bluuebunny/crossref_metadata_2025 huggingface dataset:
Neuroendocrine and circadian aspects (melatonin and β‐endorphin) of atopic dermatitis in the child
Authors: Muñoz‐Hoyos A. , Espín‐Quirantes C. , Molina‐Carballo A. , Uberos J. , Contreras‐Chova F. , Narbona‐López E. , Gutiérrez‐Salmerón M. J.
Published: April 2008

Atopic dermatitis (AD) is a disease of increasing incidence among paediatric patients. Among the factors involved in its pathogenesis is the alteration of the immune response, and so the objective of this study was to evaluate the involvement of certain neuroendocrine factors with immune properties in the development of the disease. Fifty‐five subjects were selected and divided into the following three groups: healthy subjects, those diagnosed with symptomatic AD and those with asymptomatic AD. Plasma levels of melatonin and β‐endorphins were measured by radioimmunoassay, in serum samples obtained at 9 am and 9 pm, with two samples being obtained from each of the patients and controls. In the phases of AD outbreaks, there is a reduction in the serum levels of both melatonin and β‐endorphin. In the case of melatonin, the difference is statistically significant only during the day, although nocturnal levels are greater for both hormones. In AD, a central neuroendocrine dysfunction may be a primary pathogenic event. Our hypothesis is that the physiological nocturnal peak of melatonin due to pineal gland production may mask the decline of melatonin of possibly extrapineal (immunological) origin during episodes of dermatitis outbreaks. Further studies are required, particularly of neurovegetative and hormonal aspects, to better define this process. Such a definition would also be of therapeutic interest.
Evaluation of Mueller‐Hinton‐agar as a simple medium for the germ tube production of Candida albicans and Candida dubliniensis
Authors: Rimek Dagmar , Fehse Brigitte , Göpel Petra
Published: April 2008

Candida albicans is the most frequently isolated yeast species from clinical specimens. A classical rapid presumptive differentiation from non‐albicans species is based on its ability to produce germ tubes after incubation in human serum. The only non‐albicans Candida species producing germ tubes is Candida dubliniensis. In this study, we evaluated Mueller‐Hinton‐agar (MH‐agar) as a medium for germ tube formation of C. albicans and C. dubliniensis. A total of 859 yeast isolates from stool samples, including 632 strains of C. albicans, 10 C. dubliniensis and 217 other yeast strains from 20 different species, were grown on Sabouraud glucose (2%) agar at 37 °C for 24–72 h. Species were identified by standard methods. For the germ tube test (GTT), an inoculum from a single colony was streaked onto a MH‐agar plate and covered by a sterile coverslip. After incubation at 37 °C for 2 h, the MH plates were examined using a light microscope at ×200. The GTT was positive in 578 of 632 C. albicans strains (sensitivity 91.5%), in six of 10 C. dubliniensis strains (sensitivity 60.0%), and in none of the other yeast strains. MH‐agar is a suitable medium for the GTT and the presumptive identification of C. albicans. It is safer to use than human serum and is widely available in microbiology laboratories.
Long‐term treatment of erectile dysfunction with a phosphodiesterase‐5 inhibitor and dose optimization based on nocturnal penile tumescence
Authors: Mathers Michael J. , Klotz Theodor , Brandt Alexander S. , Roth Stephan , Sommer Frank
Published: April 2008

Associate Editor

Michael G. Wyllie

Editorial Board

Ian Eardley, UK

Jean Fourcroy, USA

Sidney Glina, Brazil

Julia Heiman, USA

Chris McMahon, Australia

Bob Millar, UK

Alvaro Morales, Canada

Michael Perelman, USA

Marcel Waldinger, Netherlands

OBJECTIVE

To test the hypothesis that a variable dosage of the oral phosphodiesterase type 5 (PDE5) inhibitor sildenafil (25, 50, 100 mg) or vardenafil (5, 10, 25 mg) determined according to results obtained from nocturnal penile tumescence and rigidity (NPTR, RigiScan), given nightly for 1 year, can improve spontaneous erectile function (EF) in men with mild‐to‐moderate arteriogenic erectile dysfunction (ED); this regimen was compared with a fixed daily dosage of sildenafil 25 mg or vardenafil 5 mg.

PATIENTS AND METHODS

In a prospective open‐label, parallel‐group trial 154 men with ED were randomized either to fixed low‐dose sildenafil 25 mg or vardenafil 5 mg (group 1) or to the lowest erectile dosage of sildenafil (25, 50 or 100 mg) or vardenafil (5, 10 or 20 mg) (group 2) provoking an erectile event as measured by NPTR nightly for 1 year. The EF domain of the International Index of Erectile Function (IIEF) was assessed before and 1 year after the beginning of treatment, and at 4 weeks after ending treatment.

RESULTS

After 1 year, 27 of 63 (64%) evaluable men in group 1 had an EF domain score in the normal range, vs 46 of 61 (75%) men in group 2. After the subsequent 4‐week wash‐out phase, both groups continued to have improved EF domain scores; 22 of 63 (35%) men in group 1 still had a score in the normal range, whereas 38 of 61 (62%) in group 2 had a normal score. The EF domain score in group 1 and 2 improved significantly after 1 year of treatment, from 13.6 to 18.9, and 15.1 to 23.9, respectively (P < 0.01). After the subsequent 4‐week wash‐out phase, men from both groups maintained this significant level of EF, at 17.1 and 22.4, respectively (P < 0.05).

