bluuebunny/crossref_metadata_2025 huggingface dataset:
A Rare Insertion Site for Abductor pollicis longus and Extensor pollicis brevis Muscles
Authors: Aydınlıoğlu A. , Şakul B.U. , Dıyarbakırlı S.
Published: April 2003

During an investigation performed on cadaver forearms in the anatomy department, an unusual insertion of the abductor pollicis longus (APL) muscle together with the extensor pollicis brevis (EPB) muscle was encountered unilaterally in a 40-year-old male cadaver forearm. APL originated from the posterior ulnar surface distal to the anconeus, the adjoining interosseous membrane and middle third of the posterior radial surface. It lay distal to the supinator muscle and close to the EPB, while the EPB arose from the posterior radial surface and from the adjacent interosseous membrane. These muscles were inserted to the palmar side of the base of the first metacarpal bone together. To our knowledge, this variation has not been cited in recent medical literature.
Successful Allogeneic Bone Marrow Transplantation
Authors: Ikehara Susumu
Published: April 2003

We have previously found that a major histocompatibility complex (MHC) restriction exists between pluripotent hemopoietic stem cells (P-HSCs) and stromal cells. Based on this finding, we have recently found using chimerism-resistant mouse combinations that successful allogeneic (allo) BMT can be executed by recruiting donor bone marrow stromal cells. The strategies include donor bone grafts under the skin, injection of whole bone marrow cells (BMCs) including stromal cells via the portal vein (PV), and injection of whole BMCs directly into the bone marrow cavity (intra-bone marrow [IBM] injection). In this paper, we show how stromal cells play crucial roles in overcoming chimerism-resistant allo BMT.
Thrombotic Complications of Central Venous Catheters in Cancer Patients
Authors: Monreal Manuel , Davant Ester
Published: April 2003

Today many patients with cancer have indwelling long-term central venous catheters. Benefits from catheter use include increased ease of administration of either chemotherapy or other drugs. However, these patients are prone to a number of complications, including deep venous thrombosis (DVT) and infection. Two kinds of catheter-related thrombi may develop: sleeve thrombi developing on the outside of intravenous catheters and occlusive DVT. Recent studies have demonstrated that the prevalence of pulmonary embolism in patients with arm DVT is high, and it is close to that observed in cohorts of patients with lower-extremity DVT. Accordingly, some kind of prophylaxis seems to be warranted. Furthermore, patients with confirmed catheter-related DVT should receive long-term anticoagulant therapy.
Antioxidant Status in Patients with Cystic Fibrosis
Authors: Madarasi A. , Lugassi A. , Greiner E. , Holics K. , Biró L. , Mozsáry E.
Published: April 2003

Background: The aim of the study was to assess the antioxidant status in cystic fibrosis (CF) patients compared to healthy controls. In order to determine the influence of nutrition on the level of the antioxidants, nutrient intake was also monitored in both groups at the time of the antioxidant assessment. Subjects and Methods: The authors measured the serum malondialdehyde levels in children with CF, n = 21; 9 females and 12 males, mean age: 8.71 years (6–12 years) and compared these values to the levels found in age-matched healthy control subjects, n = 24; 13 females and 11 males, mean age: 8.33 years (6–12 years). In order to assess the antioxidant status, catalase and superoxide dismutase activities in washed erythrocytes, glutathione peroxidase activity of heparinized whole blood and serum ascorbic acid, α-tocopherol and retinol levels were measured. Total antioxidant status (TAS) was also tested. The patients with CF received vitamin supplementation in doses prescribed in international guidelines (α-tocopherol: <10 years 100 mg daily, >10 years 200 mg daily, retinol: 2.5 mg daily, ascorbic acid: 100–200 mg daily). Results: Plasma levels of malondialdehyde were significantly higher (p < 0.05), superoxide dismutase activities were significantly lower (p < 0.05) in patients with cystic fibrosis. There were no significant differences in catalase, glutathione peroxidase activities and TAS levels between CF patients and control group. Plasma ascorbic acid, α-tocopherol and retinol levels were within normal limits in both groups. Conclusion: On the basis of the present results this regime failed to provide sufficient antioxidant protection. Therefore, the authors suggest that the daily dose of these antioxidants should be either increased or to administer in parenteral route to patients with severe form of the disease.
Lipoic Acid Prevents Suppression of Connective Tissue Proliferation in the Rat Liver Induced by n–3 PUFAs
Authors: Arend Andres , Zilmer Mihkel , Vihalemm Tiiu , Selstam Gunnar , Sepp Ennu
Published: April 2003

As previously shown, dietary n–3 polyunsaturated fatty acids (n–3 PUFAs) suppress connective tissue proliferation in the rat liver wound concurrent with an elevated level of lipid peroxidation. The present study was undertaken to investigate the influence of α-lipoic acid (LA), a natural anti-oxidant, on these effects of n–3 PUFAs. Rats were fed with a commercial pellet diet (control group) or with diets enriched with 10% of sunflower oil (n–6 group) or 10% of fish oil (n–3 group) for 8 weeks followed by addition of LA to the same diets for 10 days. Then a liver thermic wound was induced and the administration of LA was continued for 6 days. The proliferation of the connective tissue, the level of lipid peroxidation and their peroxidizability and the content of prostaglandins E2 and F2α were measured in the liver wounds. LA prevented the suppression of connective tissue proliferation in the healing wound induced by n–3 PUFAs, avoided the increase in peroxidation of lipids, reduced peroxidizability of lipids and modulated the decrease in PGE2 and PGF2α. The results indicate that dietary LA may prevent the suppression of liver wound healing induced by n–3 PUFAs.
Contribution of Ready-to-Eat Cereals to Nutrition Intakes in French Adults and Relations with Corpulence
Authors: Bertrais Sandrine , Polo Luque Maria Luz , Preziosi Paul , Fieux Bernadette , Torra de Flot Maria , Galan Pilar , Hercberg Serge
Published: April 2003

