bluuebunny/crossref_metadata_2025 huggingface dataset:
Vitamin and Mineral Supplements for the Use of Children on the German Market: Products, Nutrients, Dosages
Authors: Kersting Mathilde , Alexy Ute
Published: April 2003

A market survey of vitamin and mineral supplements was carried out considering various points of purchase. 37 of 146 producers offered a total of 110 supplements marketed ‘directly’ (42%) or ‘indirectly’ (58%) for the use of children. These products contained 31 different nutrients, vitamins more frequently than minerals. The number of nutrients per product ranged from 1 (23%) to over 10 (13%), maximum 26. In most cases, the daily dosage recommended by producers reached from 100 to 200% of the reference doses for nutrition labelling for vitamins and from 50 to 100% for minerals. In total, the findings point to an abundancy of products, nutrients and dosages in the German market supply of vitamin and mineral supplements for the use of children.
Effects of Age and Diabetes on Blood Flow Rate and Primary Outcome of Newly Created Hemodialysis Arteriovenous Fistulas
Authors: Lin Shuei-Liong , Huang Ching-Huai , Chen Huan-Sheng , Hsu Wei-An , Yen Chung-Jen , Yen Tsan-Shin
Published: April 2003

To study the feasibility of creating a radiocephalic hemodialysis fistula in elderly and diabetic patients, we prospectively studied 176 patients undergoing the first permanent vascular access creation and followed the outcome of fistula until primary failure or success was assessed. Color duplex ultrasonography was used to measure the blood flow rate. Fistula blood flow rate was significantly smaller in elderly patients, however, it was >400 ml/min in over 78% of the elderly patients with successful fistulas. There was no difference in fistula blood flow rate between nondiabetics and diabetics. Dialysis adequacy (Kt/V) via fistula was the same between age groups and between diabetes mellitus status. Old age or diabetes per se did not significantly predispose a new fistula to primary failure, but concurrent old age and diabetes markedly increase the risk. In conclusion, a good primary outcome of newly created radiocephalic fistula and adequate dialysis via fistula were demonstrated for elderly and diabetic patients. However, the longevity of fistula in elderly and diabetic patients needs further study.
Evaluation of Renal Tubular Functions in Convalescent Phase of Hemorrhagic Fever with Renal Syndrome
Authors: Kim Gheun-Ho , Han Jin Suk , Earm Jaeho , Jeon Un Sil , Kim Yon Su , Ahn Curie , Kim Suhnggwon , Lee Jung Sang
Published: April 2003

To evaluate renal tubular functions and to investigate the causative factors of urinary-concentrating defects in the late stage of hemorrhagic fever with renal syndrome (HFRS), 11 HFRS patients in the convalescent phase were studied and compared with 8 acute renal failure (ARF) patients in convalescence (disease controls) and 9 healthy adults preparing for kidney donation (normal controls, NC). Minimal urine osmolality induced by water loading was higher (p < 0.05) in HFRS (89.5 ± 22.1 mosm/kg) and ARF patients (84.8 ± 14.7 mosm/kg) than in NC (47.8 ± 4.6 mosm/kg), but the solute-free water clearance of HFRS patients (9.0 ± 1.3%), measured at maximal diuresis, was not different from that of ARF patients (6.7 ± 1.2%) or NC (10.5 ± 1.4%). After 12-hour water deprivation + vasopressin stimulation, HFRS had lower urine osmolality (433.7 ± 31.1 versus 850.0 ± 35.1 mosm/kg; p < 0.05), urine-to-plasma osmolality ratio (1.47 ± 0.11 versus 2.91 ± 0.11; p < 0.05), and solute-free water reabsorption (0.53 ± 0.07 versus 0.91 ± 0.12%; p < 0.05) than NC. As compared with ARF patients (1.09 ± 0.16%) or NC (1.49 ± 0.16%), HFRS patients (0.43 ± 0.20%) had lower solute-free water reabsorption measured at maximal antidiuresis induced by water deprivation + vasopressin stimulation + hypertonic saline infusion (p < 0.05). In HFRS, the plasma vasopressin level and plasma vasopressin/osmolality ratio increased from 3.9 ± 0.8 to 6.1 ± 1.1 pg/ml and from 0.013 ± 0.003 to 0.020 ± 0.004 pg/ml/mosm/kg after 12-hour water deprivation, respectively (p < 0.01). However, neither basal nor stimulated values of the plasma vasopressin level or plasma vasopressin/osmolality ratio was different among the 3 groups. HFRS patients were not different from ARF patients or NC in lithium clearance, urinary-acidifying capacity, and fractional excretions of sodium, potassium and bicarbonate. We conclude that in the convalescent phase of HFRS, the urinary-acidifying ability is not disturbed, the urinary-diluting defect is mild, and the urinary-concentrating capacity is obviously impaired. This study suggests that the most important factor contributing to the urinary-concentrating defect in HFRS is the reduced collecting duct responsiveness to vasopressin.
Collagenofibrotic Glomerulonephropathy Associated with Immune Complex Deposits
Authors: Hisakawa Naoko , Yasuoka Nobukazu , Nishiya Koji , Kumon Yoshitaka , Okamoto Kazuo , Itoh Hiroyuki , Hashimoto Kozo , Moriki Toshiaki
Published: April 2003

