bluuebunny/crossref_metadata_2025 huggingface dataset:
Iodine concentration in commercial cat foods from three regions of the USA, 2008–2009
Authors: Edinboro Charlotte H , Pearce Elizabeth N , Pino Sam , Braverman Lewis E
Published: February 2013

Fluctuations in iodine concentration in food have been suggested as one risk factor for the development of feline hyperthyroidism, an epidemic disease first described in 1979. Three international studies have examined iodine concentrations of commercial cat foods. The iodine concentration of 112 commercial cat foods from across the USA was measured, and the daily iodine intake by hypothetical 4.5 kg adult cats or 1.4 kg kittens calculated in this descriptive epidemiologic study to examine differences in feline iodine intake due to (i) geographical source of foods, (ii) packaging type, (iii) brand-to-brand variation, (iv) form of iodine supplementation, (v) types and numbers of seafood ingredients and (vi) kitten and ‘therapeutic’ diets. Dramatic variation among canned foods (resulting in ingestion of approximately 49–9639 μg iodine/day) suggests that the disparity in iodine concentrations may lead to development of nodular hyperplasia and, later, clinical hyperthyroidism, if cats consume diets that are at first iodine-deficient and later contain excessive iodine. Manufacturers are encouraged to ensure adequate iodine supplementation across all products and areas of the USA.
Changes in electromyography and F wave responses in two cats with presumed local tetanus: implications for diagnosis and prognosis
Authors: Bianchi Ezio , Biserni Roberta , Gallucci Antonella , Pisoni Luciano , Menchetti Marika , Gandini Gualtiero
Published: February 2013

Two cases of focal tetanus in the cat are described. Clinical findings included severe muscular spasms of the pelvic limbs in one cat, and involvement of the thoracic limbs and muscles of the neck and face in the other. Electromyography in both cats showed spontaneous activity characterised by the presence of motor unit potentials. F waves, never previously reported in focal tetanus in animals, showed significantly increased F/M amplitude ratio in both cats and increased F wave duration in one cat. The electrodiagnostic findings provided relevant diagnostic and, possibly, prognostic information.
Expression of cathepsins S and D signals a distinctive biochemical trait in CD34+ hematopoietic stem cells of relapsing–remitting multiple sclerosis patients
Authors: Martino Sabata , Montesano Simona , di Girolamo Ilaria , Tiribuzi Roberto , Di Gregorio Maria , Orlacchio Antonio , Datti Alessandro , Calabresi Paolo , Sarchielli Paola , Orlacchio Aldo
Published: February 2013

Background:

The elucidation of mechanistic aspects of relapsing–remitting multiple sclerosis (RRMS) pathogenesis may offer valuable insights into diagnostic decisions and medical treatment.

Results:

Two lysosomal proteases, cathepsins S and D (CatS and CatD), display an exclusive pattern of expression in CD34+ hematopoietic stem cells (HSCs) from peripheral blood of acute MS (A-MS) patients ( n = 20). While both enzymes normally exist as precursor forms in the HSCs of healthy individuals ( n = 30), the same cells from A-MS patients consistently exhibit mature enzymes. Further, mature cathepsins are expressed at lower rates in stable MS subjects (S-MS, n = 15) and revert to precursor proteins after interferon-β1a treatment ( n = 5). Mature CatD and CatS were induced in HSCs of healthy donors that were either co-cultured with PBMCs of A-MS patients or exposed to their plasma, suggesting a functional involvement of soluble agents. Following HSC exposure to several cytokines known to be implicated in MS, and based on relative cytokine levels displayed in A-MS, S-MS and control individuals, we identified IL-16 as a specific cell signaling factor associated with cathepsin processing.

Conclusions:

These data point to an evident correlation between CatS and CatD expression and MS clinical stage, and define a biochemical trait in HSCs with functional, medical, and diagnostic relevance.
Concurrent self-regulatory efficacy as a mediator of the goal: Exercise behaviour relationship
Authors: Jung Mary E , Brawley Lawrence R
Published: February 2013

Examining exercise as a single goal-directed behaviour, without acknowledging the influence of other concurrent goals, may oversimplify the self-regulation needed in daily life. Concurrent self-regulatory efficacy, confidence in one’s ability to self-regulate the management of multiple goals, was explored as a potential mediator in the relationship between value of an exercise goal and future exercise behaviour. Undergraduate students were observed during a 4-week examination period where they faced greater than usual challenges to exercising regularly. Consistent with self-efficacy theory, concurrent self-regulatory efficacy was a significant partial mediator of the value of an exercise goal–exercise behaviour relationship.
Cutaneous malignant melanoma incidence rates in Norway
Authors: Moan Johan , Baturaite Zivile , Grigalavicius Mantas , Juzeniene Asta
Published: February 2013

Aims: The incidence rates of cutaneous malignant melanoma (CMM) increase throughout the world, in spite of introduction of strategies for prevention. However, a decrease in incidence rates is observed in some countries. If the reason for this could be found, it might be useful to transfer the knowledge to other fields of medicine. Methods: CMM age-standardized incidence rates in different age groups in Norway were obtained from NORDCAN for the years 1970–1989 and 1990–2009. Results: Until 1990, the CMM rates increased, but after that time a stabilization or a decrease was observed for young age groups (15–54 years old), while in older generations (>55 years old) the rates continued to increase. Conclusions: The decreasing CMM pattern in young age groups may be due to changing patterns to sunlight in sunbathing and use of sunbeds.
Nocturnal Oxygen Enrichment in Sleep Apnoea
Authors: Pokorski M , Jernajczyk U
Published: February 2013

