bluuebunny/crossref_metadata_2025 huggingface dataset:
Gastric Emptying in Trauma Patients
Authors: Carlin C.B. , Scanlon P.H. , Wagner D.A. , Borghesi L. , Geiger J.W. , Long C.L.
Published: April 2003

Background/Aim: The aim of this study was to obtain quantitative data on gastric emptying following trauma. Methods: In order to assess gastric emptying for early enteral feeding, we evaluated the absorption of an amino acid, L-[1-13C]phenylalanine, within 24 h of admission and 7 days later in 14 trauma patients (injury severity score 36 ± 2). Following nasogastric administration of 100 mg L-[1-13C]phenylalanine, the plasma L-[1-13C]phenylalanine enrichment at 30 and 60 min and the expired 13CO2 for 1 h in the breath were used to measure the degree of gastric emptying. Results: The plasma L-[1-13C]phenylalanine enrichment concentration at 30 min was 0.53 ± 0.23 mmol/l during the first study and 2.46 ± 0.62 mmol/l during the second study (p = 0.006, a fivefold increase). The L-[1-13C]phenylalanine plasma level in historic controls was 4.57 ± 1.48 mmol/l. The percent of the dose oxidized and expired as 13CO2 in 1 h was 0.51 ± 0.17 during the first 24-hour study compared to the second study of 3.37 ± 0.68 (p = 0.0008) 7 days later (an over sixfold increase). The percent of the dose oxidized in 1 h in 37 normal historic controls was 7.08 ± 0.33. Conclusion: These data indicate delayed gastric emptying with limited recovery in 1 week. We conclude that gastric feeding should not be employed, and the route for early nutritional intervention should be transpyloric for the trauma patient.
Beneficial Effects of Hydrocortisone in a Model of Experimental Acute Pancreatitis
Authors: Osman Maher O. , Jacobsen Niels O. , Kristensen Jorgen U. , Larsen Christian G. , Jensen Steen L.
Published: April 2003

Background: Proinflammatory cytokines like TNF-α and IL-8 have been thought to play a pivotal role in the propagation of severe acute pancreatitis (AP) and the development of its systemic complications, particularly acute lung injury. Objective: To investigate the effects of pretreatment with hydrocortisone on the production of cytokines and the occurrence of acute lung injury in rabbits with AP. Methods: AP was induced in 17 rabbits by infusion of 5% chenodeoxycholic acid into the pancreatic duct, followed by ductal ligation. The rabbits were allocated to pretreatment with subcutaneous and intravenous hydrocortisone (25 mg/kg, respectively; n = 7) or 0.9% saline (n = 10) 30 min before induction of AP. Rabbits were observed for 12 h. Serum amylase, lipase, TNF-α, IL-8, glucose, calcium and leukocyte count were measured every 3 h. At the end of the experimental period, ascitic fluid was collected and tissue specimens from the pancreas, lungs and kidney were obtained. Results: Hydrocortisone pretreatment improved survival from 40 to 100%. Serum TNF-α and IL-8 were lower in the hydrocortisone group than in the control group at 6 h (p = 0.006 and p < 0.001, respectively). Hydrocortisone abolished leukopenia (p < 0.001), hyperamylasemia (p = 0.05), the occurrence of acute lung injury and reduced the volume of ascites. Conclusions: Our findings suggest a role for TNF-α and IL-8 in mediating the progress of AP from a local disease into a systemic illness. Hydrocortisone should be tested experimentally after the induction of AP and clinically as a prophylactic measure to avoid severe AP induced by endoscopic retrograde cholangiopancreaticography.
Need for a Standard Report and Future Directions in Pancreatic Resections for Cancer
Authors: Birk Dieter , Bassi Claudio , Beger Hans Günther
Published: April 2003

The ability to compare treatment results is essential for the proper evaluation of treatment protocols. Especially in the case of exocrine pancreatic cancer different classifications and documentation systems hinder the comparison between institutions and do not allow multicenter analysis across the world. This might explain the vastly different results of similar therapeutical trials and studies. In the classifications used at present, the features included, as well as terminology and description, vary greatly. First attempts to stage pancreatic malignancies according to UICC criteria were mentioned in the 1987 edition. These rules were predominantly based on the suggestions of the AJCC Cancer of the Pancreas Task Force of 1981 and have since not been changed. In Japan a different staging system has emerged and was first published by the Japanese Pancreatic Society (JPS) in 1986: General Rules for Surgical and Pathological Studies on Cancer of the Pancreas. The major difference between the two classifications concerns the evaluation of local tumor growth and the extent of lymph node involvement. Unfortunately most attempts to ‘restage’ Western patients postoperatively according to the JPS criteria, or vice versa, in order to compare treatment results have not added to a clearer understanding. Much in contrary, the results were frequently confusing since not comparable data were nevertheless retrospectively compared. Thus, a uniform standard report is needed, leading to prospective data acquisition and biometric analysis of outcome. The report should serve as a standard format for worldwide data acquisition and documentation and thereby become the common language to describe diagnosis, treatment, pathology and outcome of pancreatic cancer patients undergoing surgical therapy. It should enable: (1) inter-institutional data exchange from different staging systems; (2) comparisons between institutions on an international basis; (3) quality management in clinical practice and studies, and (4) reliable insight into tumor biology and differences in growth patterns.
Recommendation for the Examination of Pancreaticoduodenectomy Specimens Removed from Patients with Carcinoma of the Exocrine Pancreas
Authors: Lüttges Jutta , Zamboni Giuseppe , Klöppel Günter
Published: April 2003