CONCLUSION

Nightly PDE5‐inhibitor treatment 1 year in a dosage determined by NPTR measurements results in better EF than giving a fixed dosage of sildenafil (25 mg) or vardenafil (5 mg). This improvement persisted for >4 weeks beyond the end of treatment. The results from this open‐label, randomized trial warrant verification under double‐blind, placebo‐controlled conditions.
Individual Differences in Insular Sensitivity During Loss Anticipation Predict Avoidance Learning
Authors: Samanez-Larkin Gregory R. , Hollon Nick G. , Carstensen Laura L. , Knutson Brian
Published: April 2008

The anterior insula has been implicated in both the experience and the anticipation of negative outcomes. Although individual differences in insular sensitivity have been associated with self-report measures of chronic anxiety, previous research has not examined whether individual differences in insular sensitivity predict learning to avoid aversive stimuli. In the present study, insular sensitivity was assessed as participants anticipated monetary losses while undergoing functional magnetic resonance imaging. We found that insular responsiveness to anticipated losses predicted participants' ability to learn to avoid losses (but not to approach gains) in a behavioral test several months later. These findings suggest that in addition to correlating with self-reported anxiety, heightened insular sensitivity may promote learning to avoid loss.
Beyond Fear
Authors: Brosch Tobias , Sander David , Pourtois Gilles , Scherer Klaus R.
Published: April 2008

There is much empirical evidence for modulation of attention by negative—particularly fear-relevant—emotional stimuli. This modulation is often explained in terms of a fear module. Appraisal theories of emotion posit a more general mechanism, predicting attention capture by stimuli that are relevant for the needs and goals of the organism, regardless of valence. To examine the brain-activation patterns underlying attentional modulation, we recorded event-related potentials from 20 subjects performing a dot-probe task in which the cues were fear-inducing and nurturance-inducing stimuli (i.e., anger faces and baby faces). Highly similar validity modulation was found for the PI time-locked to target onset, indicating early attentional capture by both positive and negative emotional stimuli. Topographic segmentation analysis and source localization indicate that the same amplification process is involved whether attention orienting is triggered by negative, fear-relevant stimuli or positive, nurturance-relevant stimuli. These results confirm that biological relevance, and not exclusively fear, produces an automatic spatial orienting toward the location of a stimulus.
Is it Time to Cut the Gordian Knot of Polar Sovereignty?
Authors: Jabour Julia , Weber Melissa
Published: April 2008

There has been recent discussion on the abandonment of sovereignty in the Arctic and territorial and marine claims in Antarctica in the interests of redefining these regions into global commons with joint management. Global commons refers to a region, or group of valued resources, protected from exploitation in the interests of the global population and future generations. While it may be reasonable to examine the possibility of shifting sovereignty in these regions and locking access to any of the resources, an academic examination must not focus on sovereignty in isolation from existing management regimes. Sovereignty is not displaced easily, and nor are sovereign rights; however there is a large capacity for negotiation, consent and agreement towards how resources and areas may be used and enjoyed while maintaining an indifference to existing or exerted territorial and/or marine claims. Sovereignty and sovereign rights can also be preserved, but their utility minimized in the presence of alternative arrangements, as exemplified in the Antarctic Treaty. In the absence of such arrangements, the self‐interest of States is manifest. A false sense of probability is fostered by any examination that only considers sovereignty and disregards State practice or current management initiatives. This article demonstrates that the current governance arrangements are legitimate in a dynamic world, regardless of sovereignty, and identifies the lengths to which the stakeholders go to preserve both their national interest and that of the global community in de facto global commons areas. It concludes by offering a view that cutting the Gordian knot of polar sovereignty is both risky and premature in the absence of suitable alternatives.
Alternatives for an Arctic Treaty – Evaluation and a New Proposal
Authors: Koivurova Timo
Published: April 2008

This article examines the alternative proposals for an Arctic treaty that have been put forward by scholars and international organizations. The numerous proposals on record draw their inspiration from various sources: chief among these is the Antarctic Treaty System (ATS), but maritime regimes and even principles such as the common heritage of humankind are represented as well. The goal of the article is to examine the proposals in depth to ascertain what is viable and what is problematic in each. This analysis will help in outlining a new treaty that can accommodate both the political realities in the Arctic and the societal goals pursued in the region.
TCF7L2 Polymorphisms are Associated with Type 2 Diabetes in Khatri Sikhs from North India: Genetic Variation Affects Lipid Levels
Authors: Sanghera D. K. , Nath S. K. , Ortega L. , Gambarelli M. , Kim‐Howard X. , Singh J. R. , Ralhan S. K. , Wander G. S. , Mehra N. K. , Mulvihill J. J. , Kamboh M. I.
Published: April 2008