We hypothesized that a modest oxygen enrichment, rather than 100% oxygen supplementation as used in previous trials, could result in improvement in ventilatory and cardiac symptoms, in patients with obstructive sleep apnoea (OSA), without jeopardizing the chemostimulant ventilatory drive. This hypothesis was tested in five male patients with OSA in a single-blinded trial consisting of one night spent sleeping in control room air (control night), followed by one night spent sleeping while exposed to air with a 9% enriched oxygen content (oxygen-enriched night). Oxygen enrichment resulted in a significant shift in the oxygen saturation profile towards values of ≥ 95% and to decrease desaturation dips throughout the night. The apnoea index decreased from the control night to the oxygen-enriched night from 52.7 ± 10.4 to 38.9 ± 9.3; the decrease being greatest for the longest apnoeas (≥ 30 s). Additionally, the cardiovascular status improved. No signs of depressed chemostimulant drive in the oxygen-enriched night were detected. We conclude that nocturnal oxygen enrichment merits consideration for therapeutic trial in the prevention of long apnoeic and desaturation episodes.
Effect of Intrarectal Prostaglandin E2 Analogue (Enprostil) on Trinitrobenzenesulphonic Acid-Induced Colitis in Rats
Authors: Onizuka Y , Murase K , Furusu H , Isomoto H , Mizuta Y , Takeshima F , Makiyama K , Kohno S
Published: February 2013

Prostaglandins exert a protective effect on colonic mucosa in experimentally induced colitis. This study investigated the effect of enprostil, a prostaglandin E2 (PGE2) analogue, on trinitrobenzenesulphonic acid (TNBS)-induced colitis in rats. Each rat received a rectal enema containing TNBS (30 mg), followed 24 h later by intrarectal once-daily enprostil (200 μg). Enprostil-treated and control rats were killed on day 3 (enprostil group, n = 5; control, n = 6) or day 10 (enprostil group, n = 5; control, n = 5) after TNBS treatment. The area of damaged mucosa of the colon was measured relative to the total colonic area. We also determined the macroscopic score of mucosal damage, and measured PGE2, 6-ketoprostaglandin F1α (6-keto-PGF1α) and thromboxane B2 (TXB2) concentration in portal vein blood samples. Enprostil significantly reduced both the area of damaged mucosa (including the ulcer area) and the macroscopic score after 3 days' treatment compared with control. Similarly, enprostil significantly reduced plasma concentration of PGE2, 6-keto-PGF1α and TXB2 during the acute phase at day 3 of treatment compared with control, but not at day 10. These results suggest that PGE2 enema may have therapeutic potential for treating patients with proctitis or left-sided colitis.
Amtolmetin Guacyl versus Piroxicam in Patients with Osteoarthritis
Authors: Montrone F , Santandrea S , Caruso I , Gerli R , Cesarotti MEF , Frediani PV , Bassani R
Published: February 2013

The efficacy and tolerability of amtolmetin guacyl (AMG), a new non-steroidal anti-inflammatory drug, were compared with piroxicam, in patients with osteoarthritis. In a randomized double-blind study patients with arthritis ( n = 99) received either 600 mg AMG on an empty stomach or 20 mg of piroxicam on a full stomach, once daily for 30 days. All clinical parameters improved significantly with both drugs; there were no significant differences between the two treatments. Tolerability, assessed by the patients, was significantly better in the AMG group. In the piroxicam group nine of 50 patients withdrew because of side-effects (gastrointestinal) compared with two of 49 (nausea and headache) in the AMG group. There were three cases of perforation, ulcer and bleeding in the piroxicam group but no serious side-effects with AMG. Total numbers of side-effects were similar in the two groups, but epigastric and abdominal pain were more frequent and more intense with piroxicam. AMG was as effective as piroxicam in controlling the symptoms of osteoarthritis, but showed better gastrointestinal tolerability.
Functional Expression of Fas and Fas Ligand on Human Colonic Intraepithelial T Lymphocytes
Authors: Hongo T , Morimoto Y , Iwagaki H , Kobashi K , Yoshii M , Urushihara N , Hizuta A , Tanaka N
Published: February 2013

The expression of Fas, a cell surface receptor directly responsible for triggering cell death by apoptosis, and its ligand (FasL) was investigated on both human colonic intraepithelial T lymphocytes (IELs) and peripheral blood mononuclear lymphocytes (PBMLs). FACS analysis indicated that IELs have increased expression of Fas compared with PBMLs, together with the progress activation marker, CD45RO. A discrete fraction of freshly isolated IELs also constitutively expressed FasL, perhaps as a result of recent in vivo activation. Using monoclonal antibody APO2.7, which detects mitochondrial 7A6 antigen specifically expressed by cells undergoing apoptosis, we further investigated the apoptosis-inducing effect of anti-Fas monoclonal antibody (CH11) on both IELs and PBMLs. FACS analysis revealed that CH11 increased the percentage of apoptotic cells, in IELs but not in PBMLs. Culture with anti-FasL monoclonal antibody (4H9) significantly recovered cell viability in IELs, but not in PBMLs. These results indicate that IELs constitutively express both Fas and FasL and that Fas crosslinking generates signals resulting in apoptosis, outlining a potential mechanism involved in intestinal tolerance.
Characterization of Peptostreptococcus Species in Skin Infections
Authors: Higaki S , Kitagawa T , Kagoura M , Morohashi M , Yamagishi T
Published: February 2013