Aims: The nutrient impact of ready-to-eat (RTE) cereal consumption was assessed in adults (men 45–60 years; women 35–60 years old) who regularly consumed RTE cereals anytime during the day, compared to those who did not or who were occasional eaters. Methods: Data were obtained for 2,188 men and 2,851 women living in France and participating in the SU.VI.MAX cohort, who reported twelve 24-hour dietary records during 2 years of follow-up (60,468 records). Results: In the heavy consumers group, RTE cereals provided 193 kcal/day for men and 168 kcal/day for women and contributed 8–10% of total daily energy intake; 15–17% of total daily carbohydrates intake; 4% of total daily lipids intake; 5–6% of total protein intake; and 19–23% of total fiber intake. Moreover, RTE cereals contributed 20–30% of total daily intake for vitamins B1, B2, B6 and folic acid, and 7% for vitamin B12. For minerals, they provided, respectively, for men and women, 22 and 25% of total daily intake for iron, 12 and 14% for magnesium, and 4% for calcium. In both genders, heavy consumers of RTE cereals derived a greater proportion of daily energy from carbohydrates and a lesser proportion of energy from fats. Total daily fiber intake is higher for RTE cereal consumers than for nonconsumers and increases with the frequency of consumption. Frequent consumers of RTE cereals have higher dietary intakes of calcium, magnesium, iron, vitamins B1, B2, B6, and folic acid than do nonconsumers. BMI and waist/hip ratio were significantly lower in heavy consumers of RTE cereals than in nonconsumers. Conclusion: The present data suggest that the consumption of RTE cereals contributes to a balanced diet. The strong association between cereal consumption and vitamin and mineral intakes confirm previous studies suggesting that RTE cereals make a major contribution to micronutrient intakes. The consumption of RTE cereals also appears to be associated with lower corpulence.
Role of Plant-Derived Omega–3 Fatty Acids in Human Nutrition
Authors: Crawford Michael , Galli Claudio , Visioli Francesco , Renaud Serge , Simopoulos Artemis P. , Spector Arthur A.
Published: April 2003

An international workshop on the role of plant-derived omega–3 fatty acids in human nutrition took place in Milan on February 9, 2000. The meeting was sponsored by the Nutrition Foundation of Italy and was organized by its Scientific Director, Dr. Andrea Poli. It was attended by experts in polyunsaturated fatty acids and human lipid nutrition. This is the first meeting devoted to the health aspects of alpha-linolenic acid, the omega–3 fatty acid contained in plant-derived edible products, as distinct from the more widely studied long-chain omegy–3 products typically present in fish and fish-derived products. This report, which is based on updated scientific evidence presented and discussed at the workshop, was prepared by the international expert panel.
Effects of Long-Chain Monounsaturated and n-3 Fatty Acids on Fatty Acid Oxidation and Lipid Composition in Rats
Authors: Halvorsen B. , Rustan A.C. , Madsen L. , Reseland J. , Berge R.K. , Sletnes P. , Christiansen E.N.
Published: April 2003

Long-chain n-3 fatty acids and fat fish are reported, among multiple physiological properties, to enhance peroxisomal β-oxidation and effect triacylglycerol status. Long-chain n-3 and monounsaturated fatty acids are the main portion of fatty acids in fat fish. The individual effect of long-chain monounsaturated fatty acids on β-oxidation and fatty acid composition was tested and compared to the effect of n-3 polyunsaturated and saturated fatty acids in a 3-week feeding experiment of rats. To explore the contribution from long-chain monounsaturated fatty acids in these aspects, the effect of long-chain n-3 and monounsaturated fatty acids on mitochondrial and peroxisomal β-oxidation was compared, as well as fatty acid composition of adipose tissue, liver and serum. Fatty acid oxidase, palmitoyltransferase I and II activities, the amount of serum lipids, and the fatty acid composition of lipid fractions from the organs were analysed. The peroxisomal β-oxidation was enhanced by the n-3 fatty acids, whereas a small, significant increase with the monounsaturated fatty acids was observed. There was a stimulation of the mitochondrial oxidation with the n-3 fatty acids, but monounsaturated fatty acids gave a small, nonsignificant decrease. With n-3 fatty acids there was a considerable decrease in the levels of serum triacylglycerol, phospholipids, free fatty acids and total cholesterol, while there were only minor effects of monounsaturated fatty acids. As judged from the fatty acid composition data, there was a mobilization on n-3 fatty acids from the adipose tissue to liver and plasma with the n-3 diet. This observation was also seen with the monounsaturated fatty acid-enriched diet. In conclusion, monounsaturated fatty acids seemed to stimulate peroxisomal β-oxidation and to increase plasma triacylglycerol, whereas the mitochondrial oxidation was slightly decreased.
Body Fat Distribution and Total Body Fat as Risk Factors for Microalbuminuria in the Obese
Authors: Mulyadi Lufiani , Stevens Clair , Munro Sue , Lingard Jennifer , Bermingham Margaret
Published: April 2003