Recently, the transcription factor‐7‐like 2 (TCF7L2) gene has been identified as the most important type 2 diabetes mellitus (T2DM) susceptibility gene. Common intronic polymorphisms in this gene have been found to be strongly associated with T2DM susceptibility showing marked reproducibility in multiple populations. The purpose of this study was to confirm the reported association of six TCF7L2 variants in a Khatri Sikh diabetic sample from North India. We genotyped six‐associated SNPs in a case‐control sample consisting of 556 T2DM cases and 537 controls. We also examined the impact of these variants on body mass index (BMI), waist to hip ratio (WHR), fasting insulin, and glucose and lipid levels. We report replication of association of four of the six SNPs with T2DM in this Khatri Sikh sample [rs7903146, (p = 0.010); rs11196205, (p = 0.011); rs10885409, (p = 0.002) and rs4918789, (p = 0.029)], under a dominant model conferring odds ratios (ORs) of 1.39, 1.44, 1.57 and 1.36, respectively. Haplotype analysis provided further evidence of association by showing a significant difference between cases and controls as revealed by the global omnibus test (χ2= 19.36; p = 0.0036). Multiple linear regression analysis also revealed the risk allele carriers of three of four significant SNPs (rs7903146, rs11196205, rs10885409) to be significantly associated with increased fasting total cholesterol (p value = 0.019, 0.025, 0.006) and LDL cholesterol levels (p value = 0.021, 0.018, 0.005), respectively.

Our findings confirm that the TCF7L2 gene is a major risk factor for development of T2DM in Khatri Sikhs. It also provides new information about the significant impact of TCF7L2 gene variants on plasma cholesterol levels that appear to be independent of BMI.
Pathways from adolescent deliberate self‐poisoning to early adult outcomes: a six‐year follow‐up
Authors: Aglan Azza , Kerfoot Michael , Pickles Andrew
Published: April 2008

Background:  Prospective studies show that the adult outcomes of adolescents who deliberately harm themselves are marked by high rates of adversity and psychiatric disorders. The goal of this study was to identify pathways linking childhood risk factors to early adult outcomes of suicidal adolescents.

Methods:  A clinical sample of 158 adolescents who deliberately poisoned themselves was followed up six years later. Eighty per cent of the cohort (n = 126) were interviewed in early adulthood using a battery of standardised measures of psychopathology and social functioning.

Results:  Multivariate mediation path analysis identified four pathways linking child and adolescent risk factors to adverse outcomes in early adulthood. Family dysfunction, conduct disorder and hopelessness contributed to the risk of high adversity in early adulthood indirectly through its effect on other risk domains, including dropping out of school and adopting adult roles at a younger age. Hopelessness not only predicted dropping out of school but also independently contributed to the risk of chronic major depressive disorder in early adulthood. Child sexual abuse independently predicted high adversity and chronic major depression over and above the influence of hopelessness. Juvenile onset major depression independently predicted chronic major depression in early adulthood. A substantial proportion of the effects of child sexual abuse and hopelessness on the risk of deliberate self‐harm in early adulthood was mediated by high adversity and the duration of major depression. However, chronic major depression was the only risk factor independently associated with deliberate self‐harm in adulthood once correlation with adversity was taken into account.

Conclusions:  Chronic major depressive disorder is central to deliberate self‐harm repetition. However, adult outcomes of suicidal adolescents are also dominated by the accumulating effects and consequences of other childhood risk factors, including child sexual abuse and adolescent hopelessness.
Effect of whey protein concentrate addition on the physical properties of homogenized sweetened dairy creams
Authors: EMAM‐DJOME ZAHRA , MOUSAVI MOHAMMAD EBRAHIMZADEH , GHORBANI ABDEL‐VAHAB , MADADLOU ASHKAN
Published: April 2008

The influence on their whipping properties of homogenization at first and second stage pressures of 3.5/1.5 MPa and addition of whey protein concentrate (WPC) powder at three different (0.7, 1.4, and 2.1 wt percentage) concentrations to sweetened and homogenized creams was studied. Homogenization of cream significantly decreased maximum overrun and made the foam microstructure less open, while increasing whipping time, cream and foam lightness (Hunter L‐value) and apparent viscosity. It also resulted in a less elastic foam structure with an increased drainage. Addition of WPC decreased the amount of maximum overrun, foam drainage and its lightness in parallel with developing a more compact microstructure. It increased the whipping time, apparent viscosity of unwhipped creams and foams, and resulted in a less elastic foam structure. The apparent viscosity of whipped cream with 2.1 wt percentage WPC, however, was lower than that of whipped cream with 1.4 wt percentage WPC, due most probably to the start up of gel formation at 2.1% WPC concentration in sweetened cream when it was sheared. Fresh foam whipped from sweetened cream with 2.1 wt percentage WPC also tended to have a slightly but not statistically significant lower elastic modulus (G′) than fresh foam whipped from sweetened cream with 1.4 wt percentage WPC. This concentration can be considered as the critical value for gel formation in sweetened creams enriched by whey proteins when sheared. This study indicated the potential of WPC powder for reducing foam drainage from whipped homogenized sweetened cream.
Reproducibility of treadmill exercise in patients with intermittent claudication
Authors: Berglund B.O. , Eklund Brita
Published: April 2008

Summary. The reproducibility of pain limited exercise time (ET) and heart rate (HR) have been evaluated in repeated treadmill exercise tests in 24 patients with arterial occlusive disease of the lower limbs and intermittent claudication. The protocol includes a walking speed of 1 m/s and load increments of 10 watt/min and the two tests were separated by 1–14 days. The total ET was systematically increased by about 30 sec (.P<0–05) at the second exercise test. The reproducibility of ET at the onset of leg pains was 34%, whereas the corresponding value at maximal leg pain was 16%. HR at the termination of the test did not differ systematically between the two tests and the reproducibility of HR was 61% and 5‐5% at the onset of pain and maximal pain, respectively.