We examined the characteristics of Peptostreptococcus species in infectious skin diseases. P. magnus was the species identified most frequently, followed by P. asaccharolyticus. Peptostreptococcus species were mainly isolated from infected atheroma and secondary infections due to ulcers; their resistance to five antimicrobial agents was generally low. The resistance of the three predominant Peptostreptococcus species to the antimicrobials was similar to that of all of the Peptostreptococcus species. The predominant Peptostreptococcus species isolated from infected atheroma might be pathogenic. It was considered that the presence of anaerobes as well as aerobes was important to induce the infectious condition.
Lonidamine Cytotoxicity: Involvement of the Lysosomal Compartment
Authors: Dell'Antone P , Bragadin M , Piergallini L
Published: February 2013

Lonidamine (LND) was found to decrease significantly the pH gradient across intracellular compartments in Ehrlich ascites tumour cells. The effect was maximal in the range 0.2–0.3 mM LND, and was observed both in the presence of glucose — i.e. conditions in which a high bioenergetic status of the cells was maintained by glycolysis (due to a strong Crabtree effect in these cells) – and in the absence of glucose. Moreover the LND effect was also observed in the presence of bafilomycin, a specific inhibitor of the H+-vacuolar ATP-ase. Based on these findings, we suggest that the LND effect on the proton gradient reflects an LND-induced increase in membrane proton conductance. The consequent impairment of intracellular proton gradients might be involved in the mechanism of action of LND, allowing drugs that are weak bases to accumulate preferentially in the cytoplasm and nucleus.
Aldosterone Escape during Angiotensinconverting Enzyme Inhibitor Therapy in Essential Hypertensive Patients with Left Ventricular Hypertrophy
Authors: Sato A , Saruta T
Published: February 2013

Continuous angiotensin-converting enzyme (ACE) inhibitor therapy does not necessarily produce significant decreases in plasma aldosterone levels (aldosterone escape). We examined the role of aldosterone escape in 75 essential hypertensive patients treated with an ACE inhibitor (enalapril maleate [34 patients], imidapril hydrochloride [24 patients] or trandolapril [17 patients]) for 40 weeks. With treatment, blood pressure decreased and plasma renin activity increased, while plasma aldosterone concentrations did not change. Aldosterone escape was observed in 38 of the 75 patients and in 17 of 37 patients with left ventricular hypertrophy before treatment. Left ventricular mass index did not change in patients with aldosterone escape but decreased significantly in patients without aldosterone escape. The present study demonstrated a high incidence of aldosterone escape in patients with essential hypertension despite the use of ACE inhibitors. The results also suggest that aldosterone escape may reverse the beneficial effects of an ACE inhibitor on left ventricular hypertrophy.
Anti-Pituitary Antibody-Induced Multiple Endocrine Disorders in Mice
Authors: Koike H , Kanda T , Motooka M , Tamura J , Kobayashi I
Published: February 2013

Circulating anti-pituitary antibodies (APAs) have been detected in patients with autoimmune diseases, although the role of autoantibodies in the pathogenesis of autoimmune diseases is still unclear. With the aim of elucidating the autoimmune mechanisms involved in patients with multiple endocrine disorders, we evaluated the pathological changes in the pituitary gland, thyroid, pancreas and adrenal gland of mice, both wild-type and using a murine model of autoimmune thyroid disease [MRL-lpr/lpr] that had been immunized with murine, rat, porcine or human pituitary glands. In four of seven mice, a 22 kD band corresponding to APA was detected by Western blotting in the serum from mice that had been immunized with human pituitary tissues but not in the serum from mice immunized with rat or pig tissue. Inflammatory changes were detected in all groups of mice, occurring in the hypophysis, pancreas and adrenal glands but not in the thyroid. In conclusion, APA-induced autoimmune endocrine disorders are likely to be important for studying the mechanisms involved in autoimmune syndromes.
Clinical Experience in Germany of Treating Community-Acquired Respiratory Infections with the New 8-Methoxyfluoroquinolone, Moxifloxacin
Authors: Landen H , Möller M , Tillotson GS , Kubin R , Höffken G
Published: February 2013

Moxifloxacin, a new 8-methoxyfluoroquinolone, was evaluated in a large community-based study involving 16 007 patients over a 9-month period. This study was designed as a large post-marketing observational study of the speed, efficacy and tolerability of moxifloxacin when used in clinical practice for the treatment of community-acquired bacterial pneumonia, or acute exacerbations of chronic bronchitis. Physicians and patients were specifically questioned about overall efficacy and safety as well as symptom relief. According to physicians' assessments 96.3% of patients were cured or improved after moxifloxacin treatment. Symptom relief (‘feeling better’) occurred in almost 70% of patients by day 3 and only 2.3% reported an adverse drug reaction. No individual adverse drug reaction was reported at a frequency above 1%. Among the 209 events considered as serious, only 34 were regarded as possibly or probably related to therapy. There were no moxifloxacin-related clinically relevant cases of phototoxicity, hepatotoxicity or cardiotoxicity. Overall, 92.1% of patients considered moxifloxacin to have been beneficial.
Donor Dendritic Cells and Recipient Kupffer Cells in the Induction of Donor-Specific Immune Hyporesponsiveness
Authors: Nakagawa K , Matsuno T , Iwagaki H , Morimoto Y , Fujiwara T , Sadamori H , Inagaki M , Urushihara N , Yagi T , Tanaka N
Published: February 2013