A 66-year-old Japanese male, who suffered from persistent proteinuria and leg edema, underwent renal biopsy. Light microscopy revealed marked narrowing of the glomerular capillary lumen with a diffuse accumulation of weakly PAS-positive material. By electron microscopy, abundant abnormal collagen fibers were observed predominantly in the subendothelial space and occasionally in the mesangial matrix. The fibers had a periodicity of about 60 nm and were immunoreactive for anti-type III collagen. Subendothelial electron-dense deposits were also found in some of the capillary walls. The serum level of procollagen III peptides was elevated and changed in parallel with the amount of proteinuria during the patient’s clinical course. On the basis of these findings, a diagnosis of the collagenofibrotic glomerulonephropathy was made. A review of the literature, including 29 similar or identical cases, failed to reveal the etiology and pathogenesis of this disease. We suggest that this disease may be divided into two different clinical subtypes, an adult-onset type and a pediatric type.
Hyporeninemic Hypoaldosteronism in Patients with Nephrotic Syndrome
Authors: Usberti Mario , Gazzotti Rosa Maria
Published: April 2003

Five nephrotic patients, who did not present sodium retention when on sodium balance, have been studied. All had membranous nephropathy, were normotensive and renal function was normal in 2 and slightly reduced in 3. The following parameters were measured: 24-hour excretion of aldosterone, the response of plasma renin activity (PRA) and of plasma aldosterone to upright posture, postural changes of the fractional excretion of sodium and lithium, and natriuretic response to spironolactone. The resting values of plasma aldosterone were low in all patients, and after stimulation by upright posture they increased hardly to the low-normal limit only in 1 patient. Resting PRA was normal in all patients and increased slightly, after stimulation. The 24-hour urinary excretion of aldosterone was low in 4 patients and borderline in 1. No natriuretic response to spironolactone was observed in any patients. After upright posture the fractional excretions of sodium and lithium decreased significantly and to the same extent in all patients. Four nephrotic patients with fluctuating, spontaneous episodes of sodium retention and of sodium excretion have been studied as controls. These patients had normal values of urinary aldosterone and of resting PRA and aldosterone. After upright posture the changes of PRA and of aldosterone were clearly evident in 2, and exaggerated in the other 2 patients. In these patients, a significant increase of sodium excretion occurred after treatment with spironolactone. These results suggest that a not negligible number of patients with nephrotic syndrome have hyporeninemic hypoaldosteronism. This diagnosis should be taken into account when investigating the role of aldosterone in sodium retention in nephrotic syndrome.
Effect of Chronic Therapy with Proteolytic Enzymes on Hypertension-Induced Renal Injury in the Rat Model of Goldblatt Hypertension
Authors: Šebeková Katarina , Dämmrich Jobst , Fierlbeck Wolfgang , Krivosiková Zora , Pączek Leszek , Heidland August
Published: April 2003

This study investigated the possible beneficial effect of intraperitoneal proteolytic enzyme administration on the development of hypertension-induced renal injury in the rat model of 2-kidney 1-clip (2K1C) Goldblatt hypertension. Male Wistar rats (120–150 g) underwent either sham surgery (control, n = 5) or clipping of the left renal artery. From day one 2K1C rats were randomized into 2 groups, placebo treatment (n = 7), and proteolytic enzyme treatment (n = 9). To the verum group a fixed mixture of trypsin (2.42 mg), bromelain (4.54 mg), and rutin (5.04 mg) dissolved in 2 ml of sterile 0.9% NaCl was administered intraperitoneally daily, while the placebo group received only vehicle. Rats were pair-fed. The duration of the study was 7 weeks. All 2K1C rats developed hypertension and the mean values of systolic blood pressure (SBP) did not differ significantly between the groups at any time recorded (SBP at sacrifice: controls 122.0 ± 8.5 mm Hg; placebo 191.4 ± 7.6 mm Hg; enzyme 180.5 ± 6.5 mm Hg). Enzyme treatment prevented the rise in proteinuria (controls 12.4 ± 2.6 mg/24 h; placebo 19.7 ± 3.9 mg/24 h; enzyme 12.2 ± 1.3 mg/24 h; p < 0.05) and ameliorated the increase in serum urea concentrations. Histomorphologically, signs of malignant nephrosclerosis were not found in control rats, while they were present in 4/7 (57%) of placebo-treated rats, but only in 1/9 (11%) of the enzyme-treated group. The volume fraction of renocortical interstitium was increased in both 2K1C groups in comparison with controls; however, enzyme treatment decreased the accumulation of interstitial tissue significantly (–22%) compared to placebo treatment. Cellular infiltration with mononuclear cells was also lower in the protease-treated group. To summarize, in the rat model of 2K1C hypertension, systemic treatment with proteases ameliorates the severity of nephrosclerosis and tubulointerstitial fibrosis in the non-clipped kidney, as well as proteinuria, without affecting high blood pressure.
Biochemical Parameters, Nutritional Status and Efficiency of Dialysis in CAPD and CCPD Patients
Authors: Gao Hubin , Lew SusieQ. , Bosch JuanP.
Published: April 2003