It is concluded that a slight improvement in walking capacity at a second exercise test must be taken into account when evaluating different types of therapy in patients with intermittent claudication and, furthermore, that ET, walking distance or work load, should preferably be evaluated at or near maximal leg pain.
Spectral analysis of Doppler velocity patterns in normals and patients with carotid artery stenosis
Authors: Bodily K. C. , Zierler R. E. , Greene F. M. , Blackshear W. M. , Phillips D. J. , Beach K. W. , Strandness D. E.
Published: April 2008

Summary.A computerized pattern recognition program was utilized to assess the predictive ability of various parameters obtained from the spectra of ultrasonic pulsed Doppler signals from the carotid arteries. The most accurate features selected by linear regression analysis were the natural log (In) of the ratio of the mean velocity in the internal carotid artery compared to that in the common carotid artery, and the In of the maximum velocity, the In of the maximum frequency, and the square of the fractional broadening term, all of which were measured at peak systole in the internal carotid artery. Using the combination of the velocity ratio and the fractional broadening term, the average difference in the estimated percentage stenosis, as compared to that obtained by arteriography, was 12‐8%.
Muscle citrate content and the regulation of metabolism in fed and fasted human skeletal muscle
Authors: Maughan R. J. , Williams C.
Published: April 2008

Summary. Blood and muscle metabolite levels were measured in seven healthy young adult male subjects in a fed state and again following a 24‐hour fast. Skeletal muscle samples were obtained under local anaesthesia from m. vastus lateralis using a needle biopsy technique.

The blood glucose concentration fell during fasting; the blood lactate concentration remained unchanged. Plasma free fatty acid concentrations rose, as did 3‐hydroxybutyrate and acetoacetate levels. There was no change in the amount of carbohydrate stored as glycogen in the muscle in response to fasting. The muscle content of phos‐phagens (adenosine triphosphate and phosphocreatine), glycolytic intermediates (glucose‐6‐phosphate, fructose‐6‐phosphate, fructose‐1, 6‐diphosphate, triose phosphates and lactate) and citrate was also not affected by fasting. There was a significant increase in the muscle content of 3‐hydroxybutyrate.

These results give no indication as to the mechanism by which a decreased rate of carbohydrate degradation might occur in muscle in the fasted state. It is clear, however, that an intracellular accumulation of citrate and a consequent inhibition of glycolysis at the level of phosphofructokinase does not take place in fasting human skeletal muscle.
Tissue zinc levels as an index of body zinc status
Authors: Jackson M. J. , Jones D. A. , Edwards R. H. T.
Published: April 2008

Summary. Dietary depletion of zinc was found to result in a 30% decrease in the total body zinc content of experimental rats when compared with control animals. In the depleted animals there was no decrease in the zinc content of hair, skin, heart or three different skeletal muscles although the levels in plasma, liver, bone and testes were significantly reduced. The analysis of tissues from three patients suffering from disturbances of zinc metabolism suggest that man reacts to zinc deficiency in a similar way. These findings indicate that for a simple screening test of zinc status, analysis of the plasma zinc concentration remains the single most useful measurement.
Reference values for intramuscular pressure in the lower leg in man
Authors: Qvarfordt Peter , Eklöf Bo , Ohlin Per
Published: April 2008

Summary. Intramuscular pressures in the anterior tibial and superficial posterior compartments of the lower leg were measured by the wick catheter technique in 34 healthy individuals (17 males and 17 females, mean age 42 years). The pressures were measured at rest, during and after exercise and during venous and arterial occlusion. The pressure was 1·1 (range 0·3‐3·0) kPa in the anterior tibial and 0·5 (range 0·0–2·0) kPa in the superficial posterior compartment at rest. During exercise the intramuscular pressures rose to 3·5 (range 1·0–8·0) kPa and 0·9 (range 0·1–2·8) kPa respectively. The anterior tibial compartment pressures were lower in females than in males at exercise and lower in older than in younger persons at rest. After exercise the pressures were back to the pre‐exercise levels within 5 min. Venous occlusion caused an increase in the pressure which was more marked in the anterior tibial compartment than in the superficial posterior compartment. Arterial occlusion did not cause any dramatic changes in intramuscular pressures, but there was a slight elevation during the period of reactive hyperaemia.
Effects of externally applied compression on blood flow in the human dependent leg
Authors: Nielsen Henrik Vagn
Published: April 2008

Summary. In healthy humans placed in a horizontal position, venous transmural pressure was increased from about 10 to 45 mmHg in the mid‐calf region by lowering the leg below heart level. This increase in vascular transmural pressure evoked a vasoconstrictor response, as 133Xe‐measured blood flow was reduced by 56% (P < 0·01) in subcutaneous tissue and by 31% (P < 0·01) in skeletal muscle, when recorded at the same mid‐calf level.