The prognosis of ductal adenocarcinoma of the pancreas is poor. Despite many attempts at a more aggressive surgical approach, tumor recurrence rates of around 80% are common. For various reasons, most of the studies on the subject are difficult to compare. Not only do the surgical techniques vary, but, more importantly, the methods used for processing the specimens and for the pathological examination differ. If we are to improve the situation, it would appear imperative to standardize procedures. Standardized pathological staging of pancreaticoduodenectomy specimens should be performed mainly with reference to the guidelines of the WHO and UICC, with optional staging of the lymph nodes according to their anatomical site. Precise definition and accurate examination of the resection margins, especially of that towards the retroperitoneum, is essential for a better comparison of the results of the different therapeutic strategies and approaches to pancreatic carcinoma.
Technical Aspects of Left-Sided Pancreatic Resection for Cancer
Authors: Andrén-Sandberg Åke , Wagner Markus , Tihanyi Tibor , Löfgren Pia , Friess Helmut
Published: April 2003

Adenocarcinoma of the pancreas that originates to the left of the portal vein, i.e. in the body or tail of the pancreas, is seen in approximately one third of all cases with exocrine pancreatic cancer. Except for symptoms of pain and weight loss, these patients usually appear normal upon physical examination. In 5–10% of cases, the tumor is resectable by standard surgical procedures. Unresectability is due to local spread (30–40%) or distant metastases (50–65%). The technique of distal pancreatic resection was outlined by Mayo in 1913. The intimate relationship of the splenic artery and vein to the body of the pancreas makes en bloc mobilization of the spleen and pancreatic tail a safe option; the splenic artery and vein being ligated near their origin and termination. Although the spleen can frequently be preserved when performing a distal pancreatectomy for benign disease, splenic artery preservation is hazardous for oncologic radicality when resection is performed for cancer. Therefore, splenectomy is routine in distal pancreatectomy – in Mayo’s and all subsequent descriptions – with the splenic artery being ligated early in the procedure. Recent reports from specialized centers indicate that the procedure is associated with a decrease in mortality rate, often zero or less than a few percent.
Transverse Coloplasty Pouch
Authors: Z’graggen K. , Maurer C.A. , Büchler M.W.
Published: April 2003

Background: The functional results after complete rectal excision can be improved by a neorectal reservoir. We recently developed a new technique for the formation of a small colon pouch, which we named the transverse coloplasty pouch. The technique demonstrated favorable functional results in an animal model. We report the first description of the human ‘transverse coloplasty pouch’ according to our early clinical experience. Methods: The technical steps in the formation of the transverse coloplasty pouch are described in detail, illustrated and discussed. After completion of the total mesorectal excision, a purse-string suture is fitted to the distal opening of the mobilized colon. The anvil of a circular stapler is secured by tying the purse-string suture. The colon is opened longitudinally, starting 2 cm proximal to the rim of the anvil. Depending upon the size of the colon, the incision measures 7–9 cm. In analogy to a pyloroplasty, the transverse coloplasty pouch is formed by lateral traction and the transverse opening is closed by running sutures. The continence-preserving neorectal reconstruction is completed by either a stapled anastomosis or a handsewn end-to-end pouch-anal anastomosis. Conclusion: The advantages of the transverse coloplasty pouch are the simplicity of the technique and the facilitated tension-free anastomosis of the neorectum to the dentate line. This is a particular advantage in obese patients with a thick mesocolon and in individuals with a narrow muscular pelvis and/or a short mesocolon.
Primary Malignant Fibrous Histiocytoma of the Duodenum
Authors: Farinon Attilio M. , Bock Enrico , Federico Francesco , Rulli Francesco , D’Antini Pasquale
Published: April 2003

Background/Aim: We report on a case of primary malignant fibrous histiocytoma of the duodenum. Methods: Report of a case and review of the literature on the occurrence of this tumor in the alimentary tract. Results: The neoplasm was detected incidentally at the time of diagnostic workup for upper gastrointestinal bleeding. Curative surgery using the Whipple procedure was carried out with uneventful postoperative course; no evidence of liver metastases was detected during intraoperative ultrasonography. The patient died of diffuse metastatic liver disease 2 months after surgical resection. Up-to-date review of the literature has added only 3 cases to those previously reported, including that reported by us. Conclusions: The biological behavior of malignat fibrous histiocytomas is extremely aggressive and mainly conditioned by size and histological grading. The treatment of choice, whenever possible, is based on early and complete surgical excision of the tumor.
A Case of Jejunal Intussusception with Gastrointestinal Bleeding Caused by Metastatic Testicular Germ Cell Cancer
Authors: Hofflander Ronald , Beckes David , Kapre Sheela , Matolo Nathaniel , Liu Samuel
Published: April 2003

Background/Aim: We report an unusual case of metastatic testicular germ cell tumor with its unusual presentation. Method: A patient presented to the San Joaquin General Hospital with gastrointestinal bleeding and obstruction and a testicular mass is described. The patient’s clinical course is followed and the literature reviewed. Results: The patient presented with jejunal intussusception due to metastatic testicular cancer. He was treated with orchiectomy and bowel resection followed by postoperative chemotherapy. Conclusion: This case illustrates the need to consider metastatic small-bowel obstruction and/or intussusception in patients presenting with testicular mass and abdominal pain.
Systemic and Cell-Mediated Immune Response after Laparoscopic and Open Cholecystectomy in Patients with Chronic Liver Disease
Authors: Lausten S.B. , Ibrahim T.M. , El-Sefi T. , Jensen L.S. , Gesser B. , Larsen C.G. , Tønnesen E. , Jensen S.L.
Published: April 2003