Background/Aims: Several studies indicate that small solute transport is influenced by peritoneal dialysate volume and dwell time. This study focuses on the clinical impact of peritoneal dialysis modality, continuous ambulatory peritoneal dialysis (CAPD) and continuous cycling peritoneal dialysis (CCPD). Methods: We studied 18 patients on CAPD and 11 on CCPD for 18 months and assessed biochemical parameters, nutritional status and efficiency of dialysis at 6-month intervals. Results: Four-hour D/P urea and creatinine ratios were similar in both CAPD and CCPD patients. However, 24-hour D/P urea and creatinine ratios were significantly higher in CAPD than in CCPD patients (0.9 ± 0.1 vs. 0.8 ± 0.2 and 0.8 ± 0.1 vs. 0.6 ± 0.2, p < 0.05 and p < 0.01, respectively). The dialysate urea nitrogen concentration was significantly different between the two groups (65 ± 14 mg/dl in CAPD, 48 ± 13 mg/dl in CCPD; p < 0.05). Total weekly Kt/V and total weekly creatinine clearance were not significantly different between CAPD and CCPD patients at 18 months (1.6 ± 0.4 vs. 1.7 ± 0.3 and 52 ± 21 vs. 50 ± 12 liters, respectively). Two-way ANOVA with a post-hoc Bonferroni-Dunn test showed serum potassium concentration was significantly lower in CCPD patients at 18 months (3.8 ± 0.5 mEq/l, p < 0.05), and significant increases in triglyceride levels in the CAPD groups by 18 months (301 ± 286 mg/dl, p < 0.05). Conclusion: This study demonstrates that the mean serum triglyceride level increases in CAPD patients over time, and the mean serum potassium concentration decreases in CCPD patients at 18 months. Dialysis adequacy and nutritional status are not significantly different between the two peritoneal dialysis modalities, CAPD and CCPD. We suggest the peritoneal dialysis prescription for CAPD or CCPD with respect to volume and frequency of exchanges be individualized to achieve adequate of therapy.
Plasma Exchange in Rapidly Progressive Renal Failure Due to Multiple Myeloma
Authors: Moist Louise , Nesrallah Gihad , Kortas Claude , Espirtu Eleanor , Ostbye Truls , Clark William F.
Published: April 2003

Background/Aims: To evaluate the effect of plasma exchange on renal function in patients with rapidly progressive renal failure secondary to multiple myeloma. Methods: The study was done through a retrospective chart review using a standardized form at a tertiary care centre in southwestern Ontario. Patients were included in the study if they had a diagnosis of multiple myeloma and rapidly progressive renal failure. Multiple myeloma was defined by a bone marrow aspirate >15% plasma cells plus one of the following: serum monoclonal paraproteins, monoclonal light-chain excretion, or lytic lesions. Patients were excluded if they had evidence of chronic renal failure or failed to complete three plasma exchanges. Twenty-six patients were reviewed; of these 24 were followed up to 1 year. All patients received hydration, standard chemotherapy, and plasma exchange. The plasma exchange volume was 50 ml/kg of 50% normal saline and 50% human serum albumin. Primary outcome measures included (1) prevention of acute dialysis and (2) prevention of progression from acute to chronic dialysis; secondary end points included (1) a decrease in creatinine of 25% or more within 3 months of the last plasma exchange and (2) survival at 1 year. Results: Sixteen of 24 patients, followed up to 1 year, did not require dialysis. Two patients required dialysis initially, but were able to come off dialysis after 3 months. Fourteen patients were alive at 1 year, 13 of whom were dialysis independent. Twelve of 13 dialysis-independent patients had a >25% reduction in creatinine at 3 months. Two patients were lost to follow-up after discharge and were not included in the analysis. Conclusions: This retrospective study suggests that plasma exchange may offer some benefit in preventing the initiation or continuation of dialysis in patients with rapidly progressive renal failure secondary to multiple myeloma. A randomized controlled prospective study is needed to determine whether plasma exchange should be recommended as a standard treatment for patients with rapidly progressive renal failure due to multiple myeloma.
Percutaneous Cuffed Catheter Insertion by Nephrologists
Authors: Choudhury Devasmita , Ahmed Ziauddin , Girgis HanyI. , Kronfli Saeed
Published: April 2003

The use of Dacron cuff double-lumen permanent catheters for hemodialysis has become more common in the dialysis unit as patients await for creation or maturation of a permanent hemoaccess for various reasons. Placement of these catheters is often done by surgeons. Nephrologists skilled in the placement of temporary central vein accesses can extend their skill to placement of cuff catheters with the current available peel-away insertion technique. Data are presented on the percutaneous placement of 77 Dacron cuff permanent catheters by 4 nephrologists in two medical centers in a nonoperating room setting with minimal complications.
Pre-Columbian Medicine and the Kidney
Authors: Peña José Carlos
Published: April 2003

Medicine in Mesoamerican cultures began in the year 1500 BC and ended with the conquest and destruction of Mexico-Tenochtitlan in 1521 by Spain. Mesoamerica started with the Olmec civilization followed by the Teoitihuacanes, Toltecs, and Mayas and perished with the Nahoa Empire. The medicine used by the Aztecs (ticiotl) is undoubtedly the sum of all Mesoamerican medicine. The medical history of the ticiotl was recovered in the years that followed the conquest from the works of Bernardino de Sahagún and Francisco Hernández and the Cruz-Badiano codex. All these works describe the use of plants and herbs in the treatment of diseases, including, edema, urinary retention, kidney stones, and podagra. The Aztec doctors (titicih) were also well acquainted with innumerable diseases and were excellent healers of wounds and fractures. The works of modern historians confirm the theory of the ticiotl medicine and its application by the titicih and define the differences between the hippocratic-galenic medicine and the ticiotl medicine. The latter used a complex and philosophically elaborated medical theory based on the polarity cold/warm, different from the four-humor theory. They demonstrate that every culture is capable to understand and ‘invent’ the meaning of disease and its cure, even when it is different from our modern medical views.
Observations on the Liber medicine orinalibus by Hermogenes
Authors: Iorio Luigi , Avagliano Faustino
Published: April 2003

Our report is based on a text of the philosopher Hermogenes entitled Liber medicine orinalibus now conserved in Cod. Casin. 69 (10th century), pp 545–551, of the Montecassino Archive. This text was written in Beneventano-Cassinese characters. The Liber medicine orinalibus presents an articulate description of urines, which is interesting because of the information it provides regarding the knowledge of medicine in the 2nd century AD. This text allows us to appreciate the level reached in urine diagnostics that were performed in the medical laboratory annexed to the ‘Ospitium’.
Renal Growth Factors: Past, Present and Future
Authors: Schena F.P. , Strippoli G.F.M. , Wankelmuth P.
Published: April 2003