The aim of this study was to investigate the ability of portovenously administered donor antigens to induce immune hyporesponsiveness. Lewis (LEW, RT-1l) rats received Brown Norway (BN, RT-1n) rat donor splenocytes, via either the portal vein (PV group) or the peripheral vein (IV group). The immune responses of LEW rats, treated with either donor BN or third party Wistar King A (WKA, RT-1k) splenocytes were established by the persistence of donor dendritic cells (DCs) in the host liver measured using fluorescence microscopy and flow cytometry and by the mixed lymphocyte reaction (MLR). The effect of intravenous gadolinium chloride (GDCl3) on the blockade of Kupffer cell function prior to portovenous administration of splenocytes was also assessed. The MLR response was strongly inhibited in a BN-restricted manner after portovenous administration of donor BN splenocytes, but not by venous nor by portovenous administration of WKA splenocytes. Immunosuppression was blocked by pretreatment with GDCl3. The percentage of donor DCs in hepatic non-parenchymal cells (NPCs) was significantly higher in the PV group compared with the IV group. Treatment with GDCl3 decreased the percentage of donor DCs. In addition, cytotoxic T lymphocyte antigen 4 (CTLA4/CD152), which may function as an immune attenuator, was strongly stained, and B7 was weakly stained in recipient liver in the PV group compared with the IV group. These results suggest that both donor DCs and recipient Kupffer cells (self DCs) are involved in the induction of immune hyporesponsiveness by donor cells. This occurs via portovenous administration, in which a signal of the CTLA4–B7 pathway played an important part in inhibiting the interaction of CD28 and its B7 ligands.
A Randomized, Double-Blind, Parallel-Group Study to Compare the Anti-Hypertensive Effects of Imidapril and Nifedipine in the Treatment of Mild-to-Moderate Essential Hypertension
Authors: van der Does R , Euler R
Published: February 2013

This 12-week, multicentre, double-blind, placebo-controlled, parallel-group study compared efficacy of the angiotensin-converting enzyme (ACE) inhibitor imidapril 5–10 mg/day and the calcium channel blocker nifedipine slow-release (SR) formulation 20–40 mg twice daily. In total 320 patients aged 18–75 years, with mean sitting diastolic blood pressures of 95–115 mmHg, were randomized to treatment with imidapril ( n = 157) or nifedipine SR ( n = 163). Efficacy evaluations were based on the intent-to-treat principle. On study completion, there was no difference between the groups with respect to the primary efficacy variable of response to treatment (imidapril 63.1%; nifedipine SR 61.3%). After 2 weeks' treatment, clinically relevant decreases in blood pressure were observed in both groups, with a trend towards further reductions until study end. Fewer patients in the imidapril-treated group than the nifedipine group withdrew due to adverse events that occurred on treatment with study medication (3.2% versus 16.0%) or experienced adverse events (40.1% versus 49.7%). In addition, fewer adverse events were causally related to imidapril (24.2%) compared with nifedipine SR (41.7%). These results show that imidapril is effective in the treatment of essential hypertension and is better tolerated than nifedipine SR
Graft-versus-Host Reaction in Small-Bowel Transplantation and Possibilities for Its Circumvention
Authors: Watanabe K , Yagi T , Iwagaki H , Kimura Y , Mitsuoka N , Inagaki M , Tanaka S , Tanaka N
Published: February 2013

To study graft-versus-host reaction (GVHR) in small-bowel transplantation and its underlying mechanisms and to find methods for circumventing GVHR, we used an unidirectional GVHR model in which F1 Lewis (LEW) × Wistar King A (WKA) hybrid rats received small-bowel transplants from either LEW or WKA parent rats. The survival time of F1 hybrid rats that received full-length small-bowel transplantation from LEW and WKA was 16.3 ± 2.1 days and 18.2 ± 3.4 days, respectively. When one-quarter of LEW small bowel was transplanted to an F1 hybrid recipient, the survival time was significantly longer at 44.0 ± 23.4 days compared with rats that had received full-length LEW small-bowel transplantation. The survival time of F1 hybrid rats which received an injection of high-dose (5 × 108 cells) LEW or WKA spleen cells was 11.9 ± 4.0 days and 13.1 ± 3.6 days, respectively. However, when an injection containing a low dose (1 × 108 cells) of LEW spleen cells was used, survival was > 100 days, showing significance compared with the survival of rats receiving the higher dose LEW spleen-cell injection. Both small-bowel transplantation and spleen-cell injection were compared for the effective period of recipient resistance to donor cell or small-bowel transplantation as second challenge. When the F1 rats given a quarter LEW small-bowel transplant as first challenge were treated with a high-dose of spleen cells 30 days after transplantation, they survived for > 30 days without GVHR. F1 rats that were treated with a low-dose LEW spleen-cell injection, followed 30 days later by full LEW small-bowel transplantation, had a survival time of > 100 days. These results indicate that segmental small-bowel transplantation and spleen-cell injection as first challenge may facilitate the prevention of GVHR, resulting in resistance to subsequent immunological challenge
Use of Ampicillin/Sulbactam and Sultamicillin in Pediatric Infections: A Re-Evaluation
Authors: Dajani AS
Published: February 2013

Ampicillin/sulbactam is an effective solution to the emergence of β-lactamase-mediated resistance among common pediatric pathogens, and is a widely recognized treatment option for a variety of pediatric infections. Recent antimicrobial surveillance data confirm the continued susceptibility of many Gram-positive and Gram-negative aerobes and anaerobes to ampicillin/sulbactam. Pharmacokinetic studies have demonstrated high drug concentrations at a variety of infection sites, including cerebrospinal fluid and bone. Furthermore, clinical studies have shown that ampicillin/sulbactam, administered intravenously, intramuscularly or orally (as the mutual prodrug sultamicillin), is clinically and bacteriologically effective against upper and lower respiratory tract infections, urinary tract infections, skin, bone and soft-tissue infections, and meningitis, and provides effective surgical prophylaxis. Sultamicillin has an excellent tolerability profile, which is associated with a low rate of treatment discontinuation. Accordingly, ampicillin/sulbactam and sultamicillin should be considered first-choice options for the management of a variety of pediatric infections.
Role of Blood Pressure in the Progression of Microalbuminuria in Elderly Japanese Type 2 Diabetic Patients: A 7-Year Follow-up Study
Authors: Ito Y , Utsugi T , Ohyama Y , Ohno T , Uchiyama T , Tomono S , Kawazu S , Kurabayashi M
Published: February 2013

