incomplete separation of sister chromatids in ∼70% of mitotic telophase cells and >2.5% of daughter cells showing a micronucleus, due to disruption of non-separated sister chromatids by the newly forming cell wall. In homozygous condition, this elongated chromosome mediated a slower growth and reduced fertility of the carrier plants. Its meiotic transmission was not impaired because of the larger spindle dimensions in meiocytes as compared to those in mitotic cells.
Physical map of the chromosome 6q22 region containing the oculodentodigital dysplasia locus: analysis of thirteen candidate genes and identification of novel ESTs and DNA polymorphisms
Authors: Boyadjiev S.A. , Chowdry A.B. , Shapiro R.E. , Paznekas W.A. , Wandstrat A.E. , Choi J.W. , Kasch L. , Zhang G. , Wollnik B. , Burgess C.E. , Schalling M. , Lovett M. , Jabs E.W.
Published: April 2003

Oculodentodigital dysplasia (ODDD) is an autosomal dominant condition with congenital anomalies of the craniofacial and limb regions and neurodegeneration. Genetic anticipation for the dysmorphic and neurologic features has been inferred in a few families. Our previous linkage studies have refined the ODDD candidate region to chromosome 6q22→q23. In an attempt to clone the ODDD gene, we created a yeast artificial chromosome contig with 31 redundant clones spanning the region and identified and ordered candidate genes and markers. Fluorescent in situ hybridization mapped two of these YAC clones to chromosome 6q22.2 telomeric to a known 6q21 fragile site, excluding it as a possible cause of the suggested anticipation. We performed mutation analysis on thirteen candidate genes – GRIK2, HDAC2, COL10A1, PTD013, KPNA5, PIST, ROS1, BRD7, PLN, HSF2, PKIB, FABP7, and HEY2. Although no mutations were found, we identified 44 polymorphisms, including 28 single nucleotide polymorphisms. Direct cDNA selection was performed and fifty-five clones were found to contain sequences that were not previously reported as known genes or ESTs. These clones and polymorphisms will assist in the further characterization of this region and identification of disease genes.
Cloning and mapping of platypus SOX2 and SOX14: Insights into SOX group B evolution
Authors: Kirby P.J. , Waters P.D. , Delbridge M. , Svartman M. , Stewart A.N. , Nagai K. , Graves J.A.M.
Published: April 2003

Group B SOX genes, the closest relatives to the sex-determining gene SRY, are thought to have evolved from a single ancestral SOX B by a series of duplications and translocations. The two SOX B genes SOX2 and SOX14 co-localize to chromosome 3q in humans. SOX2 and SOX14 homologues were cloned and characterized in the platypus, a monotreme mammal distantly related to man. The two genes were found to co-localize to chromosome 1q in this species. Proximity of the two related genes has therefore been conserved for 170 Myr, since humans and platypus diverged. The sequence similarity and conserved synteny of these group B genes provide clues to their origin. A simple model of SOX group B gene evolution is proposed.
Emergence and Evolution of the Circadian Rhythm of Melatonin in Children
Authors: Ardura Julio , Gutierrez Regina , Andres Jesus , Agapito Teresa
Published: April 2003

Objective: To assess the age at which the circadian rhythm of melatonin begins. Methods: 55 children, divided into groups from the neonatal period to 24 months of life, were studied. Urine samples were taken from 28 newborn babies to measure 6-sulfatoxymelatonin (aMT6s). Salivary samples were collected from infants (27 cases), to measure melatonin (aMT). aMT was measured by RIA and aMT6s by ELISA using commercial kits. Changes in the levels of aMT6s and aMT were evaluated using the Friedman test and Wilcoxon matched pair test. Results: The group aged 27–41 days showed statistically significant differences in daily aMT6s and aMT concentrations. The highest values were always found between 24.00 and 8.00 h. This day/night difference persisted from 2–3 to 13–24 months of age. Conclusion: The data indicate that the circadian melatonin rhythm appears at the end of the neonatal period and persists thereafter.
Web-Based Programs for the Display and Analysis of Transmembrane α-Helices in Aligned Protein Sequences
Authors: Zhou Xiaofeng , Yang Nelson M. , Tran Can V. , Hvorup Rikki N. , Saier Jr. Milton H.
Published: April 2003

We developed novel programs for displaying and analyzing the transmembrane α-helical segments (TMSs) in the aligned sequences of homologous integral membrane proteins. TMS_ALIGN predicts the positions of putative TMSs in multiply aligned protein sequences and graphically shows the TMSs in the alignment. TMS_SPLIT (1) predicts the positions of TMSs for each sequence; (2) allows a user to select proteins with a specified number of TMSs, and (3) splits the sequences into groups of TMSs of equal numbers. TMS_CUT works like TMS_SPLIT, but it can cut sequences with any combination of TMSs. The BASS program similarly allows comparison of protein repeat elements, equivalent to TMS_SPLIT plus IC, but it provides the comparison data expressed in BLAST E values. These programs, together with the IntraCompare program, facilitate the identification of repeat sequences in integral membrane proteins. They also facilitate the estimation of protein topology and the determination of evolutionary pathways.
Primary Squamous Carcinomatous Ureteric Stricture of a Solitary Kidney with Spontaneous Intraperitoneal Urinary Extravasation
Authors: Pandey S. , Kumar S. , Dorairajan L.N. , Agarwal A. , Krishnan S. , Elangovan S.
Published: April 2003