Background/Aim: Despite evidence linking type of obesity with subsequent organ malfunction, such a link with renal malfunction has not been widely researched. The aim of this study was to investigate percentage of total body fat (%TBF), and body fat distribution in relation to the renal function in overweight/obese subjects. Methods: Body mass index (BMI), waist-to-hip ratio (WHR), TBF (by bioelectric impedance), and albumin excretion rate (AER) were determined in 77 subjects: 48 overweight/obese (BMI ≧27.8 for men and ≧27.3 for women) and 29 controls (BMI <27.8 for men and <27.3 for women). Obese subjects were subdivided into those (n = 33) with central fat distribution (WHR ≧0.81 for women and ≧0.92 for men) and those (n = 15) with peripheral fat distribution (WHR <0.81 for women and <0.92 for men). Results: Obesity, irrespective of type, was significantly related to increased AER. Furthermore, in subjects who did not differ in %TBF, the age-adjusted relative risk of abnormal AER was 18 times greater in centrally obese subjects as compared with controls, while only four times greater in peripherally obese subjects. Conclusion: A significant difference in risk of renal malfunction was observed in individuals having the same %TBF, but differing in the distribution of this fat, with a central fat pattern being the greater risk.
Effect of Saturated Fatty Acid Consumption on Energy and Nutrient Intake and Blood Lipid Levels in Preschool Children
Authors: Ortega Rosa M. , Requejo Ana M. , Navia Beatriz , López-Sobaler Ana M. , Andrés Pedro , Perea José M. , Faci Marta , Mena M. Carmen
Published: April 2003

In this article the effects of saturated fatty acid (SFA) consumption on energy and nutrient intake, and on a range of serum lipid parameters (indicators of cardiovascular risk) are reported in a group of 110 preschool children. Subjects were divided into 2 groups: high consumption (HC), in which ≧13% (20th percentile) of total energy came from SFAs, and low consumption (LC), in which SFAs provided <13% of energy intake. Food intake was monitored for 7 consecutive days. At participating day care centers, a ‘precise individual weighing’ method was used, while a ‘food intake record’ was kept for foods taken at home. At the blood level it was found that HC subjects showed higher HDL-cholesterol levels and better HDL-cholesterol/LDL-cholesterol ratios than did LC subjects. The greater intakes of riboflavin, iodine, zinc, magnesium and calcium seen in HC subjects suggest that these may have a better nutritive status (with respect to certain nutrients) than LC subjects. The development of criteria for providing the greatest protection against cardiovascular disease, while maintaining good nutritive condition, should be the subject of future studies. This is especially important in children of preschool age since nutritional deficiencies at this stage in life can have important effects on growth and health.
The Foods Most Consumed by German Children and Adolescents: Results of the DONALD Study
Authors: Alexy Ute , Sichert-Hellert Wolfgang , Kersting Mathilde , Manz Friedrich
Published: April 2003

Background: For a successful nutrition counseling of children and adolescents, knowledge of dietary habits is mandatory. This report describes food group intake and gives details of the customary food selection of healthy German children and adolescents. Main foods which are consumed in large amounts were identified as those on which health promotion should be concentrated. Methods: 3-day weighed dietary records of 344 children (age range 4–6 years) and 92 adolescents (age range 13–14 years) concerning the period 1990–1997 of the DONALD Study (Dortmund Nutritional and Anthropometric Longitudinally Designed Study) were evaluated. Results: The number of different foods recorded during the 3-day observation period ranged from 21 to 70 and was independent of age or sex. In contrast to dietary guidelines, the consumption of animal foods and ’fats/oils’ exceeded the consumption of plant foods with the exception of adolescent girls. Food selection was very similar in age and sex groups. Conclusion: Our study shows that under preventive aspects the current food selection could be improved without disturbing the prevailing dietary habits and food preferences.
Nutritional Disorders among Workers in North China during National Turmoil
Authors: Lee Benjamin Y. , Thurmon Theodore F.
Published: April 2003

Previously undescribed disorders of nutrition of thiamin, niacin and pyridoxin were observed among the poor people of North China during periods of prolonged deprivation. These disorders were often elicited or exacerbated by physical exertion. Thiamin deficiency syndromes included great toe pain, heel pain, temporomandibular joint click, and painful click of the knee. Syndromes of niacin deficiency included pellagral scrotal dermatitis, hypersecretion of ear wax, and night terrors. Episodic nocturnal motor hyperfunction was caused by pyridoxin deficiency. Several cases with cardiovascular diseases were observed in which nutritional debt appeared to occur simultaneously with oxygen debt following severe physical labor. Intramuscular thiamin HCl ameliorated symptoms of impending stroke. Persons with the same symptoms who did not receive thiamin progressed to fatal stroke.
Plasma Folate but Not Vitamin B12 or Homocysteine Concentrations Are Reduced after Short-Term Vitamin B6 Supplementation
Authors: Bosy-Westphal Anja , Holzapfel Anja , Czech Norbert , Müller Manfred J.
Published: April 2003