Background: As impaired immune function observed in cirrhotic patients is known to increase the risk of postoperative complications, the immunological response to surgery was investigated. Methods: Twenty-eight patients with postnecrotic liver cirrhosis or chonic hepatitis C and symptomatic gallstone disease were randomly allocated to laparoscopic (LC) or open cholecystectomy (OC). Changes in concentrations of cytokines (TNF-α, IL-1β, IL-6, IL-8 and IL-10) were followed and the effect of surgical trauma on the distribution of lymphocyte subpopulations (CD3, CD4, CD8, CD16 and CD19) and NK cell cytotoxicity were measured. Results: After OC a decrease in circulating CD3 (p < 0.05) and CD4 (p < 0.05) and an increase in CD19 (p < 0.05) cells were detected in contrast to LC after which only CD16 cells decreased (p = 0.05). The number of CD3 cells was higher after LC than after OC (p < 0.01), whereas the number of CD19 cells was higher after OC than after LC (p < 0.01). NK cell cytotoxicity was reduced after LC (p < 0.05). In cirrhotic patients circulating cytokines were unaffected by OC, whereas TNF-α (p < 0.05) and IL-1β (p < 0.05) were reduced after LC. In chronic hepatitis IL-1β decreased after OC (p = 0.05) and IL-10 was significantly higher after LC than following OC (p < 0.05). Conclusion: The immune response is less pronounced after a laparoscopic procedure compared to a conventional approach in patients with chronic liver disease.
Botulinum Toxin for the Treatment of Anal Fissure
Authors: Fernández López F. , Conde Freire R. , Rios Rios A. , García Iglesias J. , Caínzos Fernández M. , Potel Lesquereux J.
Published: April 2003

Background: The classic treatment for uncomplicated anal fissure is surgical sphincterotomy, i.e. cutting of the internal anal sphincter, thus eliminating spasm of this muscle and breaking the vicious circle of pain, spasm and inflammation. Recently, however, botulinum toxin has become available for the treatment of muscular dystonias, and thus for anal fissure. In the present study, we investigated the effectiveness of treatment with botulinum toxin in 76 patients with uncomplicated anal fissure. Material and Method: The 76 patients received an injection of 40 U of botulinum toxin on each side of the fissure. Response was monitored 7, 30 and 90 days later. All patients who did not show clear improvement after 30 days received a second dose of 40 U on each side. Results: After 90 days, 51 patients (67%) showed complete recovery, 19 patients (25%) substantial improvement though not complete recovery, and 6 patients (8%) no significant improvement. Transitory gas incontinence was reported by 2 patients (2.6%), and 1 patient presented hemorrhoidal thrombosis. Discussion: Botulinum toxin enables chemical denervation of the internal sphincter, facilitating healing of the anal fissure. Its principal advantages with respect to surgical sphincterotomy are the absence of the general risks of surgery, and reduced incidence of incontinence, which even if it occurs tends to be transitory. The technique does not require hospitalization and is well tolerated. It appears suitable for the initial treatment of uncomplicated anal fissure, reserving surgical treatment for those cases which fail to response adequately.
Bouveret’s Syndrome Complicated by Acute Pancreatitis
Authors: Fenchel R.F. , Krige J.E.J. , Bornman P.C.
Published: April 2003

Background/Aim: This study evaluated a case of Bouveret’s syndrome due to a cholecystoduodenal fistula and gallstone obstruction of the duodenum, complicated by acute pancreatitis and cholecystitis. Methods: The presenting features, special investigations, radiological findings, operative and endoscopic procedures were reviewed. Results: Symptoms persisted after laparotomy and removal of a gallstone in the duodenum. Intra-operative endoscopy identified a second previously undetected stone impacted in the distal duodenum. Conclusion: The importance of excluding more than one stone causing Bouveret’s syndrome is emphasized.
Early Perioperative Results and Surgical Recurrence after Strictureplasty and Miniresection for Complicated Crohn’s Disease
Authors: Sampietro Gianluca M. , Cristaldi Massimo , Porretta Tiziano , Montecamozzo Giulio , Danelli PierGiorgio , Taschieri Angelo Maria
Published: April 2003

Background/Aims: Strictureplasty (SP) or miniresective ‘bowel-sparing’ techniques (MR) can prevent the risk of intestinal stomia and short bowel syndrome in patients affected by Crohn’s disease (CD). The aim of this study was to analyze the perioperative morbidity and mortality in 104 of 138 consecutive patients treated for CD complications using bowel-sparing techniques. We also considered the factors that may be related to the risk of perioperative complications and the long-term outcome. Methods: One hundred and four patients were treated with SP and/or MR and then included in a prospectively maintained database. The factors claimed to influence perioperative complications were analyzed using Fisher’s exact test for categorical observations and the Mann-Whitney U test for continuous variables. A multivariate analysis, using logistic regression, and a long-term time-to-event analysis using the Kaplan-Meier function, were also performed. Results: Perioperative mortality was nil. In relation to the 6 postoperative complications (5.8%), 4 patients underwent minimal bowel resection (MR), 1 a MR with SP, and 1 SP alone. Three of these patients (2.9%) needed reoperation for septic complications, and 3 (2.9%) were treated as outpatients for enterocutaneous fistulas. A correlation (p < 0.05) was found between low serum hemoglobin levels and postoperative complications at univariate and multivariate analyses. The 5-year surgical recurrence-free rate was 75% overall, 73% for patients treated with SP, 78% with MR, and 77% with MR + SP. Conclusions: Postoperative complications are not related to conservative or miniresective surgery even when active disease is present at the resection margins or the site of SP. The higher risk reported for patients with low serum hemoglobin and hematocrit levels suggests that surgeons should consider using preoperative iron and vitamin support, parenteral nutrition and erythropoietin therapy, when necessary, in those cases. Our postoperative morbidity, mortality and long-term surgical recurrence rate results support the efficacy and safety of SP and MR surgery in the treatment of complicated CD.
Agenesis of the Gallbladder Found at Laparoscopy in an Adult Patient with Cardiac Congenital Malformation
Authors: Dell’Abate P. , Iosca A. , Galimberti A. , Faraci R. , Soliani P. , Foggi E.
Published: April 2003