This 7-year retrospective longitudinal study was carried out in order to clarify the clinical features of elderly type 2 diabetic patients with microalbuminuria. Elderly Japanese type 2 diabetic patients ( n = 22; age 50–73 years) with microalbuminuria were studied retrospectively. Patients whose urinary albumin excretion rate (UAER) decreased over 7 years were considered ‘non-progressors' ( n = 8) whereas those whose UAER increased were considered ‘progressors' ( n = 14). The mean 7-year level of glycosylated haemoglobin (HbA1c) did not differ significantly between non-progressors and progressors but the mean 7-year blood pressure (BP) of progressors (101 ± 8 mmHg) was significantly higher than that of non-progressors (92 ± 7 mmHg). In progressors who received no anti-hypertensive drugs, systolic BP was above the BP goal of 130/85 mmHg but mean BP and diastolic BP were below this goal. The results are consistent with the view that hypertension affects the progression of microalbuminuria; raised systolic BP may be a factor in this progression in elderly type 2 diabetic patients.
Expression of p73 in Colorectal Carcinoma: Clinicopathological Relevance
Authors: Liu L , Cui X , Sakaguchi T , Sasaki M , Suda T , Hatakeyama K
Published: February 2013

p73 gene expression and its correlation with clinicopathological variables were examined in 92 patients (53 male, 39 female; age range 38–89 years) with colorectal carcinoma. Gene expression was determined by immunohistochemical analysis of resected formalin-fixed and paraffin-embedded carcinoma specimens. When p73 staining of each specimen was divided into two modes (small expression, 0–50% and large expression, > 50%), small expression of p73 was obtained in most cases. Tumour, grade, stage, site and size did not correlate with the mode of expression, but tumour recurrence differed according to mode. Expression of p73 was also related to prognosis: large expression indicated a shorter survival period. Our findings suggest that p73 expression plays a role in inducing tumour recurrence, and that analysis of the expression is useful in evaluating the clinical course of colorectal carcinoma post-surgery.
A Multinational, Multicentre, Non-Blinded, Randomized Study of Moxifloxacin Oral Tablets Compared with Co-Amoxiclav Oral Tablets in the Treatment of Acute Exacerbation of Chronic Bronchitis
Authors: Schaberg T , Ballin I , Huchon G , Bassaris H , Hampel B , Reimnitz P ,   The AECB Study Group
Published: February 2013

The aim of this study was to compare the efficacy and safety of once daily dosing with moxifloxacin (BAY 12–8039) with that of co-amoxiclav given three times daily for the treatment of acute exacerbation of chronic bronchitis (AECB). Moxifloxacin (one 400 mg tablet daily) was administered orally for 5 days and co-amoxiclav (three 625 mg tablets daily) was given orally for 7 days. The study was randomized, non-blinded, multinational (12 countries) and multicentre (68 centres). A total of 575 patients, all with clear signs of AECB, were treated, 292 with moxifloxacin and 283 with co-amoxiclav. Of these, 512 patients were evaluable for efficacy (261 in the moxifloxacin group and 251 in the co-amoxiclav group). The primary efficacy parameter was clinical response at 14 days in the evaluable population. A clinical success was classified as resolution or improvement of symptoms. Variables used to assess clinical response included wheeze, cough, dyspnoea, sputum volume, rales and rhonchi. The success rate for moxifloxacin in the evaluable patients was 96.2% and that for co-amoxiclav was 91.6%. The 95% confidence intervals for this difference (0.4%; 8.7%) indicate equivalence in the treatments. Sputum samples were taken from patients and 140 of these contained a pathogen, Haemophilus influenzae being the most frequently isolated. Moraxella catarrhalis and Streptococcus pneumoniae were also commonly isolated pathogens. The eradication rate at 14 days in the evaluable patients was 87.7% in the moxifloxacin group and 89.6% in the co-amoxiclav group. Both drugs were well tolerated with no significant differences in the numbers of drug-related adverse events or the numbers of patients withdrawing because of an adverse event. These results and the broad spectrum of antibacterial activity make moxifloxacin a promising and safe alternative to conventional therapy for the empirical treatment of AECB.
Midazolam for Continuous Sedation in Japanese Critical Care Patients: Phase II Study
Authors: Kinoshita K , Sakurai A , Mera K , Shirai K , Hon'e J , Moriya T , Okuno K , Noda E , Yoshida S , Kaburagi M , Kashiwa M , Imai Y , Tanjoh K , Hayashi N
Published: February 2013

This prospective study was undertaken to evaluate the efficacy and safety of midazolam as a sedative agent in 14 critically ill patients without coma admitted to the intensive care unit at Nihon University Itabashi Hospital, Japan. Adequate sedation (sedation score [SS] 4–6) was induced with 0.058–0.372 mg/kg midazolam and maintained with a dose range of 0.03–0.4 mg/kg per h. Most burn or trauma patients required higher midazolam doses than patients with cardiovascular disease. The most frequent adverse events observed were hypotension, heart-rate fluctuation and electrocardiogram abnormalities. Pharmacokinetic analysis of the population suggested that lower drug clearance rates correlated with presence of complications. Plasma concentrations (EC50) of SS 5, estimated by logistic regression analysis, varied among patients (mean 194 ng/ml). Midazolam infusion achieved successful sedation in this critical care setting, but the optimum dose differed by patient and was influenced by the presence of complications.
Conjugated Linoleic Acid Reduces Body Fat in Healthy Exercising Humans
Authors: Thom E , Wadstein J , Gudmundsen O
Published: February 2013