It is known that a series of mediators, so-called growth factors, are able to induce hypertrophy of the kidney in a patient after uninephrectomy. The first investigator who demonstrated this phenomenon was C. Sacerdotti, an Italian pathologist of Bizzozero’s School in Turin, who published an important report in 1896. He attempted to explain how compensatory renal hypertrophy occurred and how this hypertrophy might be induced in a normal dog. Interestingly, he demonstrated that when the kidneys of a normal dog received a blood transfusion from uni- or binephrectomized dogs several mitoses appeared in the renal epithelium. These mitoses, expression of renal hypertrophy, were more evident in dogs receiving several blood transfusions for 6–7 days. He concluded that hypertrophy was induced by specific substances circulating in the blood of uni- or binephrectomized dogs. This hypothesis was in the next 100 years confirmed by the discovery of renal growth factors such as epidermal growth factor, insulin-like growth factor-1, hepatocyte growth factor, platelet-derived growth factor and others. The pathogenic role of these mediators is evident in the recovery of tubules after acute tubular necrosis and in the remnant glomeruli after glomerular damage. Today, attempts to use these growth factors for improving renal function in patients with acute tubular necrosis and to block their action in the progression of renal damage in chronic glomerulonephritides are under investigation. Future trends in these growth factors will be set by drug companies designing specific therapies such as gene therapy. In conclusion, the outstanding observation by Sacerdotti, over a century ago, remains an important step in nephrologic history for prognosis and therapy of renal diseases.
Evidence for Genetic Heterogeneity in Benign Familial Hematuria
Authors: Piccini Monica , Casari Giorgio , Zhou Janhua , Bruttini Mirella , Volti Salvatore Li , Ballabio Andrea , Renieri Alessandra
Published: April 2003

Benign familial hematuria (BFH: MIM141200) is an autosomal-dominant disease accounting for one-fifth of all hematuria of unknown cause in children. Previous observations suggest that BFH may be allelic to recessive Alport syndrome (AS: MIM 203780) with a mutation in the COL4A3/COL4A4 locus. However, it is not clear whether all cases of BFH are due to heterozygous mutation of COL4A3/COL4A4 genes. We report here the exclusion of linkage between BFH and COL4A3/COL4A4 loci at 2q35-37 in a restricted population from Sicily (Italy). Total lod score is –9.6 at theta 0. Furthermore, in some cases exclusion of linkage is evident even considering single families. We conclude that BFH is genetically heterogeneous.
Nephrology, a Newly Rich Speciality, Is Looking for an Illustrious Ancestry: What about a Famous Grandfather?
Authors: Diamandopoulos A.A. , Goudas P.C.
Published: April 2003

Nephrology is a newborn speciality compared to the other medical specialities. However, the study of the urinary tract’s physiology and pathology had begun simultaneously with the birth of medicine. The scientific revolution of the renaissance and enlightenment eras caused an intense contestation of earlier theories and methods as if all knowledge had evolved suddenly from parthenogenesis after the dark (?) medieval years and human intellect suddenly exploded to huge intelligence quotients after the 15th century while before that humans were mentally deprived. Indeed most of the scientific knowledge did evolve impressively during renaissance and enlightenment years but not through parthenogenesis. Some observations, discoveries and inventions of this era were actually reobservations, rediscoveries and reinventions. Such an example is that of the experiments of Sanctorius Santorii of the 16th century AD and of Erasistratus of the 3rd century BC. Sanctorius and Erasistratus carried out an experiment with the same basic principles, similar methodology and proportional results with an almost 2000 years lag phase. With our paper we wish to give credit to earlier researchers of physiological and medical knowledge who, despite the lack of technological support, often concluded in extremely accurate observations.
Serum Ionized Magnesium Levels in Type 2 Diabetic Patients with Microalbuminuria or Clinical Proteinuria
Authors: Corsonello Andrea , Ientile Riccardo , Buemi Michele , Cucinotta Domenico , Mauro Vittorio Nicita , Macaione Salvatore , Corica Francesco
Published: April 2003

Background/Aims: The association between microalbuminuria and magnesium depletion is a controversial issue, and serum ionized magnesium levels have not been previously studied in patients with different grades of diabetic nephropathy. Therefore, the aim of this study was to evaluate circulating ionized magnesium concentrations in patients with non-insulin-dependent diabetes mellitus (NIDDM) and incipient or overt diabetic nephropathy. Methods: We measured fasting plasma glucose, creatinine, creatinine clearance estimate, total cholesterol and triglycerides, and serum ionized magnesium (ion-selective electrodes, ISE) in 30 NIDDM patients with urinary albumin excretion rate (UAER) <20 μg/min (normoalbuminuria), 30 NIDDM patients with microalbuminuria (20 < UAER < 200 μg/min), 30 NIDDM patients with clinical proteinuria (UAER >200 μg/min), and 20 healthy subjects. Results: Serum ionized magnesium levels were significantly reduced in diabetic patients when compared to control subjects (0.39 ± 0.06 vs. 0.58 ± 0.05 mmol/l, p < 0.001). Moreover, diabetic patients with microalbuminuria or clinical proteinuria showed a significant decrease in serum ionized magnesium with respect to normoalbuminuria group (normoalbuminuria: 0.45 ± 0.02 mmol/l; microalbuminuria: 0.36 ± 0.05 mmol/l, p < 0.001; clinical proteinuria: 0.35 ± 0.04 mmol/l, p < 0.001). Serum ionized magnesium showed a significant negative correlation with plasma HbA1c and triglycerides in both microalbuminuria and clinical proteinuria groups. Multiple linear regression analysis showed that circulating ionized magnesium levels decrease together with the increase of plasma HbA1c and triglycerides in NIDDM patients with incipient or overt nephropathy, also after adjusting for age, sex, BMI, diabetes duration, systolic and diastolic blood pressure, hypoglycemic therapy, plasma creatinine, creatinine clearance, plasma cholesterol and fasting glucose. Conclusions: Microalbuminuria and clinical proteinuria, as well as poor glycometabolic control and hypertriglyceridemia, are associated to relevant alterations in magnesium metabolism, and the measurement of serum ionized magnesium seems to represent a useful biochemical tool for the study of magnesium disturbances in patients with different grades of diabetic nephropathy.
Left Ventricular Hypertrophy in Hypertensive Patients with Autosomal Dominant Polycystic Kidney Disease: Influence of Blood Pressure and Humoral and Neurohormonal Factors
Authors: Martinez-Vea Alberto , Valero F. Alfredo , Bardaji Alfredo , Gutierrez Cristina , Broch Montse , Garcia Carmen , Richart Cristobal , Oliver Jesus A.
Published: April 2003