We report a case of gallbladder agenesis in a 30-year-old woman affected by a cardiac congenital malformation who had been operated on at the age of 12. The patient was sent for laparoscopic cholecystectomy due to a preoperative diagnosis of cholelithiasis using clinical and instrumental examinations such as ultrasonography and cholangiography. During laparoscopy, the gallbladder was not found, and laparotomy with intraoperative cholangiography and ultrasonography was performed which also resulted negative. The preoperative possibility of a diagnosis of gallbladder agenesis, the association with other malformations and the steps to be taken to discover agenesis of the gallbladder are discussed.
Gastrointestinal Autonomic Nerve Sarcoma Presenting as a Giant Intra-Abdominal Cyst
Authors: Evans James D. , Mansour Paul , Brown Anita , Jones David R.
Published: April 2003

Gastrointestinal autonomic nerve sarcomas are rare tumours. A 36-year-old man presented with abdominal pain, distension and constipation. Abdominal ultrasound and CT scanning demonstrated a giant cystic intra-abdominal mass. Laparotomy confirmed a large cystic mass arising from the ileum with multiple metastases. Immunohistochemical staining was positive for vimentin, neuronal-specific enolase and PGP9.5. This is the first reported case to present as a giant intra-abdominal cyst. Specialist histopathological and immunohistochemical analysis is essential to establish the diagnosis of this rare tumour.
Surgical Treatment of Leiomyosarcoma of the Distal Duodenum
Authors: Orda R. , Sayfan J. , Wasserman I.
Published: April 2003

Malignant tumors of the small intestine are rare. An uncommon finding of leiomyosarcoma located in the fourth part of the duodenum was diagnosed by gastrointestinal contrast studies, CT and angiography. Although malignant lesions of the small bowel are usually diagnosed late and thus are far advanced, curative resection was possible in our case. The location and histology of the tumor permitted a ‘pancreas-preserving segmental duodenectomy’. The operative approach and exposure using the Cattell maneuver is described. It is emphasized that the more extensive pancreatoduodenectomy should be reserved for adenocarcinomas or lesions situated in the proximal part of the duodenum. Thirteen years following the operation, the patient is asymptomatic while CT and gastrointestinal contrast studies reveal no evidence of disease.
Patterns of Use and Their Relationship to DSM-IV Abuse and Dependence of Alcohol among Adolescents and Young Adults
Authors: Holly Alexandra , Wittchen Hans-Ulrich
Published: April 2003

First use and initiation of regular alcohol use has been frequently found to start in adolescence. However, only few studies have also investigated how many adolescents proceed during ages 14–24 to harmful drinking or even develop alcohol use disorders. This paper – using the EDSP baseline sample of 3,021 community respondents from the Munich area – examines the prevalence of use, abuse and dependence and investigates the dose/disorder relationship. Alcohol abuse was reported by 9.7% of respondents and alcohol dependence by 6.2%. Men were more likely to report an alcohol disorder than women, prevalence also increased in the older age cohorts. However, even among 14- to 17-year-olds a substantial proportion of respondents report high and regular consumption rates, the occurrence of abuse and dependence criteria and even a full dependence syndrome. There is however only a moderate association between average number of standard drinks consumed with the risk of developing abuse and dependence. In light of the substantial rates among adolescents and young adults the validity of DSM-IV alcohol disorder criteria is discussed.
Psychiatric Criteria of Legal Responsibility after the Consumption of Alcohol: The German Situation
Authors: Kröber Hans-Ludwig
Published: April 2003

Psychiatry deals with addiction but it is not concerned very much about the symptomatology of acute alcohol intoxication. This causes problems in connection with the legal system: intoxication is the most frequent cause of diminished legal responsibility in Germany, and judges want to have a system to assess the grade of intoxication as simply and reliably as possible. So they found the blood alcohol concentration (BAC) to be a safe indication. But the BAC has various effects not only on different people but also on the same person in different situations: other factors are influential, i.e. alcohol habituation and physical condition, personality, mood and situation. Therefore it is necessary to describe the typical syndromes of intoxication and their dependency on BAC.
Gipsies and Drug Addictions
Authors: Iraurgi I. , Jiménez-Lerma J.M. , Landabaso M.A. , Arrazola X. , Gutiérrez-Fraile M.
Published: April 2003