Adverse effects of high vitamin B6 intake include peripheral neuropathy. Recent studies focussing on the reduction of plasma homocysteine as a risk factor for vascular disease showed that vitamin B6 reduces plasma folate levels. The significance of this finding is unclear. We therefore analyzed plasma folate and basal homocysteine levels as well as the response to an oral methionine loading test in 8 healthy individuals before and after a controlled supplementation with oral doses of 25 mg pyridoxine for 10 days. Plasma pyridoxal phosphate increased from 40.6 ± 13.6 to 426.8 ± 200.3 nmol/l (p < 0.001), whereas plasma folate decreased from 6.3 ± 1.6 to 4.6 ±1.5 ng/ml (p < 0.01), respectively. Plasma vitamin B12 and basal homocysteine levels remained unchanged (234.0 ± 27.8 vs. 217.1 ± 50.4 pg/ml and 10.9 ± 4.8 vs. 10.1 ± 3.6 µmol/l). There was no significant effect of vitamin B6 supplementation on the area under methionine and homocysteine concentration versus time curve. Significant correlations were found between pre- and post-supplement levels of folate as well as PLP levels (r = 0.73, p < 0.05; r = 0.75, p < 0.05). These data suggest that a dose of 25 mg vitamin B6 supplemented for 10 days reduces plasma folate but did not affect basal and postprandial homocysteine levels suggesting (1) a normal cellular availability of folate or (2) a compensation of impaired homocysteine remethylation by increased transsulfuration.
Supplementation of Areca catechu L. Extract Alters Triglyceride Absorption and Cholesterol Metabolism in Rats
Authors: Byun Sung-June , Kim Hee-Sook , Jeon Seon-Min , Park Yong Bok , Choi Myung-Sook
Published: April 2003

Areca extracts have already been found to exhibit a strong inhibitory activity on cholesterol absorption in high-cholesterol-fed rats. Accordingly, this study was performed to determine whether Areca extracts also exert an inhibitory activity on triglyceride absorption in triglyceride-fed rats. Male rats were fed a diet containing corn oil (10%, w/w) with or without an Areca nut extract supplement (0.5%, w/w). The supplementation of the Areca extract significantly lowered the absorption of triglyceride and the plasma lipid concentration. The absorbed triglyceride that appeared in the blood after an oral dose of [9,10(n)-3H] triglyceride was significantly lower in the rats supplemented with the Areca nut extract, compared with the control group. The supplementation also significantly lowered the small intestinal pCEase (pancreatic cholesterol esterase) activity by 22.5% compared to the control group. The hepatic and intestinal ACAT (acyl-CoA:cholesterol acyltransferase) activities were significantly decreased in the Areca group compared with the control group. Hence, further studies are needed to elucidate the structure and chemical properties of the active compound in the water-soluble Areca extract that lowers cholesterol absorption.
Effect of Heat-Treated Proteins on Selected Parameters of the Biotransformation System in the Rat
Authors: Wenzel E. , Tasto S. , Erbersdobler H.F. , Faist V.
Published: April 2003

The intake of heat-damaged proteins from food causes various effects, like the loss of essential amino acids and a reduced protein digestibility. There is also an influence on gastrointestinal microorganisms and different digestion enzymes. Until now, very little is known about the influence of heat-treated proteins on the enzymes of the biotransformation system. In the present study, the influence of protein-bound L-lysino-D,L-alanine, NΕ-fructoselysine, and NΕ-carboxymethyllysine (CML) on selected enzymes of the biotransformation in liver, kidney, and intestinal mucosa of male Wistar rats was examined. The contents of cytochrome P-450 and cytochrome b5 and the activity of NADPH-cytochrome c reductase served as indicators of phase I biotransformation. The influence on phase II biotransformation was shown by the content of glutathione and the glutathione S-transferase activity. The results showed that treatment with heat-damaged proteins mainly affected phase II biotransformation enzymes with CML, yielding the strongest effect. The activity of glutathione S-transferase in the kidney was 86% higher in animals treated with diets containing 4,930 mg·kg–1 protein-bound CML than in animals of the control group which received a diet without any detectable CML. In addition, a higher level of glutathione was found in the kidneys of animals fed on diets containing CML. The glutathione S-transferase activity was 64% higher in the intestinal mucosa of animals fed on protein-bound NΕ-fructoselysine (2,700 mg·kg–1). The glutathione S-transferase activity was higher (p >0.05) in the intestinal mucosa of animals fed on protein-bound L-lysino-D,L-alanine (2,582 and 12,474 mg·kg–1). In conclusion, ingestion of heat-treated proteins led to an activation of the enzymes of phase II biotransformation. Whether or not the released pure compounds or the degradation products of the test proteins are responsible for the altered enzyme activities remains to be evaluated.
Effect of either Gamma-Tocotrienol or a Tocotrienol Mixture on the Plasma Lipid Profile in Hamsters
Authors: Raederstorff D. , Elste V. , Aebischer C. , Weber P.
Published: April 2003

Background/Aims: Tocotrienols has been shown to inhibit the 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase activity; however, the published animal and human studies yield conflicting results. We investigated the effects of a 4-week dietary supplement of either γ-tocotrienol (86% γ-T3) or a mixture of tocotrienols (29.5% α-T3, 3.3% β-T3, 41.4% γ-T3, 0.1% δ-T3: mix-T3) on the plasma lipid profile in hamsters receiving a high fat diet. Methods: The hamsters were randomized into 7 groups: no treatment, 16 mg/day/kg BW simvastatin, 23, 58, 263 mg/day/kg BW γ-tocotrienol, and 39 or 263 mg/day/kg BW for the mixture of tocotrienols. Plasma lipid levels were measured after 2 and 4 weeks of treatment. Results: In all groups treated with tocotrienol total cholesterol levels were decreased, ranging from 7 to 23% after 2 weeks of treatment and from 7 to 15% after 4 weeks. Low-density lipoprotein plasma levels changed accordingly: a decline of 6–37% after 2 weeks and of 12–32% at the end of the study was observed. After 4 weeks of treatment, total cholesterol and low-density lipoprotein plasma levels were significantly reduced in the 263 mg/day/kg BW mixed tocotrienols and the 58 mg/day/kg BW and 263 mg/day/kg BW γ-tocotrienol groups when compared to the no treatment group. Plasma triglycerides and high-density lipoprotein levels did not change significantly. Conclusion: This study provides further evidence that tocotrienols lower total cholesterol and low density lipoprotein plasma levels in hamsters and that γ-tocotrienol is a more potent agent than a mixture of tocotrienols.
Role of Inflammation and Its Treatment in ESRD Patients
Authors: Kaysen George A.
Published: April 2003