Left ventricular hypertrophy (LVH) is a common finding in hypertensive autosomal dominant polycystic kidney disease (ADPKD) patients. There are few studies on the influence of blood pressure (BP) and nonhemodynamic factors on LVH in these patients. The aim of this study was to evaluate the relationship between BP, humoral and neurohormonal factors and left ventricular mass (LVM) in hypertensive ADPKD patients. In 20 hypertensive ADPKD patients, ambulatory BP was monitored for 24 h, left ventricular dimensions were estimated by echocardiography, and plasma renin activity (PRA), plasma noradrenaline (NA), angiotensin II (Ang II), aldosterone, atrial natriuretic peptide (ANP) and insulin-like growth factor I (IGF-I) were also determined. Twenty age- and sex-matched essential hypertensive subjects served as controls. Ambulatory BP and LVM index were similar in the two groups, although male ADPKD patients had higher LVM indices than their matched controls. Eight ADPKD patients (40%) and 6 essential hypertensives (30%) showed LVH. PRA, Ang II, aldosterone, ANP and IGF-I levels were similar in the two groups, but plasma NA levels were higher in ADPKD patients than in controls (281 ± 158 vs. 160 ± 62 pg/ml, p = 0.004). ADPKD patients with LVH did not differ from those without LVH with regard to humoral and neurohormonal parameters, but had higher ambulatory BP levels. In ADPKD patients, correlation analysis revealed a significant association between LVM index and 24-hour systolic and diastolic BP, but not with any of the hormonal factors evaluated. On multiple regression analysis, 24-hour diastolic BP was the only independent variable linked to LVM index. In conclusion, ambulatory BP is one of the most important determinants of LVM in hypertensive ADPKD patients. Further studies are warranted to elucidate the role of nonhemodynamic factors in the pathogenesis of LVH in this population.
Gene Transfer into Rat Renal Cells Using Adeno-Associated Virus Vectors
Authors: Shimpo Masahisa , Ikeda Uichi , Maeda Yoshikazu , Ueno Shuichi , Ikeda Michiyo , Minota Seiji , Takizawa Toshihiro , Urabe Masashi , Kume Akihiro , Monahan John , Ozawa Keiya , Shimada Kazuyuki
Published: April 2003

Adeno-associated virus (AAV) vectors have a number of attractive features, including lack of cytotoxicity, ability to transduce nondividing cells, and long-term transgene expression. We investigated whether rat renal cells could be efficiently transduced with AAV vectors. Rat glomerular mesangial cells were transduced with AAV-lacZ vector containing β-galactosidase gene in vitro, and the expression of β-galactosidase was evaluated by X-gal staining and ELISA. For ex vivo experiments, sections of rat kidneys were incubated with AAV-lacZ, and then evaluated by X-gal histochemical staining. The level of β-galactosidase expression in cultured rat mesangial cells increased in a dose-dependent manner (ranging from 1 × 105 to 5 × 106 particles/cell). When transduced with 5 × 106 vector particles/cell of AAV-lacZ, about 50% of mesangial cells were stained positively with X-gal, and the level of β-galactosidase expression reached 9.9 ± 1.5 ng/mg protein. Expression was detectable during the culture period for at least 7 days. X-gal histochemical examination of the ex vivo transduced renal tissue revealed tubular cell and interstitial tissue staining. However, gene transfer was not clearly observed in glomeruli. These findings suggest that AAV vectors have the potential for gene therapy of renal diseases.
Predictors of the Development of Hyperkalemia in Patients Using Angiotensin-Converting Enzyme Inhibitors
Authors: Ahuja Tejinder S. , Freeman Jr. Daniel , Mahnken Jonathan D. , Agraharkar Mahendra , Siddiqui Mohammad , Memon Amir
Published: April 2003