Aims: To compare the retention in a Naltrexone Maintenance Programme (NMP) between a gipsy and a ‘paya’ (non-gipsy) population in the province of Alava (Basque Country, Spain). Hypothesis: The exposure factor ‘to be a gipsy’ is no different from the factor ‘to be “payo” (non-gipsy)’ with regard to the response in the continuation of treatment with opiate antagonists. Design and Participants: Based on a retrospective follow-up study, two cohorts were considered based on the ethnic group to which one belonged. The cohort of gipsies was made up of 52 cases, for whom by means of a matching process 52 ‘payo’ (non-gipsy) subjects were selected to form the other cohort. The matching variables were age, sex, the family support, and HIV+ status. After a period of detoxification, all the subjects participated in a NMP and the retention in this programme was evaluated. Findings: The survival analysis showed a continuation probability that was higher for the non-gipsy group than for the gipsy group, even though the differences were not significant but they did show a tendency (p < 0.06). The post- hoc tests showed differences between the continuations shown by both cohorts between 4 and 8 weeks, with this not being observed at other times. A subsequent proportional risks regression analysis showed a strong influence of the previous treatments variable, the effect of which was greater in the gipsy group, with this finally causing a correction in the continuation curves that reduced the differences. Conclusions: The results are discussed with regard to the context of the gipsy ethnical group, and suggestions are made with regard to the need for establishing preventive and informative measures that manage to reach the idiosyncrasy of the gipsy culture.
Variation between and within Drug Treatment Modalities: Data from the National Treatment Outcome Research Study (UK)
Authors: Stewart Duncan , Gossop Michael , Marsden John , Strang John
Published: April 2003

This paper describes treatment practices in 54 drug treatment programmes taking part in the National Treatment Outcome Research Study (NTORS). Programmes were representative of the 4 main treatment modalities in the UK: in-patient, residential rehabilitation, methadone maintenance and methadone reduction. Distinguishing features of these forms of treatment were identified. Substantial variations in treatment practices were also observed within each modality, particularly for detoxification and prescribing arrangements, counselling and non-drug treatment services, and planned duration of treatment. Many programmes reported extensive waiting lists. These findings are discussed in the context of the growing international evidence of the association between patient outcome and the manner in which programme services are delivered.
Criminality in Female Inpatients with Substance Use Disorders
Authors: Modestin Jiri , Rigoni Harald
Published: April 2003

Three groups of female inpatients were compared with each other with regard to criminal behavior: 51 patients with alcohol dependence, 39 patients with drug (mostly opioid) dependence and 488 patients not fulfilling DSM-IV criteria for substance dependence. 45% of the alcohol-dependent patients, 74% of the drug-dependent patients and 15% of the psychiatric comparison group had a criminal record compared to only 2% of the female reference general population. Comparing criminal with noncriminal patients in both groups with substance dependence, patients with a criminal record were significantly younger than patients without a criminal record; however, otherwise only very few differences appeared. In contrast, alcohol-dependent and drug-dependent female patients with a criminal record appear to represent two quite different populations.
BoLA DYA Polymorphism in Czech Cattle
Authors: Hořín P. , Matiašovic J. , Trtková K. , Pavlík I.
Published: April 2003

Polymorphism at the BoLA DYA locus was determined in two groups of Czech Black Pied cattle by PCR-RFLP detecting substitutions at nucleotide positions 112 and 219. Animals for this study were nonrandomly selected according to their health status in two BoLA-associated infections: bovine leukosis (n = 59) and Johne’s disease (n = 36). A group of noninfected Czech Red Pied cows (n = 37) was used for comparison. The frequencies of DYA alleles and haplotypes were virtually identical in the two selected groups as well as in the infection-free animals. In contrast, distribution of BoLA DRB3.2 alleles differed considerably between the infected groups as expected based on the previously detected associations with BoLA. The results suggest that the polymorphism of the DYA unexpressed gene was not influenced by selecting animals for this study according to their health status.
Molecular Heterogeneity of Second and Fourth Components of Complement and Their Genes in Systemic Sclerosis and Association of HLA Alleles A1, B8 and DR3 with Limited and DR5 with Diffuse Systemic Sclerosis
Authors: Venneker G.T. , van den Hoogen F.H.J. , van Meegen M. , de Kok-Nazaruk M. , Hulsmans R.F.H.J. , Boerbooms A.M.T. , de Waal L.P. , Bos J.D. , Asghar S.S.
Published: April 2003

Deficiency of the complement component C4 at the functional, protein and gene level and deficiency of complement component C2 at the functional level were investigated and HLA analysis was performed on patients with limited and diffuse systemic sclerosis (SSc). One of the patients with limited SSc (n = 15) had subnormal C4, 1 subnormal C2 and 1 subnormal C4 and C2 activities; the latter patient had HLA alleles A11;B35;Dw1 associated with type II C2 deficiency and therefore most likely had a defect at the C2 locus. One of the patients with diffuse SSC (n = 12) had subnormal C4 and 1 subnormal C4 and C2 activities. C2 deficiencies in patients other than the one with the haplotype associated with C2 deficiency appeared not to be determined by the gene at the C2 locus. The incidence of partial C2 deficiency in a normal Caucasian population is reported to be 16 in 10,000, and that of partial C4 deficiency also appears to be very low. The percentages of C4A*Q0 and C4B*Q0 alleles in normal controls (n = 45) were within the reported range. Seven patients with limited SSc (n = 14) had one or two C4A*Q0 alleles and 2 with diffuse SSc (n = 13) had one C4A*Q0 allele. Thus, the incidence of C4A*Q0 was higher than normal in limited SSc and within the normal range in diffuse SSc. The two-sided Fisher’s exact test applied on these data revealed that the association of C4A*Q0 with limited SSc did not reach a significant level (p = 0.10). Two of the 3 patients with limited SSc, who had two C4A*Q0 alleles, carried a heterozygous C4A-21-hydroxylase A (OHA) gene segment deletion as detected by Southern blotting. There was no correlation between the subnormal activity of C4 and the occurrence of one or two C4A*Q0 (and C4A-21-OHA segment deletion). HLA alleles A1, B8 and DR3 (p = 0.002) were associated with limited SSc (n = 23) and DR5(w11) (p = 0.018) with diffuse SSc (n = 17).
New Australian Aboriginal Complotypes Characterised by Increased C4 Gene Copy Number
Authors: Ulgiati Daniela , Townend David C. , Christiansen Frank T. , Abraham Lawrence J.
Published: April 2003