This study was designed to investigate the efficacy and tolerability of daily conjugated linoleic acid (CLA) in healthy exercising humans. This was a randomized, double-blind, placebo-controlled study in 20 healthy humans of normal body weight and body mass index less than 25.0 kg/m2, who did standardized physical exercise in a gym for 90 min three times weekly. Participants took either placebo (hydrogel) or CLA 0.6 mg, three times daily, as two capsules during meals, for 12 weeks. Body fat, measured using near infrared light, was significantly reduced in the CLA group during the study, but not in the placebo group. No effects on body weight were observed. Tolerability was good and similar in the two groups. Compliance, as judged by the number of returned capsules, was more than 80% of the recommended dose for all participants. Thus CLA reduces body fat but not body weight in healthy exercising humans of normal body weight.
Successful Treatment of Patients with Rheumatic Disorders and Acquired Factor VIII Inhibitors with Cyclophosphamide and Prednisolone Combination Therapy: Two Case Reports
Authors: Nishino Y , Ueki K , Suto M , Uchiumi H , Ota F , Tamura S , Kaneko Y , Kuroiwa T , Tsukada Y , Maezawa A , Nojima Y
Published: February 2013

Acquired haemophilia associated with autoimmune disorders can be fatal and has been reported to be refractory to steroid therapy alone. We report two cases of female patients, aged 24 years and 54 years, with acquired haemophilia caused by factor VIII inhibitors. Underlying diseases were systemic lupus erythematosus in the 24-year-old patient and rheumatoid arthritis in the 54-year-old patient. Both conditions were nearly quiescent when the patients manifested haemorrhagic diathesis. In response to combination therapy with prednisolone and cyclophosphamide, coagulation abnormalities were resolved together with complete elimination of factor VIII inhibitors in both patients. Thus, combination therapy with alkylating agents may be recommended as initial therapy for the management of autoimmune patients with factor VIII inhibitors.
Fatal Hydrothorax Due to Misplacement of a Nasoenteric Feeding Tube
Authors: Yavaşcaoğlu B , Acar HV , İşçimen R , Gurbet A , Uysal H , Kutlay O
Published: February 2013

Blind nasoenteric intubation was attempted in a patient with chronic parkinsonism. The tube was inadvertently misplaced and penetrated the left pleural cavity. The next day, the patient developed cardiopulmonary arrest during dietary supplement infusion. This complication ultimately led to the patient's death. We have reviewed the known complications of nasoenteric tube placement and conclude that difficult insertion in patients at risk from tube misplacement should be followed by chest radiography to confirm the correct placement of the tube before nutritional support is started.
Recurrent Pyogenic Vertebral Osteomyelitis Associated with Type 2 Diabetes Mellitus
Authors: Isobe Z , Utsugi T , Ohyama Y , Miyazaki A , Ito H , Okuno S , Uchiyama T , Ohno T , Arai M , Tomono S , Kurabayashi M
Published: February 2013

We report a case of recurrent pyogenic vertebral osteomyelitis associated with type 2 diabetes mellitus. A 51-year-old male was admitted to our hospital because of lumbago and general fatigue, with multiple ulcers on the soles of his feet. Staphylococcus aureus was isolated from peripheral blood and the foot ulcers, and 67Gallium scintigram showed abnormal isotope uptake, accumulated at the lower thoracic spine. Antibiotics were administered and the patient underwent intensive insulin therapy. Magnetic resonance imaging (MRI), performed after the levels of C-reactive protein decreased to 0.0 mg/dl, indicated old inflammatory changes at the Th8–Th9 spine and antibiotics were stopped. Unexpectedly, 8 days later the patient complained of lumbago with fever again, and MRI showed acute inflammatory changes at the same lesion site. This case report suggests that it is important for complementary antibiotic therapy to continue after signs of inflammation have disappeared in cases of pyogenic vertebral osteomyelitis.
Clinical Advantages of Amisulpride in the Treatment of Acute Schizophrenia
Authors: Burns T , Bale R
Published: February 2013

Five studies have been conducted with the atypical anti-psychotic amisulpride (100–1200 mg/day) involving 1358 patients with acute exacerbations of schizophrenia; four studies were short-term (4–8 weeks), double-blind studies and one was a 12-month, open, randomized comparison. Amisulpride improved positive symptoms consistently, and changes were more pronounced than with haloperidol, flupenthixol and risperidone; amisulpride showed a more rapid onset of action compared to haloperidol, and improvement in negative symptoms was more effective than with any comparator. An optimum response was obtained with amisulpride doses 400–800 mg/day. The long-term study confirmed the usefulness of amisulpride for maintenance treatment in schizophrenia, with a clear advantage over haloperidol, leading to better functioning and quality of life. Amisulpride caused fewer neurological side-effects than conventional anti-psychotics and less weight gain than risperidone, both of which are crucial factors for long-term compliance.
The Impact of Acute Dynamic Exercise on Intraocular Pressure: Role of the β2-Adrenergic Receptor Polymorphism
Authors: Güngör K , Beydaăi H , Bekir N , Arslan C , Süer C , Erbağci İ , Ergenoğlu T , Aynacioğlu AŞ
Published: February 2013