The tissue pressure in the dependent leg was elevated stepwise by inflation of a standard whole leg cuff. The vasoconstrictor response was still present when the cuff was inflated to 10 mmHg, but absent in both tissues when external pressures between 20–40 mmHg were applied. The results suggest that the observed absence of vaso‐constriction can be ascribed to inhibition of the local veno‐arteriolar reflex mechanism. External pressures exceeding 40 mmHg reduced blood flow in both tissues. External pressures of 60 mmHg reduced blood flow by 45% (P < 0·01) in subcutaneous tissue and by 19% (P < 0·02) in skeletal muscle.

In conclusion, the vasoconstrictor response evoked in the dependent leg is qualitatively similar, but quantitatively different in the two tissues, possibly due to a difference in basal vascular tone. The vascular adjustments to external compression of the dependent leg is similar in the two tissues at low external pressures (0–40 mmHg), but different at high pressures, the latter probably due to a difference in vessel collapsibility in the compressed tissues.
Studies on kinetics of albumin in uraemic patients on chronic haemodialysis: evidence of interstitial albumin wash‐down
Authors: Hildebrandt Per , Jensen Henrik Aerenlund , Henriksen Jens H.
Published: April 2008

Summary. Albumin‐kinetic studies were performed in nine uraemic patients without oedema on chronic haemodialysis and in seven normal controls in order to determine microvascular leakiness and thereby, during steady state, lymph drainage of albumin. Transvascular escape rate of albumin [TERalb, i.e. the fraction of intravascular mass (IVMalb) passing into, or returning from, the extravascular space per unit time] and the distribution ratio (DRalb) between IvMalh and total albumin mass were determined from intravenously injected radioiodinated serum albumin. Before haemodialysis, TERalb was significantly elevated (mean 9·6%IVMalb h1, range 5·9–14) as compared to the value 15 h after haemodialysis (mean 7–3, range 5·2–11, P < 0·02) and to controls (mean 5·9, range 4·3–7·4, P < 0·01). Average DRalb, (mean 0·54, range 0·44–0·69) was clearly elevated in patients with respect to controls (mean 0·44, range 0·42–0·48, P < 0·01), and the extravascular mass of albumin was significantly decreased (mean 27.9 μmol kg1, range 14·1–41·2 n̈. mean 35·9, range 27·1–43·8, P < 0·05). We interpret the results as to indicate increased transvascular filtration of albumin in microcirculatory beds with permeable capillaries (splanchnic organs), in between the haemodialysis treatment, and filtration of protein‐poor fluid in areas with ‘tight’ capillaries (skeletal muscle, cutis) resulting in interstitial space protein depletion here. As the patients were considered to be in steady state during the measurements, the increased TERalh indicates increased lymph flux of albumin. The interstitial space protein ’wash‐down’ and increased lymph drainage probably serve as oedema prevention.
Permselectivity of the liver blood‐lymph (ascitic fluid) barrier to macromolecules in decompensated cirrhosis: relation to calculated pore‐size
Authors: Henriksen Jens H.
Published: April 2008

Summary. This study was undertaken to investigate permselectivity of the liver blood‐lymph (ascitic fluid) barrier to endogeneous rnarcomolecules in patients with decompensated cirrhosis. Albumin (mol wt 69,000), immunoglobulin‐G (mol wt 160,000) and immunoglobulin‐M (mol wt 900,000) were determined in plasma and ascitic fluid from 13 cirrhotic patients. As previously substantiated in patients with cirrhosis, the ascitic fluid/plasma concentration ratio (R) of a protein is proportional to the transport rate from blood to lymph (ascitic fluid). Mean Ralh= 0·28 and RIgG= 0·29 were identical, but significantly higher than, RIgM= 0·18 (P < 0·01). Ralh was directly correlated to RIgG (r= 0·97, P < 0·001) and to RIgM (r= 0·78, P < 0·005). Mean RIgM/Ralh= 1·03, which expresses the relative flux rates between IgG and albumin, was significantly above the ratio between the free diffusion coefficients (DIgM/Dalb= 0·64, P < 0·01). Mean RIgM/Ralh= 0·61 was significantly above DIgM/DalB= 0·39 (P < 0·05) and significantly below unity (P<0.0l). The resdts are best explained by filtration as the dominant mechanism of the liver blood‐lymph (ascitic fluid) exchange of endogeneous macromolecules. A significant ‘sieving’ is present in this barrier to the largest macromolecule (IgM). Calculations of pore‐size equivalent to the observed permselectivity of macromolecules suggest microvascular gaps (or channels) with an average radius about 300 Å, i.e. in the lower end of the range of gaps in normal liver sinusoids (from 200 to 5000 Å).
Difference in systolic blood pressure between arm and ankle region in children 0–15 years old
Authors: Nielsen Poul Ebbe , Larsen Steen , Olsen Niels
Published: April 2008

Summary. Arm and ankle systolic blood pressure was measured in a supine position in 95 children aged between 2 days and 16 years using either the ultrasound Doppler technique (0–6 years) or the strain‐gauge technique (7–16 years). Among children below 1 year of age, the ankle systolic blood pressure was significantly lower than the arm blood pressure and lowest when recorded over the dorsal pedal artery as compared to the post‐tibia1 artery. Children over 1 year of age had a higher ankle systolic blood pressure compared to the arm which corresponds to earlier findings among adults. The study indicates that lower limb systolic pressure is greater than upper limb systolic pressure but first demonstrable at the time when the babies begin to stand or walk. These findings might be used in evaluation of children suspected for aortic coarctation.
Measurement of right and left ventricular ejection fraction in dogs
Authors: Brynjolf Ingelise , Qvist Jesper , Mygind Thorkild , Jordening Henrik , Dorph Sven , Munck Ole
Published: April 2008

Summary. Three techniques for measurement of right (RVEF) and two techniques for left (LVEF) ventricular ejection fraction were evaluated in five dogs. RVEF was measured with a first‐pass radionuclide technique using erythrocytes labelled in vitro with Technetium‐99m methylene disphosphonate (MDP) and compared with RVEF measured with a thermodilution technique. Thermodilution‐determined RVEF was compared with RVEF values measured with cine angiocardiography. LVEF was measured with a radionuclide ECG‐gated equilibrium technique and compared with cine angiocardiography. Measurements were performed before and during a continuous infusion of dopamine.