Complement component C4 genes are located within the central region of the human MHC. The genomic arrangement of these genes is complex, with each chromosome usually encoding either one or two C4 genes. C4 allotyping of a group of Western Australian Aborigines demonstrated certain discrepancies in the densitometric ratios between the C4A4 and the C4A3 protein bands; however, the mechanism causing the increase in density of the C4A4 band was unknown. Our aim was to determine whether the increase in densitometry was due to an increase in the expression of the C4A4 isotype, or whether these individuals carried a new complotype characterised by an increased gene copy number. Using pulsed-field gel electrophoresis and Taq I RFLP analysis we will show that the apparent increase in C4A4 protein expression was due to the existence of new, previously uncharacterised Aboriginal complotypes defined by at least three C4 genes. Segregation analysis from an extensive family suggests that one of the new C4 complotypes is likely to contain the duplicated C4A4 isotype together with a C4B2 gene (C4A4, C4A4, C4B2) and is the first such chromosomal arrangement seen in this population group.
The Mouse (Mus musculus) Immunoglobulin Kappa Variable (IGKV) Genes and Joining (IGKJ) Segments
Authors: Martinez Christèle , Lefranc Marie-Paule
Published: April 2003

The ‘Mouse (Mus musculus) Immunoglobulin Kappa Variable (IGKV) Genes and Joining (IGKJ) Segments’, third report of the ‘IMGT Locus on Focus’ section, comprises four tables entitled: (1) ‘Mouse (Mus musculus) germline IGKV gene table’; (2) ‘Correspondence between Mouse (Mus musculus) IMGT IGKV subgroups and previous designations’; (3) ‘Mouse (Mus musculus) germline IGKJ table’, and (4) ‘Mouse (Mus musculus) IGKJ allele table’. These tables are available at the IMGT Marie-Paule page from IMGT, the international ImMunoGeneTics database (http://imgt.cnusc.fr:8104) created by Marie-Paule Lefranc, CNRS, Université Montpellier II, Montpellier, France.
Xenopus laevis Pancreatic DNase I: Purification and Immunological Characterization
Authors: Hosomi Osamu , Yasuda Toshihiro , Takeshita Haruo , Nakajima Tamiko , Nakashima Yoshimitsu , Hanaoka Yoichi , Kishi Koichiro
Published: April 2003

Deoxyribonuclease I (DNase I) was purified from Xenopus laevis pancreas to apparent electrophoretic homogeneity using a series of column chromatographies. The purified enzyme showed a molecular mass of about 36 kDa and maximum activity at pH 7.0–8.0, required divalent cations, Ca2+ and Mg2+, for its activity, and was inhibited by EDTA, EGTA and an antibody specific to the enzyme, but not by G-actin. The N-terminal amino acid sequence of the enzyme up to the 37th residue shared 38–44% homology with that of mammalian DNases I derived from bovine, ovine, porcine, rat, mouse, rabbit and human. A systematic survey of DNase I activity distribution in 20 different kinds of frog tissues showed that the pancreas and rectum produced higher amounts than other tissues. This is the first report concerning the purification and chemical and immunological characterization of frog pancreatic DNase I.
The Human T Cell Receptor Beta Diversity (TRBD) and Beta Joining (TRBJ) Genes
Authors: Folch Géraldine , Lefranc Marie-Paule
Published: April 2003

‘Human T cell Receptor Beta Diversity (TRBD) and Beta Joining (TRBJ) Genes’, the 10th report of the ‘IMGT Locus in Focus’ section, comprises 6 tables: (1) ‘Human germline TRBD genes’; (2) ‘Human TRBD allele table’; (3) ‘Nucleotide and protein displays of the human TRBD alleles (overview)’; (4) ‘Human germline TRBJ genes’; (5) ‘Human TRBJ allele table’, and (6) ‘Nucleotide and protein displays of the human TRBJ alleles (overview)’. These tables are available on the IMGT Marie-Paule page from IMGT, the international ImMunoGeneTics database (http://imgt.cines.fr:8104) created in 1989 by Marie-Paule Lefranc, Université Montpellier II, CNRS, France.
Cells and Cytokines in the Pathogenesis of Inflammatory Bowel Disease: New Insights from Mouse T Cell Transfer Models
Authors: Bregenholt Søren
Published: April 2003

Recently, a number of experimental models of human inflammatory bowel disease (IBD) of immunological basis have been developed. These have proven useful tools in the study of IBD, allowing a more detailed dissection of the pathogenesis of the disease. Studies from these models have revealed new, important knowledge about environmental factors, cell subset, cytokines and effector molecules in the pathogenesis of IBD. This review focuses on recent advances in the understanding of the development of IBD obtained from adoptive CD4+ T cell transfer models of the disease.
Long-Term Study of a Female Hyper-IgM Immunodeficiency
Authors: Kaneko Hideo , Fukao Toshiyuki , Inoue Ryousuke , Kasahara Kimiko , Matsui Eiko , Kondo Naomi
Published: April 2003