Background/Aims: Angiotensin-converting enzyme inhibitors (ACEI) are the antihypertensives of choice in patients with chronic renal failure (CRF). ACEI by decreasing the synthesis of aldosterone, the main regulator of serum potassium, predispose to the development of hyperkalemia. Although hyperkalemia with administration of ACEI is uncommon in patients with a normal renal function, a preexisting abnormality in potassium hemostasis, as seen in patients with chronic renal failure, may increase the risk of hyperkalemia. Method: To determine the predictors of development of hyperkalemia (K >5.1 mEq/l) in patients on ACEI, we retrospectively reviewed medical records of 119 patients followed in our renal clinic. Results: The mean age of the patients was 56 ± (SD) 13 (range 20–84) years. Sixty-three percent were males, and 37% were females. Sixty-seven percent had a history of diabetes. Eighty five percent of the patients had CRF [creatinine clearance (CrCl) <80 ml/min]. The baseline serum Cr was 2.3 ± 1.2 (range 0.6–6.9) mg/dl, and the CrCl was 50 ± 27.5 ml/min. Of the 119 patients 46 (38.6%) developed hyperkalemia (mean K 5.68 ± 0.3, range 5.2–6.7 mEq/l). Ninety-six percent of the patients who developed hyperkalemia had CRF, and 84% were diabetics. Pearson product-moment correlation revealed a significant positive correlation of hyperkalemia with Cr and a negative correlation of hyperkalemia with CrCl and HCO3 (Cr: r = 0.42, p < 0.0001; CrCl: r = –0.34, p < 0.0001; HCO3: r = –0.41, p < 0.0001). Multivariate logistic regression analysis revealed diabetes and serum creatinine to be the main predictors of hyperkalemia. In 31 patients hyperkalemia resolved either with a low-potassium (2 g/day) diet or with diet and a decrease in the dose of ACEI. In 15 patients ACEI had to be discontinued due to persistent hyperkalemia. Conclusions: We conclude that hyperkalemia is common in patients with CRF on ACEI. The majority of the patients who develop hyperkalemia on ACEI have CRF and diabetes. A large number of patients with CRF require discontinuation of ACEI due to hyperkalemia and are deprived of their renoprotective effects.
Lactic Acidosis in the Setting of Antiretroviral Therapy for the Acquired Immunodeficiency Syndrome
Authors: Shaer Andrea J. , Rastegar Asghar
Published: April 2003

Type B lactic acidosis, a rare but often fatal disorder, has been reported in 21 AIDS patients on antiretroviral therapy (ART). We present an AIDS patient with severe and prolonged lactic acidosis on stavudine and lamivudine. The lactic acidosis occurred in the absence of mitochondrial myopathy, hepatomegaly, or liver failure. This is the second report of lactic acidosis in a patient on stavudine and lamivudine. This patient recovered after aggressive supportive therapy including intravenous alkali and fluid administration as well as continuous venovenous hemodiafiltration. A single dose of dichloroacetate (DCA) was associated with a decrease in the serum lactate level by 20%, which persisted for more than 24 h. Seventeen months after recovery, the patient was rechallenged with ART without recurrence of lactic acidosis. We review and summarize all reported cases of patients with ART-associated lactic acidosis reported in the English literature.
Ahasver – Der Ewige Wanderer
Authors: Körner Waltraut
Published: April 2003

Anhand der Legendenfigur des «Ewigen Juden» Ahasver geht die Autorin einem tiefenpsychologischen Aspekt des Antisemitismus nach, der in der Auseinandersetzung mit der vergangenen und der aktuellen Judenfeindschaft bisher wenig beachtet wurde. Unser Verhältnis zum Judentum ist nach wie vor ambivalent; denn bei aller Ablehnung besass die jüdische Kultur und Geistigkeit für uns doch immer einen hohen Wert, der von den christlichen Kirchen verdrängt wurde. Die christliche Identitätsproblematik erlaubte es lange Zeit nicht, die eigenen alttestamentarischen Wurzeln anzuerkennen. Dadurch haben die Christen aber wesentliche Aspekte ihrer Spiritualität aufgegeben, die im Judentum weiterlebten und weiterentwickelt wurden. Mit Ahasver wurde in der Reformationszeit eine Figur geschaffen, die trotz ihrer bewussten negativen Ausformung die verdrängte Spiritualität verkörpert. Der wandernde Jude wird durch sein tieferes Wissen unwillkürlich zum Symbolträger des Individuationsprozesses, den das Christentum durch seinen Dogmatismus unterdrückt hat, nach dessen Erfahrung es sich aber stets sehnte. Daher sind «die Juden» durch ihre Wanderschaft immer auch Projektionsträger für die Möglichkeiten einer vollständigeren Identitätsfindung und Selbstverwirklichung gewesen und riefen einen Neid in den «dogmatisch sesshaften» Christen hervor, der möglicherweise auch bei der heutigen Fremdenfeindlichkeit eine Rolle spielt.
In wieweit ist empirische Forschung für die psychoanalytische Theorie und Praxis relevant?
Authors: Bovensiepen Gustav
Published: April 2003

Leider besteht für diesen Artikel keine Zusammenfassung. Als Einstieg stellen wir den Textanfang zur Verfügung.Unter dem Vorsitz von Joseph Sandler fand am 1.11.97 in einer ganztägigen Konferenz eine interessante Diskussionsveranstaltung statt, bei der die beiden Hauptredner Daniel Stern und André Green ihre kontroversen Auffassungen vortrugen, ergänzt durch kürzere Diskussionsbeiträge von Anne Alvarez, Irma Brenman Pick und Rosine Perleberg. An der Veranstaltung nahmen über 200 Kolleginnen und Kollegen aus Europa und z.T. aus Übersee teil, und es entwickelte sich eine lebhafte Teilnahme der Zuhörer. Auch einige Londoner jungianische Kolleginnen und Kollegen wurden gesichtet. Ich werde den Schwerpunkt meines Berichtes auf eine Zusammenfassung der beiden Hauptreferate legen und versuchen, einige Linien der Diskussion darzustellen.
Gedanken über den Schmerz1
Authors: Wilke Hans-Joachim
Published: April 2003

Leider
besteht für diesen Artikel keine Zusammenfassung. Als Einstieg stellen wir den
Textanfang zur Verfügung. Darüber gibt es einfache, sehr alte und populäre Gedanken und Fragen: Könnte der Schmerz die Münze sein, mit der wir die Lust unseres Lebens – oftmals nach langer Stundung – dem Schicksal zu begleichen haben? Oder ist die Gegenüberstellung von Schmerz und Lust nur eine unserer üblichen Polarisierungen, Ausdruck unseres Ordnungsbedürfnisses, das Zusammenhängendes und eng Verflochtenes auseinanderreisst und Freud und Leid in zwei verschiedene Schubladen tut? «Wie liebe zu leide zujungest kommen mag», heisst es im Nibelungenlied, und bei Salomo hat alles seine Zeit: «Weinen hat seine Zeit, Lachen hat seine Zeit, Klagen hat seine Zeit».
Entwicklung und Erziehung
Authors: Mehlin Urs
Published: April 2003