There was an excellent correlation between RVEF measured with the first‐pass and the thermodilution technique, rs being 0·86, n = 9, P < 0·01. When RVEF measured with the thermodilution technique was compared with cine angiocardiography rs was 0·75, n = 10, P < 0·01. LVEF measured with the ECG‐gated equilibrium technique correlated well with cine angiocardiography (rs= 0·91, n = 10, P < 0·01).
Arachidonic acid metabolism and regulation of blood flow: effect of indomethacin on cutaneous and subcutaneous reactive hyperaemia in humans
Authors: Carlsson Inger , Linde Birgitta , Wennmalm Åke
Published: April 2008

Summary. The role of locally formed vasodilator prostaglandins (PGs) in the vascular relaxation response to short‐lasting arterial occlusion (reactive hyperaemia) in human cutaneous and subcutaneous tissue was investigated. The finger was chosen to represent cutaneous tissue, and its blood flow was determined using venous occlusion plethysmography; thigh adipose tissue represented subcutaneous tissue, and blood flow here was measured with an isotope clearance technique. Flow rates were determined in the basal state and during the hyperaemic phase following a period of arterial occlusion. The procedure was repeated after administration of the PG synthesis inhibitor indomethacin, given in a dose of 1·5 mg/kg.

In neither cutaneous nor subcutaneous tissue was the basal blood flow affected by indomethacin. In the finger, an increase in blood flow developed after the end of the arterial occlusion, reaching a peak value at 65 s of about 65 ml‐1 100 ml tissue min‐1. Indomethacin reduced the amplitude of this post‐occlusive increase to about 45 ml 100 ml‐1 min‐1, but did not change its duration. The total reactive hyperaemia in the finger was reduced by more than 50% following indomethacin. The subcutaneous tissue likewise showed an increase in blood flow following release of the arterial occlusion. This increase was not affected by indomethacin, in terms of either amplitude, duration or total reactive hyperaemia.

From these data, we conclude that short‐lasting arterial occlusion leads to formation of a vasodilator PG that plays a decisive role in the subsequent vascular smooth muscle relaxation response in human cutaneous tissue. A similar chain of events does not take place in ischaemic subcutaneous vascular tissue.
Measurement of water filtration in skeletal muscle in man by an osmotic transient method
Authors: Palm T. , Nielsen S. L. , Lassen N. A.
Published: April 2008

Summary. Water filtration in the human forearm was determined with a new method using a hyperoncotic transient of albumin solution infused into the brachial artery. Baseline dilution of labelled albumin in deep forearm vein plasma in excess of the contribution from arterial blood and from infusate was assumed to originate from extravascular water filtered into the blood by the transient. The filtration coefficient (Fe) was determined as the ratio between filtered water and increase in colloid osmotic pressure in the blood samples, and gives the filtrative water permeability in the exchange areas of the microcirculation. In 10 normal volunteers, Fe was 0·00082 ml (ml mmHg)‐1 (SD = 0·00007). Multiplication of Fe by plasma flow in the forearm gave a filtration capacity (Kf) of 0·0036 ml (100 ml tissue min mmHg)‐1 (SD=0·00137). This filtration capacity (Kf) represents that of fast flowing regions in the forearm muscles, but it is of the same order of magnitude as the capillary filtration coefficient (CFC) determined plethysmographically for the entire forearm by the venous stasis technique.
In vitro analysis of thermal transport in coronary sinus thermodilution catheters
Authors: Bålfors Eva , Häggmark Sören , Jr Serafin Ariola , Biber Björn , Pontèn Johan , Reiz Sebastian
Published: April 2008

Summary. The continuous thermodilution technique for measuring blood flow in the range 50–300 ml/min was evaluated in vitro. Experiments indicated that thermo‐transport within the catheter from the indicator line to the mixing thermistor exists. The resulting error in calculated thermodilution flow will increase with increasing flow rate. A correction factor for thermal transport, Ft, obtained from a blood circulation model was incorporated in a modified formula for calculation of thermodilution flow. Flows derived with the standard Ganz formula were significantly lower than timed volumetric flows, whereas flows obtained with the modified formula agreed with volumetric flow. The coefficient of variation for four consecutive measurements was 3·4%.
Regional pulmonary clearance of inhaled C15O and C15O2 in man at rest and during exercise
Authors: Pande J. N. , Hughes J. M. B.
Published: April 2008