As renal function declines, the prevalence of both malnutrition and cardiovascular disease increase. Both malnutrition and vascular disease correlate with the levels of markers of inflammation both in patients treated with dialysis and in those not yet on dialysis. While it is possible that the markers of inflammation (increased levels of C-reactive protein (CRP) or interleukin-6 (IL-6)) are a result of inflammation arising from the atherosclerotic process, changes in endothelial cell gene expression, in plasma protein composition and in lipoprotein structure that arise from inflammation are likely to be atherogenic. The causes of inflammation are likely to be multifactorial. CRP levels are associated with cardiovascular risk in the general population and decrease following treatment with HMG-CoA reductase inhibitors. It is speculated that use of these agents or directly suppressing inflammation may have use in treating the inflammatory-malnutrition syndrome in dialysis patients.
Vitamin D Analogs for the Treatment of Secondary Hyperparathyroidism
Authors: Slatopolsky Eduardo , Brown Alex J.
Published: April 2003

Calcitriol controls parathyroid gland (PTG) growth and suppresses the synthesis and secretion of PTH. However, because of its potent effects on intestinal calcium and phosphorus absorption and bone mobilization, calcitriol treatment can induce hypercalcemia and hyperphosphatemia often precluding its use at therapeutic doses. In the past decade, several vitamin D analogs have been developed. These analogs retain the action on the PTG while having less effect on calcium and phosphorus. Most of these analogs for the treatment of secondary hyperparathyroidism (SH) have a modification on the side chain of calcitriol. In the USA, two vitamin D analogs 19-nor 1,25(OH)2D2 and 1α(OH)D2 are currently used for the treatment of SH. Studies in animals demonstrated that 19-nor-1,25(OH)2D2 is less calcemic and phosphatemic than 1α(OH)D2. The lower Ca × P product in 19-nor-1,25(OH)2D2-treated rats may be an important consideration in patient therapy. Further studies in patients are necessary to define these differences.
Haemodialysis Hypotension and Nitric Oxide Production: Comparison of Heparin with Parnaparin
Authors: Arıcı Mustafa , Altun Bülent , Dinler Ozkan , Kıykım Ahmet A. , Usalan Celalettin , Erdem Yunus , Yasavul Ünal , Turgan Çetin , Çağlar Sali
Published: April 2003

Background: There is increasing evidence for the role of nitric oxide (NO) in haemodialysis hypotension but the source of elevated NO is still controversial. Heparin has been reported to enhance NO production by cultured human endothelial cells. The aim of this study was to compare the role of unfractionated heparin and low molecular weight heparin (LMWH, parnaparin) on mean arterial pressure (MAP) and NO production in haemodialysis patients with hypotensive episodes. Patients and Methods: Ten maintenance haemodialysis patients with hypotensive episodes were involved in this study. Patients were anticoagulated with heparin for 3 weeks and then switched to parnaparin for 3 weeks. Serum NO levels were analysed before starting dialysis, at the nadir of MAP during a haemodialysis session and at the end of dialysis in the last haemodialysis session of the 3rd week of each anticoagulation treatment. Results: NO levels were 39.4 ± 13.2 µM at the beginning of haemodialysis, 92.4 ± 31.4 µM during hypotensive episode and 43.1 ± 25.1 µM at the end of dialysis with heparin treatment (p < 0.05). In the parnaparin period, NO levels were 47.2 ± 22.7 µM at the beginning, 80.7 ± 46.5 µM during the hypotensive episode and 45.8 ± 23.2 µM at the end of the session (p < 0.05). The percent increase in NO levels during the hypotensive period compared to that at the beginning of haemodialysis with heparin was significantly higher than that with parnaparin (140.2 ± 50.4 vs. 119.6 ± 44.8%; p < 0.05). The percent decrease in MAP with heparin use was also significantly higher than with parnaparin use (48.6 ± 6.4 vs. 39.6 ± 5.3%; p < 0.05). Conclusion: We have observed that MAP decrements and NO increases were less manifest during hypotensive episodes with parnaparin treatment compared to heparin. This difference may be related to differences in endothelial binding capacity, thrombin affinity and/or effects on platelet functions of unfractionated heparin and LMWHs.
Functional Roles and Structural Analysis of Lung Collectins SP-A and SP-D
Authors: Kuroki Yoshio , Sano Hitomi
Published: April 2003

Pulmonary surfactant proteins A and D (SP-A and SP-D) belong to the collectin subgroup of the C-type lectin superfamily along with mannose-binding protein (MBP) and conglutinin. Phospholipids are also ligands for collectins, in addition to carbohydrates and glycosphingolipids. SP-A binds dipalmitoylphosphatidylcholine, and SP-D and MBP bind phosphatidylinositol. SP-A also interacts with alveolar type II cells, implicating SP-A in surfactant phospholipid homeostasis. We analyzed an epitope for anti-SP-A monoclonal antibodies that block SP-A-specific functions using a phage display peptide library and SP-A/MBP chimeric proteins. We also investigated the regions of SP-A and SP-D that are required for ligand interactions using SP-A/SP-D chimeras. Lung collectins play key roles in the innate immune system of the lung which is critical for immediate antibody-independent host defense. We have found that SP-A exhibits different interactions with distinct serotypes of lipopolysaccharides and affects differently their elicited cellular responses by a direct interaction with the lipopolysaccharide receptor CD14. In addition to the basic aspects, lung collectins as clinical markers will be discussed.
Fatty Acid Composition of Human Colostrum in Slovenian Women Living in Urban and Rural Areas
Authors: Fidler Nataša , Salobir Karl , Stibilj Vekoslava
Published: April 2003