We report a very rare case of a carcinoma of the ureter occurring in association with contralateral renal agenesis. Owing to this association, the patient had a unique presentation with urinary ascites and anuria. He was initially managed by retrograde ureteral stenting and supportive measures for renal failure. Thereafter, once the renal parameters became normal, distal ureterectomy and Boari flap reconstruction were performed. Although most patients with ureteral tumours present with advanced disease, the disease was localized in our patient, as the absence of the contralateral kidney resulted in an early presentation.
Gynecomastia following Chemotherapy for Testicular Cancer
Authors: Uygur Mehmet Cemil , Özen Haluk
Published: April 2003

A 22-year-old man received 4 cycles of bleomycin, etoposide and cisplatin combination chemotherapy for clinical stage IIA embryonal cell carcinoma of the right testis. The treatment resulted in complete remission. Five months following cessation of the chemotherapy first on the left and then 2 weeks later on the right side painful gynecomastia developed. His hormonal values are all normal with no evidence of recurrence of the cancer. Gynecomastia on both sides resolved in 8 months spontaneously without any treatment. He is still in clinical remission 14 months after completion of the chemotherapy. We should be aware that gynecomastia following cytotoxic chemotherapy in a young man does not necessarily mean the return of the cancer.
Prognostic Significance of Changes in Short-Term Prostate Volume and Serum Prostate-Specific Antigen after Androgen Withdrawal in Men with Metastatic Prostate Cancer
Authors: Furuya Yuzo , Nagakawa Osamu , Fuse Hideki
Published: April 2003

Objective: Endocrine therapy is the standard treatment for metastatic prostate cancer although progression to androgen independence is inevitable. To evaluate prognostic factors in metastatic prostate cancer, patients who had been treated with endocrine therapy were investigated especially for the change in prostate volume. Methods: Fifty-nine patients with untreated metastatic prostate cancer who received endocrine therapy were included in the present study. Blood chemistry, histological grade, extent of bony metastasis, clinical response to hormone therapy including the short-term change in prostate volume and serum prostate-specific antigen (PSA), and prognosis of the patients were evaluated. Results: With univariate analysis, hemoglobin concentration, serum alkaline phosphatase, lactate dehydrogenase (LDH), histological grade, extent of bony disease, the short-term change of prostate volume and response of PSA at 3 months were shown to be significant prognostic factors. Response of PSA, LDH and the change in prostate volume were significant for predicting prognosis with multivariate analyses. Five-year survival rate in patients whose prostate had regressed 20% or more at 1 month and whose PSA had been normalized at 3 months was 67%, whereas that in patients whose prostate had regressed less than 20% and whose PSA had not been normalized was 0%. Conclusions: The patients in whom PSA had not been normalized at 3 months and the prostate volume had regressed less than 20% at 1 month were in the high-risk group. New or more aggressive treatment should be considered.
Significance of Protein p53 Overexpression in the Clinical Course of High-Risk Superficial Bladder Cancer
Authors: Gil P. , Allepuz C. , Blas M. , Borque A. , del Agua C. , Plaza L. , Rioja L.A.
Published: April 2003

Objectives: This is a retrospective study in which the long-term biological behavior of 67 ‘high-risk’ superficial bladder tumors and the prognostic relevance (prediction of disease recurrence and progression) of the determination of the p53 phenotype in these cases were studied. Material and Methods: 67 tumors with a ‘high risk’ of progression were selected from the 1,103 transurethral resections for bladder cancer carried out in 640 patients in this center between 1987 and 1992. These included 39 T1G3, 14 Tis (isolated or associated with Ta-T1, non-G3 tumors), and 14 Ta-T1, non-G3 tumors with submucosal lymphatic affection (L+). The median follow-up of these cases was 69.7 months. An immunohistochemical technique with monoclonal antibodies (DO-7) was used to detect the p53 phenotype in paraffin-fixed material. Results: Tumor recurrence occurred in 31 patients (46.3%) and local or distant progression in 14 (20.9%). Radical cystectomy was carried out in 16 (23.9%) cases. p53 overexpression of ≧20% (‘p53+’) was detected in 40 tumors (59.7%). The rate of recurrence and progression, the disease and progression-free intervals, cancer-specific survival, disease-free survival and progression-free survival were similar in the 3 tumor groups (in all cases, p > 0.05). There were no significant differences in the overexpression of protein p53, using the standard cutoff point of 20% stained nuclei, on comparing the same variables in the whole group of 67 patients (in all cases, p > 0.05). Conclusion: The detection of protein p53 was not found to be of use in the retrospective prediction of disease progression or survival in ‘high-risk’ superficial bladder cancer.
Assessment of the Subclinical Irritation of Surfactants: A Screening Open Assay Model
Authors: Zhai Hongbo , Fautz Rolf , Fuchs Anne , Branco Nara , Maibach Howard I.
Published: April 2003

Background: Open application utilizing an exaggerated forearm washing model to determine surfactant subclinical irritant effects has limitations. Objective: A modified screening open model for rapid assessment of surfactant subclinical irritation was used as part of a validation process. Methods: Eight subjects were enrolled and 5 candidate surfactants studied. Sodium lauryl sulfate served as the irritant ‘gold standard’ control. In addition, one site for water washing and one site for normal skin (no treatment) were also included. A technician conducted 3 successive washings with each test surfactant to each volar forearm. Skin irritation and subclinical irritations were assessed with visual scores and bioengineering (transepidermal water loss, skin capacitance and skin color). Squamometry was performed after the last wash. Results: Squamometry provided a sensitive assessment for detecting surfactant-induced subclinical irritation with 3 successive washings in this open assay model. Neither clinical scores nor other biometric methods provided valuable biologic insight. Conclusion: This minimally invasive assay provides a facile and robust means to rank detergent irritant effects in man.