Summary. The regional clearance of radioactive carbon monoxide (C15O2) and carbon dioxide (C15O2), after a single maximal inspiration, was investigated in six normal subjects seated on a bicycle, at rest and during exercise at 50 W. The clearances were measured sequentially during breath‐holding by four pairs of scintillation counters vertically aligned over the right lung. The clearance rate (k) for C15O and C15O2 increased from apex to base and from rest to exercise. On exercise, the apex base gradient (calculated over 11 cm vertical distance) for C15O decreased by 52% because of a larger increase in the upper zones but the C15O2 gradient did not change. Thus the increase in blood flow (=kC15O2) on exercise was accompanied by recruitment and/or distension of pulmonary capillary blood volume (=kC15O2), most marked in the upper regions. The ratio of the clearance (C15O/C15O2) decreased in the lower zones on exercise by 25% without significant change in the upper zone. This ratio reflects the product of capillary mean transit times and peripheral vascular and extravascular volumes. Since the latter increase on exercise, capillary transit times must have shortened considerably at a moderate level of exercise at all levels in the lung.
Effects of jejunal reinfusion of aspirated duodenal fluid on biliary and pancreatic secretion in man
Authors: Björnsson Ó. G. , Panayiotides T.
Published: April 2008

Summary. The standard duodenal perfusion technique was used to measure biliary and pancreatic secretion in normal subjects, with and without jejunal reinfusion of aspirated duodenal fluid. In studies carried out without reinfusion of the duodenal aspirate, and where a continuous background stimulation of caerulein and secretin was given throughout the studies to eliminate extrahepatic biliary storage, a gradual fall in bile salt and bilirubin secretion was observed. In contrast, when the experiments were carried out in these same individuals, and under exactly the same experimental conditions except that the duodenal aspirate, rich in bile and pancreatic juice, was in every successive collection period re infused into the jejunum, the bile salt secretion remained stable and the bilirubin secretion increased. In neither series of studies were there any definite changes in the secretory output of trypsin. The total secretory output of bicarbonate was, however, marginally greater in studies carried out with jejunal reinfusion of the aspirate than in the studies where the aspirate was discarded. Carried out under basal conditions, a gradual fall in both biliary and pancreatic secretion was observed in both series of studies. These results indicate that partial diversion of bile and pancreatic juice from the jejunum in man may affect hepato‐biliary secretion of bile salts and bilirubin and the secretion of bicarbonate.
Comparison between 99Tcm‐porcine plasmin and 99Tcm‐labelled erythrocytes in diagnosis of deep vein thrombosis
Authors: Edenbrandt Carl‐Magnus , Dahlström Jan Anders , Nilsson Jan , Ohlin Per
Published: April 2008

Summary In 20 patients with suspect deep venous thrombosis (DVT), scintillation detector measurements were performed over each leg during the first 60 min after intravenous injection of 99Tcm‐porcine plasmin. Thereafter, 99Tcm‐labelled autologous erythrocytes were injected i.v. and repeat measurements were performed. Finally, scintillation camera images of both legs were obtained. Phlebography was used as a reference method. A close relationship (P<0.01) was found between the scintillation detector measurements, both in patients with DVT (n=11) and in patients without DVT (n=9). Thus, 99Tcm‐plasmin is not specifically bound to the thrombus. Rather the clinical utility of the test depends mainly on circulatory changes secondary to the thrombus. Scintillation camera images of 99Tcm‐erythrocytes in the legs were not useful for diagnosis of DVT in the calves but showed a high specificity for DVT in the popliteal and femoral veins.
Sympathetic vasoconstrictor nerve function in alcoholic neuropathy
Authors: Jensen Kai , Andersen Kjeld , Smith Torben , Henriksen Ole , Melgaard Bjørn
Published: April 2008

Summary. The peripheral sympathetic vasomotor nerve function was investigated in 18 male chronic alcoholics admitted for intellectual impairment or polyneuropathy. By means of the local 133Xenon washout technique, the sympathetic veno‐arteriolar axon‐reflex was studied. This normally is responsible for a 50% decrease in tissue blood flow, when the ankle is lowered 40 cm below heart level in the supine individual.

The patients with moderate to severe polyneuropathy, taken as a group, did not differ significantly from the group of patients with no or only mild polyneuropathy, although a lesser response was seen (18% and 48% decrease respectively). However, in three patients with moderate neuropathy, and in one patient with no signs of neuropathy, this veno‐arteriolar reflex was absent, indicating dysfunction' of the peripheral sympathetic adrenergic nerve fibres. The three patients also showed a lesser degree of arteriolar constriction during 45° passive head‐up tilt, although none developed symptoms of orthostatic hypotension. Anhidrosis of the feet was found in only three patients. This study lends support to the view that individual differences in the susceptibility to the deleterious effect of alcohol comprise not only the peripheral sensory and motor nerve fibres, but also the thin pseudomotor and vasomotor nerves.
Physical training and fasting serum insulin levels in sedentary men
Authors: Woodhouse S. P. , Sutherland W. H. F. , Nye E. R. , Sargent J. , Waite G. , Merhtens C. , Cruickshank F. M. , Belcher M. R.
Published: April 2008