Colostrum samples were collected on the third day postpartum from 41 Slovenian women living in urban (n = 27) or rural (n = 14) areas. The fatty acid composition of total lipids, analysed by capillary gas-liquid chromatography, was very similar in women from both areas. The only difference was a higher content of oleic acid (18:1n–9) in rural vs. urban areas (36.85 vs. 34.94 wt%, p < 0.05). The fatty acid composition of colostrum lipids in Slovenia was as follows (mean wt%): saturated 37.68, monounsaturated 40.49, polyunsaturated 21.82, linoleic acid (18:2n–6) 15.25, α-linolenic acid (18:3n–3) 0.91, docosahexaenoic acid (22:6n–3) 0.43 and arachidonic acid (20:4n–6) 1.03. The ratio of polyunsaturated to saturated fatty acids was 0.58 and the ratio of n–6 to n–3 fatty acids was 8.0. Compared to published data on the colostrum fatty acid composition in other European, American and Asian countries, colostrum from Slovenian women is most similar to Spanish and French colostrum, probably due to a similar fatty acid composition of dietary lipids.
Can Anesthesiologic Strategies for Caesarean Section Influence Newborn Jaundice?
Authors: De Amici Donatella , Delmonte Paola , Martinotti Lucia , Gasparoni Antonella , Zizzi Silvia , Ramajoli Isabella , Ramajoli Felice
Published: April 2003

Rationale and Objectives: Neonatal jaundice is a frequent problem in neonatology and can be influenced by many factors. Our study arose from the clinical observation that among all newborns delivered by caesarean section in our center, some had a more intense physiological jaundice. We began by reviewing clinical anesthesiological case-sheets to ascertain whether this difference was linked to the use of different anesthesiologic strategies. We then performed a prospective study on healthy preterm and term newborns to verify this hypothesis. Study Design: We retrospectively considered all healthy term newborns with weight >2,400 g delivered by caesarean section from January 1998 to May 1999. In the prospective studies we included healthy term and preterm newborns consecutively delivered by caesarean section from May 1999 to December 1999. We excluded preterm newborns with gestational age <31 weeks and with weight <1,400 g. Results: Both in retrospective and in prospective studies anesthetic agents employed were isoflurane (A), sevoflurane (B), or bupivacaine (C). The statistical comparison of the three groups in retrospective study confirmed the clinical observation: the total bilirubin levels were significantly higher in the isoflurane group than in the sevoflurane group (p = 0.0000) and bupivacaine group (p = 0.0002). Analysis of data from the prospective study on term newborns confirmed our previous results. In preterm infants total bilirubin is statistically higher in group A starting from 96 h postdelivery. Conclusions: It is likely that anesthetic technique can be included among factors with possible influence on neonatal jaundice.
Immaturity or Starvation? Longitudinal Study of Leptin Levels in Premature Infants
Authors: Spear Michael L. , Hassink Sandra G. , Leef Kathleen , O’Connor Darlise M. , Kirwin Susan M. , Locke Robert , Gorman Robert , Funanage Vicky L.
Published: April 2003

Objective: Leptin, the protein product of the ob gene, is a potential placental growth factor and is integral to the body’s system of energy regulation as shown in animal models. Premature infants are especially vulnerable to changes in energy regulation, and several studies have demonstrated a rapid fall in leptin values at birth. The purpose of the present investigation was to measure leptin levels in premature infants throughout hospitalization. Methods: Eligible infants were less than 32 weeks’ gestation, appropriate for gestational age, and hospitalized at Christiana Hospital Special Care Nursery. Serum samples for leptin analysis were drawn within 24 h of birth and twice a week thereafter until discharge. Concurrent growth measurements were obtained with each leptin sample. Body mass index, ponderal index, and midarm circumference/head circumference ratios were calculated to assess growth. Results: Leptin levels were low and remained low for the duration of the premature infants’ hospitalization (mean ± SD = 1.35 ± 0.63 ng/ml/ml, range 0–3.06). After controlling for weight, there was a small (r2 = 0.1, p < 0.00001) but significant correlation between leptin and postnatal age after 4 days of age. Despite an increase in caloric intake during the study period, there was no relationship between leptin and caloric intake. There were significant negative correlations between measurements of growth and both leptin and the leptin/weight ratio. Maternal diabetes and the use of steroids had small but significant effects on the leptin/weight ratio. Conclusion: In this population of predominantly female premature infants, leptin levels were very low as compared to term infants, children and adults, and did not change appreciably over the study period. The low leptin levels seen in these premature infants are similar to those levels seen in malnourished adults, anorexics, and in animal models of starvation. We speculate that a critical adipose store needs to be reached before increased amounts of leptin can be adequately produced. Persistently low leptin levels may also reflect an immaturity in the hypothalamic-pituitary-adrenal axis.
Inflammatory Mediators in Umbilical Plasma from Neonates Who Develop Early-Onset Sepsis
Authors: Døllner Henrik , Vatten Lars , Linnebo Ingjerd , Zanussi Gro Flatabø , Lærdal Åge , Austgulen Rigmor
Published: April 2003