Hyper-IgM immunodeficiency (HIM) is an immunological disorder characterized by normal or elevated serum IgM levels, and reduced serum IgG and IgA levels, due to the disruption of immunoglobulin class switching in B cells. X-linked hyper-IgM is caused by the defective expression of the CD40 ligand on activated T cells, which induces immunoglobulin class switching along with some cytokines, such as interleukin 4, by the signal transduction of CD40 in B cells. We report on a Japanese girl who initially showed low serum IgM, IgG and IgA levels like patients with common variable immunodeficiency; however, in the course of time, serum IgG levels became reduced and serum IgM levels increased, resulting in the typical immunoglobulin profile of HIM. Neutropenia, one of the features of X-linked HIM, was not observed. In spite of extremely low serum IgG levels, she did not show any predisposition to severe infection, even without gammaglobulin replacement therapy. No mutation of the CD40 ligand or CD40 was detected. Sequencing of the complementarity-determining region of immunoglobulin heavy-chain genes in peripheral B lymphocytes revealed that they were all in frame, and insertion of the N region was detected. These results indicate that the heavy-chain gene rearrangement in the patient’s B cells is intact. Non-X-linked HIM has heterogeneous pathogenetic mechanisms, and some groups may show the resistance to infection at the healthy donor level. The underlying defects in non-X-linked HIM might be specifically involved in class switching.
Perceptions of Tonal Changes in Normal Laryngeal, Esophageal, and Artificial Laryngeal Male Cantonese Speakers
Authors: Ng M.L. , Lerman J.W. , Gilbert H.R.
Published: April 2003

Listeners were asked to identify six tonal variations in the production of the syllables /ji/ and /si/ produced by 10 normal laryngeal (NL), 10 standard esophageal (SE), and 10 Servox-type electrolarynx (EL) Cantonese speakers. The purpose of the present study was to determine if alaryngeal Cantonese speakers could differentiate meanings associated with different tone levels. Results indicated that listeners’ identification of the six tones for each syllable produced by the SE speakers was similar in pattern to those produced by the NL speakers of Cantonese. For both NL and SE speech, the high-level, low-falling, and high-rising tones were perceived more accurately than the mid-level, low-level, and low-rising tones. Identification of the six tones for each syllable as produced by the EL speakers was significantly poorer due to the limitations of the electrolarynx.
Lubrication Mechanism of the Larynx during Phonation: An Experiment in Excised Canine Larynges
Authors: Nakagawa Hideki , Fukuda Hiroyuki , Kawaida Masahiro , Shiotani Akihiro , Kanzaki Jin
Published: April 2003

To evaluate how the viscosity of the laryngeal mucus influences vocal fold vibration, two fluids of differing viscosity were applied separately to excised canine larynges and experimental phonation was induced. Vibration of the vocal folds was measured by use of a laryngostroboscope and an X-ray stroboscope. With the high viscosity fluid, the amplitude of vibration of the free edge and the peak glottal area was decreased while the open quotient was increased. Because the viscosity of this fluid affected the wave motion of the vocal fold mucosa, changes in viscosity of the mucus may be involved in causing such disorders as hoarseness, in the absence of apparent changes in the vocal folds themselves.
Cervical Spine Abnormalities in Professional Singers
Authors: Scotto Di Carlo Nicole
Published: April 2003

A systematic X-ray study of the cervical spine of three populations of subjects (professional singers, beginning singers, and non-singers) who exhibited no vertebral column pathology or postural disorders provided evidence of abnormalities in the shape of the cervical spine in all of the professional singers studied. The disorders observed included hypolordosis, and more frequently, cervical rectitude or hypocyphosis without functional hindrance. The findings can be explained in terms of deformations undergone by the cervical spine after many years of intensive singing. The resulting functional postures are memorized and become an integral part of the singer’s corporal schema. The considerable amount of anterior-posterior movement of the cervical spine in singing explains why lesions which prevent its mobility have an overall impact on the singer’s voice, particularly in the upper pitch range.
Learning from Multiple Perspectives: Global Implications for Speech-Language and Hearing Professionals
Authors: Cheng Li-Rong Lilly
Published: April 2003

The concept of cross-cultural communicative competence provides the framework for the discussion of global communication. A global communicator must be willing to continue to learn and embrace cultural and individual diversity. This paper presents new global realities as they exist in today’s global ‘village’. The three C’s: concepts, competence, and connections are necessary in global communication and transactions. Local implications are discussed followed by identification of the necessary competences for global communicators.
Prosodic Features of Familial Language Impairment:Constraints on Stress Assignment
Authors: Piggott G.L. , Robb M. Kessler
Published: April 2003

This paper is part of a study of prosodic features of familial language impairment (FLI) in English. It reports the results of a set of experiments designed to investigate the factors that play a role in the assignment of stress to words which are longer than two syllables. It appears that stress assignment in FLI is constrained by a restriction limiting the maximal size of the stress domain to a bisyllabic unit, formally defined as the minimal prosodic word. We hypothesize that this restriction is responsible for variable patterns of word truncation, stress levelling and compounding that characterize the production of polysyllabic words.
Voice Research and Clinical Needs
Authors: Hammarberg Britta
Published: April 2003