Summary. The present study examined fasting serum insulin levels in relation to body composition and dietary intake during the initial 4 weeks of a 12‐week physical training programme in 26 previously sedentary men. Fasting serum insulin concentrations decreased markedly during the first 4 weeks of training and remained at these reduced levels for the rest of the study. The early fall in serum insulin concentration was significantly correlated with the concomitant decrease in body fat, the increase in lean body weight and the age of the subjects. Body weight and reported dietary intake on the other hand, did not change significantly over this period. These results indicate that the decrease in fasting serum insulin in previously sedentary men with physical training is associated with the concomitant changes in body composition. Increased muscle tissue in particular may contribute to this training‐induced decrease in serum insulin.
Fat metabolism following an intravenous bolus dose of a fat emulsion and carnitine
Authors: Cederblad G.
Published: April 2008

Summary. Intravenous fat tolerance tests were performed with (carboxyl‐14C)‐triolein labelled Intralipid® in four normal subjects with and without L‐carnitine administration, 20 and 25 mg/kg body weight. The pharmacokinetics of L‐carnitine was studied simultaneously with measurements of variables reflecting fat metabolism during 4 h. 3‐OH‐butyrate concentration in plasma was higher in all subjects when carnitine was given. No effect of carnitine was found in elimination of the exogenous triglycerides, the 14CO2 activity in expired air, concentration and specific radioactivity of non‐esterified fatty acids or glucose in plasma.

The data suggest that carnitine may slightly increase fatty acid oxidation in normal subjects provided that increase of 3‐OH‐butyrate concentration in plasma is the most sensitive variable reflecting fatty acid oxidation of the variables applied in this study.
Methodological variation in systolic time intervals
Authors: Mustonen Juha , Uusitupa Matti , Selkäinaho Kalevi , Länsimies Esko
Published: April 2008

Summary. Systolic time intervals (STI) were recorded six times in 12 male students. All 72 recordings were measured twice by a physician and once by two nurses. By comparing these measurements an intra‐ and interobserver (= methodological) variation was obtained. For measured parameters (QS2‐ interval and LVET) variation was less than 2%. For calculated parameters the variation was larger, but did not reach the level of statistical significance. Methodological variation was smaller than physiologic variation. The internal consistency was almost perfect for measured parameters and only slightly worse for calculated parameters.
Renal blood flow and metabolism after cold ischaemia: peroperative measurements in patients with calculi
Authors: Henriksen Jens H. , Petersen Hans K.
Published: April 2008

Summary. Peroperative measurements of renal blood flow (RBF), renal O2,‐uptake, and renal venous lactate/pyruvate (L/P) ratio were performed before and after a period of 30–71 min of hypothermic (10–15°C) renal ischaemia in nine patients, undergoing surgery for renal calculi. Before ischaemia, RBF correlated inversely to arterial‐renal venous O2,‐difference (r = ‐0·74, P < 0·05, n= 9) and directly to the preoperatively estimated unilateral glomerular filtration rate (r = 0·76, P < 0·05, n= 8). After hypothermic ischaemia RBF decreased on the average by 42% (P < 0·01) immediately after re‐established perfusion and 36% (P < 0·02) 30 min later. In one additional patient, who had a short warm ischaemia (8 min), the flow pattern was the same. As arterial pressure remained constant, the reduced RBF signifies an increased renal vascular resistance. Renal O2,‐uptake and renal venous L/P ratio were almost constant, indicating no significant anaerobic processes being involved in the flow response. None of the patients showed any signs of reactive hyperaemia.

It is concluded that hypothermic renal ischaemia may be followed by an increased renal vascular resistance even when signs of anaerobic metabolism are sparse or absent. This conception is in contrast to that gained from previous animal experiments where anaerobic processes are kept responsible for the changes. The mechanism behind the described response is unknown, but the changes are probably reversible.
Quantification of heart valve regurgitation: a critical analysis from a theoretical and experimental point of view
Authors: Wranne Bengt , Ask Per , Loyd Dan
Published: April 2008

Summary. . A theoretical analysis is presented regarding factors of importance for the determination of distance of intrusion of the regurgitant jet in heart valve regurgitation. The analysis is based on hydrodynamic theory. In the idealized model situation, for a circular hole, the intrusion of the regurgitant jet is linearly related to the product of the fluid mean velocity in the orifice and the diameter of the orifice. This was also shown to be true in an experimental fluid model.

Thus, volume regurgitation cannot be quantified by the measurement of distance of intrusion of the regurgitant jet alone. On the other hand, an estimate of volume regurgitation can, in the idealized situation, be obtained if mean fluid velocity in the orifice, distance of intrusion of the jet and regurgitation time are known.
The influence of transducer position on the M‐mode echocardiographic measurement of the left atrial dimension
Authors: Höglund C.
Published: April 2008

Summary. Eighty‐five subjects were investigated to see if the left atrial dimension (LAD) determined by M‐mode echocardiography varies with different placements of the transducer in the parasternal long‐axis view. Satisfactory images from the third and fourth intercostal spaces were obtained in all subjects. A satisfactory image from the second, third and fourth intercostal spaces was obtained in 58 subjects and from the third, fourth and fifth intercostal spaces in 27 subjects.

The mean LAD was significantly smaller (P<0–001) in the fourth intercostal space than in the third. The mean value obtained from the fifth intercostal space was smaller than that from the fourth.

The beam pathway seen on the two‐dimensional echocardiogram indicates that the transducer should preferably be placed in the third intercostal space. If the transducer is placed in a lower intercostal space the measured left atrial dimension might be underestimated.