Objectives: To study whether early-onset neonatal sepsis is associated with a prenatal immune response with elevated umbilical plasma levels of inflammatory mediators, and to study whether mediator levels may be helpful in identifying infected neonates. Setting: Nested case-control study. Methods: Cord blood was sampled from 7,073 consecutively delivered neonates. After review of the medical records, neonates suspected to suffer from infection were classified as infected (n = 52) or noninfected but sick controls (n = 33). We also included a group of healthy controls (n = 99). Umbilical plasma levels of tumour necrosis factor-α (TNFα), interleukin (IL)-1β, IL-6, IL-8, soluble TNF receptors (p55 and p75), IL-1 receptor antagonist (IL-1RA) and C-reactive protein were measured by immunoassays. Results: Infected neonates had higher levels of TNFα, IL-1β, IL-6, IL-8, p55, p75 and IL-1RA than healthy controls (all p < 0.01). Among preterm infants (GA <37 weeks), those with infection (n = 11) had higher levels of IL-1β, IL-6, IL-8, p55 and p75 than noninfected sick controls (n = 13) (all p < 0.05), but among term infants, the infected did not differ from the noninfected sick controls. Receiver operator characteristic plots showed that IL-1β, IL-6 and IL-8 identified preterm infected neonates accurately. Conclusions: Early-onset neonatal sepsis is associated with a prenatal immune response with increased TNFα, IL-1β, IL-6, IL-8, p55, p75 and IL-1RA levels in umbilical plasma. Among neonates who present symptoms suggestive of infection, cytokine levels may be helpful in identifying preterm, but not term infected individuals.
Antenatal Terbutaline Administration Decreases the Lung Hyaluronan Concentration in Preterm Rabbit Pups
Authors: Johnsson Hans , Eriksson Lars , Sedin Gunnar
Published: April 2003

Objectiv: To determine whether antenatal exposure to terbutaline alters the lung hyaluronan concentration or lung water content at birth in preterm rabbit pups. Study Design: Rabbit dams (n = 18) with timed pregnancies were injected with 30 µg terbutaline or saline (controls) one day before delivery at 27–29 days of gestation. Pups were killed immediately after delivery. Lung water content and hyaluronan concentrations were determined. Results: Pups exposed antenatally to terbutaline had lower mean lung hyaluronan concentrations than control pups. Lung hyaluronan/dry lung weight was significantly lower in pups delivered at 28 (p = 0.034) or 29 days (p < 0.001), while lung hyaluronan/wet lung weight was significantly lower at all three gestational ages. Conclusion: Antenatal exposure to terbutaline lowers the lung hyaluronan concentration at birth in preterm (27–29 days) rabbit pups without altering the lung water content.
CD14 Receptor Expression and Lipopolysaccharide-Induced Cytokine Production in Preterm and Term Neonates
Authors: Bessler H. , Komlos L. , Punsky I. , Ntambi J.A. , Bergman M. , Straussberg R. , Sirota L.
Published: April 2003

CD14 expression and the capacity of mononuclear cells (MC) from preterm and term neonates to secrete the proinflammatory cytokines interleukin (IL) 1β, tumor necrosis factor α and IL-6 in response to lipopolysaccharide (LPS) was investigated and compared to that of adults. MC were incubated with various doses of LPS, and the cytokine level in the supernatants was tested. CD14 receptors on MC and the intensity of their expression were analyzed. MC of preterm and term neonates and adults responded to LPS with low, medium and high proinflammatory cytokine production, respectively. CD14 expression was lowest in preterm infants, intermediate in term infants and highest in adults. The difference between term and preterm neonates for both parameters was significant. The results suggest a possible correlation between the lower expression of CD14 receptor on neonatal cells and the reduced secretion of proinflammatory cytokines by these cells. This decreased production may possibly contribute to the low ability of neonates to develop fever.
Cytochrome P450 3A Expression in the Human Fetal Liver: Evidence that CYP3A5 Is Expressed in Only a Limited Number of Fetal Livers
Authors: Hakkola Jukka , Raunio Hannu , Purkunen Raija , Saarikoski Seppo , Vähäkangas Kirsi , Pelkonen Olavi , Edwards Robert J. , Boobis Alan  R. , Pasanen Markku
Published: April 2003

CYP3A is the major cytochrome P450 subfamily constitutively expressed in the human liver. CYP3A4 is the predominant hepatic P450 form in adults and it is expressed at high but very variable levels among individuals. The fetal liver contains mainly CYP3A7, while the presence of the other CYP3A enzymes in fetal liver has remained controversial. In this study, the relative levels of CYP3A4, CYP3A5 and CYP3A7 expression were determined in a panel of 9–11 fetal livers with a similar gestation age (9–12 weeks) and compared to adult livers. CYP3A7 was found to be the major CYP3A form in all the fetal liver samples. The abundance of CYP3A7 varied more at the mRNA (77-fold variation) than at the protein level (4.8-fold variation). CYP3A5 mRNA was also detected in all of the fetal liver samples, but the average level was 700-fold lower than that of CYP3A7. CYP3A5 protein was detected by immunoblot analysis in only 1 fetal liver out of the 9 investigated, the level of expression being moderately high in this sample. CYP3A4 mRNA was detected in only a subset of the fetal liver samples and its level was the lowest of the CYP3A forms. This is the first study to demonstrate the polymorphic expression of CYP3A5 and the variability of CYP3A7 expression in fetal liver and suggests that significant interindividual differences in the metabolism of xenobiotics may already exist at the prenatal stage. These differences may contribute to individual pharmacological and/or toxicological responses in the fetus.
Alcohol and Breast Feeding: Calculation of Time to Zero Level in Milk
Authors: Ho Elaine , Collantes Alexis , Kapur Bhushan M. , Moretti Myla , Koren Gideon
Published: April 2003