Effects of mutations in the β2-adrenergic receptor (β2AR) gene on intraocular pressure (IOP), in response to acute dynamic exercise, were investigated in 19 healthy males (age 22.6 ± 2.8 years). Intraocular pressures were measured pre- and post-exercise. Weight, height, body mass index, and maximal oxygen (VO2max) uptake were recorded and subjects were genotyped for Arg16Gly, Gln27Glu and Thr164Ile mutations of the β2AR gene. Post-exercise, reductions in mean IOP values were found in 16 subjects with the Gly16Gly and Arg16Gly genotypes, but these values remained low in the eight patients with the Gly16Gly genotype 3 h post-exercise, whereas they returned to baseline within 1 h in the eight subjects with the Arg16Gly genotype. β2AR stimulation during exercise could be an important regulator of IOP response and determining β2AR polymorphisms may improve understanding of pathogenesis and treatment selection in ophthalmic diseases, e.g. glaucoma.
Plasma Thrombospondin in Immune Thrombocytopenic Purpura
Authors: Özcebe Oİ , Karakuş S , Haznedaroğlu İC , Göker H , Kosar A , Koçoğlu H , Büyükaşik Y , Sayinalp N , Kirazli Ş
Published: February 2013

Patients with immune thrombocytopenic purpura (ITP) rarely suffer life-threatening haemorrhages despite significant thrombocytopenia, probably because large numbers of hyperfunctioning platelets are present. Thrombospondin is a platelet α-granule protein and its plasma level may reflect platelet activation. We assessed circulating thrombospondin levels in 12 newly diagnosed ITP patients (one man; 11 women, aged 36 ± 16 years) before they were treated for ITP. Twelve healthy people (four men; eight women, aged 31 ± 11 years) acted as controls. Plasma thrombospondin concentrations were measured using enzyme-linked immunoassays. Thrombospondin concentrations tended to be higher, despite thrombocytopenia, in ITP patients (158.8 ± 28.2 ng/ml) compared with controls (120.7 ± 18.2 ng/ml). The difference was not statistically significant, but the relatively high circulating thrombospondin concentrations we observed suggest that residual platelets could be activated in ITP, thus indicating a more benign clinical course compared with aplastic thrombocytopenia.
Atrioventricular Nodal Re-Entrant Tachycardia with Two Functionally Discrete Fast Pathways
Authors: Manita M , Kaneko Y , Taniguchi Y , Nakajima T , Ito T , Akiyama M , Kurabayashi M
Published: February 2013

We present a case with two forms of atrioventricular nodal re-entrant tachycardia (AVNRT) that revealed similar H — A – V sequences, but could be differentiated only by their retrograde atrial activation sequences. Both tachycardias were induced following anterograde slow pathway conduction, suggesting the slow pathway as the anterograde limb of the reentry circuit. The earliest atrial activation site of one form was in the same region of the bundle of His as that of the common type of AVNRT, while that of the other form was the ostium of the coronary sinus. Properly timed extra-stimuli delivered from the atrium or ventricle during the latter tachycardia penetrated through the fast pathway without resetting the tachycardia cycle length. These rare phenomena suggest the existence of two functionally discrete fast pathways, of which the alternative pathway alters to become the more predominant retrograde limb according to time and circumstances.
Importance of Psychiatric Intervention in Intolerances in Endoscopic Procedures
Authors: Yildirgan Mİ , Çayköylü A , Başoğlu M , Atamanalp SS , Yilmaz İ , Balik AA
Published: February 2013

Despite the fact that pre-medication, in a number of different drug combinations, has been used for a long time in endoscopy units, and has been subject to extended clinical studies, it is still not possible to claim that it has attained an ideal state with regard to patient tolerance to endoscopy procedures. In this clinical study, we have investigated the effects of psychological intervention in addition to medication, which we used on patients with intolerance to endoscopy. Intolerance was very high in all endoscopic procedures (15.8% total). It was observed that average midazolam doses were significantly higher in intolerant than in tolerant patients. It was found that in patients who had received psychiatric intervention, the decrease in midazolam dose was statistically significant in a subsequent endoscopy procedure.
Amitraz Poisoning in Children: Retrospective Analysis of 21 Cases
Authors: Ertekin V , Alp H , Selimoğlu MA , Karacan M
Published: February 2013

The clinical and laboratory findings of 21 children with amitraz poisoning were evaluated retrospectively. Poisoning route, signs and symptoms of poisoning, duration of hospitalization and outcome were recorded. The mean age was 3.5 ± 1.9 years and the ratio of males to females was 1.63. In all cases poisoning was via the oral route. The time from ingestion to onset of symptoms was 30–180 min. Drowsiness (100%) and loss of consciousness (100%) were the most common clinical findings, followed by vomiting (61.9%). Hypotension was observed in 66.7% of cases, bradycardia in 61.9%, respiratory depression in 42.9%, hypothermia in 9.3%, and 14.3% had generalized seizures responsive to diazepam. Hyperglycaemia and glycosuria were detected in 47.6% and 38.1% of cases, respectively. Minimally elevated transaminases and alkaline phosphatase levels were detected in 23.8% of cases. All patients recovered completely and were discharged within 1.0–5.2 days (mean, 2.1 ± 1.1).
Evaluation of the Mandible as an Alternative Autogenous Bone Source for Oral and Maxillofacial Reconstruction
Authors: Güngörmüş M , Yilmaz AB , Ertaş Ü , Akgül HM , Yavuz MS , Harorli A
Published: February 2013