Leider besteht für diesen Artikel keine Zusammenfassung. Als Einstieg stellen wir den Textanfang zur Verfügung.Der Vortragszyklus aus Anlass des 50jährigen Bestehens des C.G.-Jung-Instituts findet an der Eidgenössisch-Technischen Hochschule statt, und ich freue mich, aus eben diesem Anlass und an eben diesem Ort über die wichtigen Fragen von Entwicklung und Erziehung aus tiefenpsychologischer Sicht sprechen zu dürfen. Für einmal ist nicht das Zusammentreffen in der Zeit, die Synchronizität, sondern das Zusammentreffen am Ort dabei einiger Überlegung wert, leistet doch die ETH als Ort zentraler Bildung und Forschung einen wesentlichen Beitrag sowohl zur Erziehung junger Menschen in deren individuellen Wünschen und Möglichkeiten als auch zur innovativ-technischen Entwicklung von unserm kollektiven Fortschritt. Die Bedeutung des in der Bezeichnung selbst fungierenden Terminus des «Technischen» ist für unsere Zeit nicht zu übersehen: Technik bestimmt nicht nur in ihren angestammten Bereichen unsere Alltagsrealität, entscheidet im globalen Wettbewerb über Gewinn und Verlust, sondern dringt in immer mehr, immer weitere Bereiche des Lebens ein. Im Zusammenhang damit drängen sich auch unabdingbar scheinende Konsequenzen für die Erziehung auf: Nicht nur Information, sondern Informatik soll immer mehr und immer früher unsere Kinder auf die anzutreffende gesellschaftliche Realität vorbereiten.
Speech Sound Representation, Perception, and Plasticity: A Neurophysiologic Perspective
Authors: Kraus Nina , McGee Therese J. , Koch Dawn Burton
Published: April 2003

Historically, auditory research has focused predominately upon how relatively simple acoustic signals are represented in the neuronal responses of the auditory periphery. However, in order to understand the neurophysiology underlying speech perception, the ultimate objective is to discover how speech sounds are represented in the central auditory system and to relate that representation to the perception of speech as a meaningful acoustic signal. This paper reviews three areas that pertain to the central auditory representation of speech: (1) the differences in neural representation of speech sounds at different levels of the auditory system; (2) the relation between the representation of sound in the auditory pathway and the perception/misperception of speech, and (3) the training-related plasticity of speech sound neural representation and speech perception.
Optical Imaging of Intrinsic Signals in Chinchilla Auditory Cortex
Authors: Harrison Robert V. , Harel Noam , Kakigi Akinobu , Raveh Eyal , Mount Richard J.
Published: April 2003

We have assessed sound frequency and intensity responses in primary auditory cortex of the (ketamine) anesthetized chinchilla using optical imaging of intrinsic signals. Temporal cortex was exposed via a 10-mm craniotomy and a windowed chamber was mounted. A 4-second period of gated tones (10 ms rise/fall; 50 ms plateau; 10/s) was presented to the contralateral ear at levels between 0 and 80 dB SPL. The cortical surface was illuminated with 540 nm light and video images captured in 0.5-second bins for 7.5 s (Imager 2001; Optical Imaging). Intrinsic signals were first apparent 0.5–1 s after stimulus onset, and were maximal after 3–4 s; they decayed over several seconds. The cortical area in which intrinsic activity was detected corresponded closely with electrophysiologically defined AI cortex. Intrinsic signals can reliably be detected to stimuli at 30–40 dB SPL, and in general, the area of intrinsic signal activity tends to expand with increasing stimulation level. Using stimulation levels of 80 dB SPL, we show that low-frequency stimuli (0.5–1 kHz) evoke intrinsic signals in anterior areas whilst posterior areas are activated by high-frequency stimuli (e.g. 16 kHz). Thus a low- to high-frequency tonotopic organization is seen along this axis.
Psychopathological Profile of Tinnitus Sufferers: Evidence Concerning the Relationship between Tinnitus Features and Impact on Life
Authors: Meric Corine , Gartner Myriam , Collet Lionel , Chéry-Croze Sylviane
Published: April 2003

This study involving 281 French tinnitus sufferers sought to investigate possible correlations between psychopathological profile and scores obtained from three tinnitus questionnaires. The patients all completed a French version of the Mini-Mult – a shortened Minnesota Multiphasic Personality Inventory – and French translations of three questionnaires designed especially for the clinical assessment of tinnitus: Tinnitus Reaction Questionnaire (TRQ), Subjective Tinnitus Severity Scale (STSS) and Tinnitus Handicap Questionnaire (THQ). Significant correlations were found (p < 0.0001) between scores on various Mini-Mult scales and total or factor 1 THQ and total TRQ scores. No significant correlation was found between the STSS and any Mini-Mult score.
Presence of Tinnitus Indicated by Variable Spontaneous Otoacoustic Emissions
Authors: Ceranic Borka J. , Prasher Deepak K. , Luxon Linda M.
Published: April 2003