The purpose of this paper is to provide a review of recent advances in voice research with special focus on clinical aspects and on the speaking voice. First an update on histological findings concerning the multilayer structure and the biomechanics of the vocal folds is given. Other topics are vocal fold closure patterns, the development of the voice from childhood to senescence, and theoretical aspects of vocal function from an acoustic-aerodynamic point of view. Special emphasis is put on voice parameters, which can be assumed to be relevant to underlying physiology, and how they can be captured by different techniques.
Recent Developments in Speech Motor Research into Stuttering
Authors: Peters HermanF.M. , Hulstijn Wouter , van Lieshout Pascal H.H.M.
Published: April 2003

This paper discusses recent speech motor research into stuttering within the framework of a speech production model. There seems to be no support for the claim that stutterers differ from nonstutterers in assembling motor plans for speech. However, physiological data suggest that stutterers may at least have different ways of initiating and controlling speech movements. It is hypothesized that stuttering may be the result of a deficiency in speech motor skill. Furthermore, objections to the use of stuttering frequency as a severity index are formulated and future developments in the assessment of speech motor behavior in stuttering are described.
Schwingungen der Halsweichteile und das EGG-Lx-Signal
Authors: Böckler R. , Hacki T.
Published: April 2003

An 3 männlichen und 2 weiblichen stimmgesunden Probanden wurde untersucht, ob sich Schwingungen der Halsweichteile im EGG-Lx-Signal nachweisen lassen. Im ersten Schritt wurde das «EGG-Lx-Signal» bei am Hals positionierter, schwingender Stimmgabel ohne begleitende Phonation aufgezeichnet. Im zweiten Schritt wurde das EGG-Lx-Signal bei der Phonation des Vokales /a/ registriert; während der Messung war eine schwingende Stimmgabel am Hals plaziert. Im dritten Schritt wurde das EGG-Lx-Signal bei Phonation des Vokales /a/ aufgezeichnet, während eine nichtschwingende Stimmgabel am Hals positioniert war. Die Stimmgabelschwingung war im Spektrogramm der EGG-Lx-Signale als frequenzspezifischer Peak erkennbar, dagegen war dieser Peak im EGG-Lx-Spektrogramm des dritten Untersuchungsschrittes nicht nachweisbar. Dieses Ergebnis kann für die Interpretation des EGG-Lx-Signales von Bedeutung sein.
Relaxed Dominance Relations among Female Moor Macaques (Macaca maurus) in Their Natural Habitat, South Sulawesi, Indonesia
Authors: Matsumura Shuichi
Published: April 2003

Field observations were made of the social behaviour of moor macaques (Macaca maurus), one of several species of macaques that live in Sulawesi, Indonesia. The present study was designed to characterise the expression of their relaxed dominance style among females in their natural habitat and to examine the factors influencing the evolution of the dominance style. The dominance rank order among adult females in the study group was linear, and it was essentially stable during the study period of 4 years. Intense aggression, including biting, was rare. Few interventions in agonistic interactions by a third individual were observed. Social relationships among adult females appeared to be egalitarian but nepotistic. During moving or feeding, encounters within 1 m between adult females were frequently observed and approaches by subordinates were not infrequent. Intragroup spacing patterns during moving or feeding and those during resting were not correlated. In wild groups, differences of dominance styles seemed to be found most apparently in intragroup spacing during feeding. The ecological model of van Schaik does not provide an adequate explanation for the egalitarian relations among female moor macaques.
Hormones Associated with Non-Maternal Infant Care: A Review of Mammalian and Avian Studies
Authors: Ziegler Toni E.
Published: April 2003

Hormonal changes during non-maternal infant care have been demonstrated in many cooperatively breeding bird species, some monogamous rodents and two species of New World primates. Coevolution of hormones and social traits may have provided for the different breeding systems that occur today. Several hormones have been shown to covary with the breeding systems of vertebrates. Elevated levels of the hormone prolactin with male parenting behaviours are common to many birds, rodents and the callitrichid monkeys Callithrix jacchus and Saguinus oedipus. In birds, prolactin may be elevated in both male and female breeders during various stages of nest building, egg laying, incubating and feeding of young. Testosterone levels appear to have an inverse relationship to prolactin levels during infant care in birds and rodents, but this relationship has not been examined for primates. In cooperatively breeding birds, helpers who remain at the nest also have elevated levels of prolactin when displaying parental care behaviours. Prolactin levels are elevated in helper callitrichid monkeys during the postpartum period. Monogamous male rodents demonstrate elevated prolactin levels with parental care behaviour but, in contrast to the birds, the mechanisms mediating prolactin increase appear to differ for male and female rodents. Two factors may influence male parental behaviours and hormonal changes: stimuli from the pregnant female and stimuli from the newborn pups; whereas maternal behaviours are influenced by the maternal hormones of the female and the pup stimuli. An experiential factor may also influence male parental behaviours. Neuropeptides such as oxytocin and vasopressin appear to be involved in male rodent parental care and there may be an interaction between a series of hormones and neurosecretions and stimuli from mates and pups. Studies of Saguinus oedipus, the cotton-top tamarin, suggest that prolactin levels are responsive to stimuli from contact with infants and the level of infant care experience influences the levels of prolactin with male infant care. Father tamarins also have elevated levels of prolactin before the birth of infants suggesting that cues from the pregnant female are important. Prolactin’s role in parental care may have evolved from prolactin’s role in other reproductive functions. Hormonal regulation of non-maternal care may occur due to a complex interaction of many hormones and neurotransmitters. Studies described here should provide the impetus for further work on parental care hormones in a wide variety of primates.