The objective of this study was to quantify the amount of bone graft material present in the different regions of the mandible while avoiding the inferior alveolar neurovascular bundle, mental foramen and tooth injury. The study was carried out on 16 samples of dry, cadaverous skull. The dimensions of the anterior part of ascending ramus, mandibular symphysis and mandibular body in these samples were evaluated. The osteotomy lines in the anterior part of the ascending ramus were made in front of the mandibular canal from the mandibular notch to 3 mm posterior of the root of the third molar. The osteotomy line in the mandibular body was made just medial to the external oblique ridge from the ascending ramus to approximately 3 mm posterior to the mental foramen. Vertical osteotomy lines were then made from the cut ends of the first osteotomy down to the lower border of the mandible. The osteotomy lines in the mandibular symphysis were performed on the mandible with 5-mm safety margins caudal to the expected position of the mandibular dentition, anterior to the position of the mental foramen, and cephalad to the inferior border of the mandible. It was determined that the dimensions of the anterior part of the ascending ramus were 37.60 mm × 33.17 mm × 22.48 mm × 9.15 mm, and the thickest part of the graft material was 12.23 mm. The average horizontal length of the mandibular body bone was 35.10 mm, and the average vertical length was 19.13 mm. The dimensions of the bone graft obtained from the mandibular symphysis were 45.36 mm × 10.31 mm, and the average thickness was 9.63 mm. Based on the results of this study, it is apparent that the different regions of the mandible can reliably be selected as the harvest site in a variety of oral and maxillofacial reconstructive procedures.
Effects of Stem Design and Pre-Cooling Prostheses on the Heat Generated by Bone Cement in an In Vitro Model
Authors: Rodop O , Kiral A , Arpacioglu O , Akmaz I , Solakoglu C , Pehlivan O , Kaplan H
Published: February 2013

The necrotizing effects of the heat, particularly at more than 50 °C, produced by the exothermic polymerization process associated with the acrylic implant cement polymethylmethacrylate (PMMA) are well documented. The temperature changes that occur are dependent on the thickness of the PMMA. The current study investigates the hypothesis that the heat produced by the bone cement may be reduced by the choice of stem design and by pre-cooling the hip prosthesis. The thermal alterations at the bone-cement interface were measured in an in vitro model. The results indicated that a temperature decrease of approximately 7 °C could be achieved by pre-cooling the prosthesis, and by changing the shape of the prosthesis stem from flat and wide to round.
The Effects of Vitamins E and C on Fracture Healing in Rats
Authors: Sarisözen B , Durak K , Dinçer G , Bilgen Of
Published: February 2013

Forty-eight rats were divided into four groups of 12. For 3 days, each group received the following vitamins in once-daily doses: group 1, vitamin E only; group 2, vitamin C only; group 3, vitamins E and C; and group 4, no treatment (control). The right tibia of each rat was fractured on day 4; the rats then received the same regimen three times a week (once-daily doses) until day 21. Fracture healing was evaluated radiologically by measuring the callus indices, and histologically by a 5-point grading scale. On days 14 and 21, the callus index values in group 2 were statistically higher than those in the other groups. Histological evaluation scores in group 2 were the highest overall, and group 3 scores were higher than those in groups 1 and 4. These findings indicate that vitamin C accelerates fracture healing, vitamin E does not exert a marked effect on this process, and vitamins E and C in combination do not have a synergistic impact on fracture healing.
Esterase Activity in Various Candida Species
Authors: Aktas E , Yigit N , Ayyildiz A
Published: February 2013

The aim of the present study is to ascertain esterase activities of various species of Candida. A total of 125 strains isolated and identified by conventional methods were tested for esterase activity using the Tween 80 opacity test. Our results showed that 58 of 59 strains of Candida albicans, all of the Candida tropicalis strains ( n = 38) and all of the Candida guilliermondii strains ( n = 3) produced positive results, whereas the remaining Candida species did not. The Tween 80 opacity test is a useful method because it is simple, economical and easy to prepare and interpret.
Comparative Cochlear Toxicities of Streptomycin, Gentamicin, Amikacin and Netilmicin in Guinea-Pigs
Authors: Kalkandelen S , Selimoğlu E , Erdoğan F , Üçüncü H , Altaş E
Published: February 2013

All the aminoglycoside antibiotics now in clinical use are ototoxic. This study was designed to compare the toxic effects of four aminoglycoside antibiotics, streptomycin, gentamicin, amikacin and netilmicin, administered to guinea-pigs systemically (at respective doses of 125 mg/kg, 50 mg/kg, 150 mg/kg or 37.5 mg/kg, twice daily for 1 week) or topically via the transtympanic route (0.25 ml/kg in 4% saline, twice daily for 1 week). Chosen doses were 10–20 times higher than the recommended human dosage. Cochlear damage was observed in all animals that were given systemic and local aminoglycosides. The severity of the cochlear damage was in the order gentamicin, amikacin, streptomycin, netilmicin, with gentamicin being the most toxic. No statistically significant difference between the severity of cochlear damage resulting from the systemic and topical applications was detected.
Polymorphism of CYP2C19 and Gastric Emptying in Patients with Proton Pump Inhibitor-Resistant Gastric Ulcers
Authors: Wada F , Murase K , Isomoto H , Soda H , Takeshima F , Omagari K , Mizuta Y , Tsukamoto K , Murata I , Kohno S
Published: February 2013

The aim of the present study was to investigate whether CYP2C19 polymorphism status and gastric emptying are related to healing in patients with gastric ulcers. We studied the CYP2C19 status in seven patients with proton pump inhibitor (PPI)-resistant ulcers, 21 with PPI-sensitive ulcers and 46 healthy volunteers using polymerase chain reaction restriction fragment length polymorphism to detect CYP2C19m1 mutation in exon 5 and CYP2C19m2 mutation in exon 4. Gastric emptying was evaluated using the 13C-acetate breath test. The frequency of phenotypes, indicated by genotypes, did not differ significantly between the three patient groups. The peak time of 13C excretion in patients with PPI-resistant ulcers was significantly longer than that of patients with PPI-sensitive ulcers and healthy volunteers. Our results suggest that rate of gastric emptying, but not CYP2C19 polymorphism, is likely to be an important factor in the delayed healing of patients with PPI-resistant gastric ulcer.