Spontaneous otoacoustic emissions (SOAE) have been widely studied in normal subjects, and there is evidence of their high frequency stability in repeated recordings. A study to determine the frequency stability of SOAE in 53 of 100 consecutive patients, who presented with tinnitus and in whom SOAE were recordable, was undertaken. Patients were divided into five aetiologically homogeneous subgroups: (i) those with normal hearing and no identified pathology, (ii) those with sensorineural hearing loss of unknown origin, (iii) those with normal hearing, but complaining of tinnitus related to head injury, (iv) those with endolymphatic hydrops, and (v) those with noise exposure. The control group consisted of 20 subjects, selected on the basis of recordable SOAE from 38 volunteers with normal hearing and no tinnitus. The prevalence of SOAE and their inter-session frequency stability (reproducibility and relative frequency shift) were analysed. In contrast to the controls, the tinnitus group had significantly increased frequency variability of SOAE (lower reproducibility and increased relative frequency shift). The prevalence of subjects with SOAE was not notably different between the controls and subjects with tinnitus, if the tinnitus group was considered in toto, but a striking 100% prevalence of bilaterally present SOAE was observed in the tinnitus subgroup with head injury.
Adaptive Denoising and Multiscale Detection of the V Wave in Brainstem Auditory Evoked Potentials
Authors: Popescu Mihai , Papadimitriou Stergios , Karamitsos Dimitrios , Bezerianos Anastasios
Published: April 2003

This paper describes a wavelet-transform-based system for the V wave identification in brainstem auditory evoked potentials (BAEP). The system combines signal denoising and rule-based localization modules. The signal denoising module has the potential of effective noise reduction after signal averaging. It analyses adaptively the evolution of the wavelet transform maxima across scales. The singularities of the signal create wavelet maxima with different properties from those of the induced noise. A non-linear filtering process implemented with a neural network extracts out the noise-induced maxima. The filtered wavelet details are subsequently analysed by the rule-based localization module for the automatic identification of the V wave. In the first phase, it implements a set of statistical observations as well as heuristic criteria used by human experts in order to classify the IV–V complex. At the second phase, using a multiscale focusing algorithm, the IV and V waves are positioned on the BAEP signal. Our experiments revealed that the system provides accurate results even for signals exhibiting unclear IV–V complexes.
Observation of Eardrum Movements during Quasi-Static Pressure Changes by High-Speed Digital Imaging
Authors: Vorwerk Ulrich , Steinicke Gunnar , Begall Klaus
Published: April 2003

Under specific quasi-static pressure conditions during the Valsalva manoeuvre, high-speed digital video pictures of eardrum displacements were recorded using an endoscope and a Kodak Image Ektapro 1000 Motion Analyzer. A new type of data interface enabled the complete videoclip to be saved and processed digitally, and, with special mathematical algorithms, it is possible to generate three-dimensional computer animations of eardrum movements under quasi-static pressure. The present study describes patterns of eardrum movements under static pressure changes (Valsalva manoeuvre). These patterns were consistent with the results of finite-element simulations of highly similar eardrum displacements reported by other workers.
Cutaneous-Evoked Tinnitus
Authors: Cacace Anthony T. , Cousins Joseph P. , Parnes Steven M. , McFarland Dennis J. , Semenoff David , Holmes Timothy , Davenport Charles , Stegbauer Keith , Lovely Thomas J.
Published: April 2003

Cutaneous-evoked tinnitus is a clinical entity that has not been reported previously in the neurootological literature. Herein, a neuroscience framework that encompasses several distinct areas of research is used to conceptualize and help understand this phenomenon. We review normal neuroanatomical and physiological interactions between auditory and somatosensory systems in mammals. Also considered are mechanistic accounts of lesion-induced changes in the CNS following deafferentation/deefferentation of peripheral sensory or motor structures that may have a relationship to this phenomenon, as well as the role of functional imaging modalities in studying various phantom perceptions.
The Human Olivocochlear System: Organization and Development
Authors: Moore Jean K. , Simmons Dwayne D. , Guan Yue-Ling
Published: April 2003

The goals of the present study were to identify olivocochlear neurons in the human brainstem, to establish the time course of their early development and to compare the organization of the human olivocochlear system to that of other mammals. To accomplish these goals, we used immunohistochemistry for choline acetyltransferase (ChAT) and calcitonin gene-related peptide (CGRP) in postmortem brainstems of human subjects ranging in age from 16 fetal weeks to 17 years. By immunostaining, we identified two classes of cells in the superior olivary complex: both classes were seen to be present from the twenty-first fetal week to the seventeenth year. Neurons which are immunostained only for ChAT are located primarily in the dorsomedial, ventral and ventrolateral sectors of the periolivary region. These neurons are predominantly bipolar or multipolar cells, and are probably homologous to medial olivocochlear neurons in other species. A second population of cells is immunoreactive for both ChAT and CGRP. This population includes a cluster of mostly small oval neurons, located on the dorsal edge of the olivary complex, and a variable number of cells found along the margin of the lateral olivary nucleus. These ChAT- and CGRP-immunoreactive cells are likely to be homologous to the lateral olivocochlear system in other mammals. With increasing age, the dorsal cluster of small cells shifts from its original cap-like position over the lateral olivary nucleus to become an extended column of cells lying among the fibers of the olivocochlear bundle.
Involuntary Attention and Distractibility as Evaluated with Event-Related Brain Potentials
Authors: Escera Carles , Alho Kimmo , Schröger Erich , Winkler István Winkler
Published: April 2003

This article reviews recent event-related brain potential (ERP) studies of involuntary attention and distractibility in response to novelty and change in the acoustic environment. These studies show that the mismatch negativity, N1 and P3a ERP components elicited by deviant or novel sounds in an unattended sequence of repetitive stimuli index different processes along the course to involuntary attention switch to distracting stimuli. These studies used new auditory-auditory and auditory-visual distraction paradigms, which enable one to assess objectively abnormal distractibility in several clinical patient groups, such as those suffering from closed-head injuries or chronic alcoholism.