Objective: To create a nomogram that will guide lactating women who drink socially on how to avoid neonatal exposure to ethanol through breast milk. Design: Pharmacokinetic modeling of ethanol elimination from milk based on reference values. Calculation of the time to zero alcohol in breast milk for a range of doses and body weights. Results: The elimination of alcohol and time-to-zero levels in breast milk are described in a nomogram as a function of the amount of alcohol consumed and the body weight of the woman. Conclusions: Careful planning of a breast feeding schedule, by storing milk before drinking and/or waiting for complete alcohol elimination from the breast milk, can ensure women that their babies are not exposed to any alcohol.
Alterations in Lymphocyte Phenotype of Infected Preterm Newborns
Authors: Juretić E. , Juretić A. , Užarević B. , Petrovečki M.
Published: April 2003

The cord blood lymphocytes from 44 premature newborns were analyzed using two-color monoclonal antibodies and flow cytometry. Depending on whether or not there was an infection at birth, the newborns were divided into two groups and the immunophenotypes of infected and uninfected newborns were compared. The percentage of T lymphocytes (CD3+) was significantly lower in the infected prematures. The percentage of both helper and cytotoxic T lymphocytes was lower. The proportion of activated T lymphocytes, cytotoxic non-MHC-restricted T lymphocytes, NK cells and B lymphocytes did not differ between the group of infected and the group of uninfected prematures. The percentage of memory helper T lymphocytes (CD45RO+CD4+) was very low in premature newborns regardless of whether or not they were infected and could not be used as a marker of bacterial infection at this age.
Chronic Exposure to Cigarette Smoke Extract Impairs Endothelium-Dependent Relaxation of Chicken Embryo Pulmonary Arteries
Authors: Carlo Waldemar F. , Villamor Eduardo , Ambalavanan Namasivayam , DeMey Jo G.R. , Blanco Carlos E.
Published: April 2003

Maternal smoking may increase the risk for various adverse neonatal outcomes including persistent pulmonary hypertension of the newborn (PPHN). We investigated whether chronic prenatal cigarette smoke extract (CSE) exposure could produce abnormal vasoreactivity in pulmonary arteries. Daily injections of CSE (diluted in phosphate buffered saline) or vehicle were added to the air cells of fertilized eggs starting on day 5 of the 21-day incubation period of the chicken embryo. On day 19, pulmonary arteries were dissected out and their contractile properties were assessed using small vessel myography. Endothelium-dependent and endothelium-independent vasorelaxations were examined by using acetylcholine (ACh, 10–8 to 10–4M) and sodium nitroprusside (SNP, 10–8 to 10–4M), respectively. The drug concentration inducing 50% of the maximal relaxation was determined for each concentration-response curve and expressed as negative log molar (pD2). Exposure to CSE significantly decreased the sensitivity of pulmonary arteries to ACh (pD2 control group: 7.29 ± 0.24; pD2 CSE-exposed group 6.24 ± 0.12, p < 0.05). SNP elicited similar responses in vessels of both groups at all tested concentrations. In conclusion, chronic prenatal exposure to CSE impaired endothelium-dependent but not endothelium-independent vasodilation in chicken embryo pulmonary arteries. This observation suggests that cigarette smoke components may produce deleterious effects on fetal vascular endothelial vasorelaxant pathways, leading to the development of adverse outcomes such as PPHN.
Effects of Macrophage Colony-Stimulating Factor on Antifungal Activity of Neonatal Monocytes against Candida albicans
Authors: Gioulekas Elias , Goutzioulis Michael , Farmakis Christos , Drossou Vasiliki , Kremenopoulos George , Tsiouris John , Roilides Emmanuel
Published: April 2003

The effects of recombinant macrophage-colony stimulating factor (M-CSF) on antifungal activities of monocytes (MNC) from healthy neonates and adults against Candida albicans were compared. Pretreatment of adult and neonatal MNC with 15 ng/ml of M-CSF for 4 days significantly increased superoxide anion (O2–) production in response to phorbol myristate acetate. While M-CSF-treated MNC from adults produced significantly higher O2– in response to Candida blastoconidia, M-CSF-treated neonatal MNC did not show a similar response. Further, M-CSF significantly enhanced phagocytosis of C. albicans by adult MNC but not by neonatal MNC. While M-CSF enhances antifungal activities of adult MNC against C. albicans, it does not appear to affect anticandidal function of neonatal MNC.
Liquid Ventilation: From Experimental Use to Clinical Application
Authors: Valls-i-Soler Adolf , Alvarez Francisco Jose , Gastiasoro Elena
Published: April 2003

Despite advances in perinatal care of preterm infants, complications of prematurity are still common. If new conventional ventilatory interventions fail, ECMO is the only alternative method, but is a complex, invasive and costly technique and difficult to apply to small infants. Perfluorocarbon liquid ventilation is a promising technique. It has been demonstrated to be effective in experimental models, in mature and immature animals. However, its role in the management of human neonates, infants, older children and adults with acute respiratory failure is still not established. Both liquid ventilation strategies, total and partial, are able not only to maintain gas exchange, but also to reduce inflammatory changes. While total liquid ventilation remains as an experimental technique, partial liquid ventilation could be readily applied, but its implementation in clinical practice awaits results from ongoing and future clinical trials that may define its effectiveness.