bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative Effect of Oral Pulse and Intravenous Calcitriol Treatment in Hemodialysis Patients: The Effect on Serum IL-1 and IL-6 Levels and Bone Mineral Density
Authors: Türk Süleyman , Akbulut Mehmet , Yildiz Alaattin , Gürbilek Mehmet , Gönen Said , Tombul Zeki , Yeksan Mehdi
Published: April 2003

Introduction: Increased serum levels of bone-resorptive cytokines such as interleukin-1β (IL-1β) and interleukin-6 (IL-6) have been implicated for changes in bone remodeling in hemodialysis patients. In this prospective randomized study, we aimed to compare the effect of oral and intravenous (IV) pulse calcitriol on serum levels of IL-1β and IL-6. Patients and Methods: Twenty-eight hemodialysis patients were included and consecutively randomized to receive either oral (n = 14, M/F = 7/7, mean age 42 ± 15 years) or IV pulse (n = 14, M/F = 6/8, mean age 38 ± 14 years) calcitriol treatment. No difference was found between groups for age, sex distribution, primary renal disease, mean time on hemodialysis and baseline biochemical parameters including serum levels of IL-1β and IL-6. Results: The percent fall of intact parathyroid hormone (iPTH) was significantly less with oral compared to IV calcitriol between 0 and the 3rd month (32 ± 21 vs. 56 ± 28%, p = 0.03). However, the percent fall in iPTH at the 6th month of the therapy was not different in the oral group compared to the IV group (57 ± 22 vs. 73 ± 24%, p = 0.12). The increase in bone mineral densities was higher in the IV group than the oral group. Oral and IV calcitriol caused a significant fall in IL-1β (p = 0.02 and p = 0.03, respectively) and IL-6 levels (p = 0.02 and p < 0.001, respectively) at the 6th month of treatment. The percent fall in serum IL-6 levels at the 6th month was significantly greater in the IV compared to the oral group (61 ± 18 vs. 36 ± 33%, p = 0.04), while the percent changes in serum IL-1β levels were similar. Conclusion: IV calcitriol therapy has a greater suppression of PTH at the 3rd month of the therapy. Despite no difference in serum PTH levels at the 6th month, IV therapy has a greater increase in bone mineral densities and a greater decrease in serum IL-6 levels. These findings suggest IV calcitriol treatment has a superior effect on bone remodeling by influencing the levels of bone-resorptive cytokines as compared to the oral therapy group, beyond its suppressive effect on iPTH.
Cellular Proliferation during Compensatory Renal Growth in Neonatal Rats Using Flow Cytometry
Authors: Han Sang Won , Rha Koon Ho , Choi Seung Kang , Lee Moo Sang
Published: April 2003

Background: Compensatory renal growth consists of cellular enlargement and a small but consistent increase in DNA content. It has been assumed that the increase in the total renal DNA content was due to new cell formation. Methods: To test the hypothesis of whether cellular hyperplasia is the cause of the compensatory renal growth after the loss of the renal parenchyma and the timing of the DNA increase in neonatal rats, we performed cell cycle analysis using flow cytometry. Results: Following unilateral nephrectomy, the maximum increases of neonatal cortical cells entering the S phase occurred at 72 and 120 h (9.4 and 9.6% compared to 7.0 and 6.1% of the sham-operated group). Peak increases of neonatal kidney cortical cells entering the G2M phase occurred at 48 and 72 h (4.3 and 4.6% compared to 3.3 and 3.9% of the sham-operated group). Conclusion: DNA synthesis and replication occurs during compensatory renal growth following unilateral nephrectomy in neonatal rats as evidenced by an increase in cells entering both the S and G2M phases. In neonatal rats these events appear to be completed within 48–120 h after nephrectomy.
Noninvasive Diagnosis of Coronary Artery Disease: A Comparison between Cardiokymographic and Electrocardiographic Stress Testing
Authors: Gauss Albrecht , Röhm Hans-Jörg , Strähle Andreas , Schäuffelen Andreas , Mohl Ulrich , Meierhenrich Rainer , Georgieff Michael , Schütz Wolfram
Published: April 2003

Noninvasive cardiokymography has been further developed to be able to record wall motion abnormalities during exercise. The study was designed to evaluate the diagnostic accuracy of stress cardiokymography and electrocardiography in the diagnosis of coronary artery disease. 223 patients were included in a prospective investigation using a newly developed computerized cardiokymography device. Sensitivity, specificity, and positive predictive value were 61, 69 and 90% for exercise cardiokymography, and 57, 74 and 91% for exercise electrocardiography, respectively. There was no statistically significant difference between cardiokymography and electrocardiography. The combination of electrocardiography and cardiokymography did not produce a significant improvement in diagnostic accuracy in comparison to exercise electrocardiography alone.
Is Postural Hypotension a Real Problem with Antihypertensive Medication?
Authors: Meredith Peter A.
Published: April 2003

Historically, postural hypotension has been cited as a consideration which might influence the selection of antihypertensive therapy. The common symptoms (dizziness, blackouts, syncope) give cause for concern but they are not attributed to every class of antihypertensive drug. For example, administration of a β-blocker is not generally associated with symptomatic postural hypotension, whereas the α-blocker prazosin was particularly problematical, with a significant and well-recognized risk of first-dose postural effects. Titration from a low starting dose and careful selection/monitoring of patients have been successfully used to circumvent this problem. However, since there is a relatively high incidence of postural hypotensive symptoms in elderly patients in general, it may be a misconception to attribute such symptoms to any particular type of antihypertensive drug. Furthermore, with the newer α1-blockers, such as doxazosin, which have a more gradual onset of action, there is a markedly reduced tendency for postural hypotension to occur. Thus, it is perhaps time to reassess the real significance of iatrogenic postural hypotension in the selection of antihypertensive therapy.
Reversal of Primary Root Caries Using a Dentifrice with a High Fluoride Content
Authors: Lynch E. , Baysan A.
Published: April 2003

Root caries is a widespread problem and can be quite serious in older populations. The restoration of root carious lesions is often difficult. Compared to enamel caries, there has been limited research into the pharmaceutical management of primary root caries lesions (PRCLs), and many of these studies have been carried out in vitro, with limited numbers of clinical trials. Fluoride is presently a cornerstone in dentifrice formulations for cost-effective and anticaries therapy. It is generally accepted that fluoride ions promote remineralization of tooth substances and reduce the rate of demineralization. The use of a dentifrice with a high fluoride content may be considered to reverse PRCLs, since more fluoride is required for the remineralization of roots than for enamel. This paper reviews the effects of dentifrices with high fluoride contents on the management of root caries.
Antimicrobial Activity of Fluoride and Its in vivo Importance: Identification of Research Questions
Authors: van Loveren C.
Published: April 2003

This manuscript discusses the antimicrobial activity of fluoride and its in vivo importance in order to identify research questions. There is a lot of information on mechanisms by which fluoride may interfere with bacterial metabolism and dental plaque acidogenicity. The antimicrobial activity of fluoride products is enhanced when fluoride is associated with antimicrobial cations like Sn2+ and amine. It is not clear whether the antimicrobial mechanisms of fluoride are operating in vivo or even to what extent antimicrobial activity can contribute to caries prevention. This latter question may be the most important one in research.
Future Perspectives for Optimizing Oral Antiplatelet Therapy
Authors: Easton J. Donald
Published: April 2003

Secondary prevention of stroke and other manifestations of atherothrombosis is essential if the burden of disease associated with these events is to be reduced. Therefore, it is important to identify patients most likely to benefit from antiplatelet therapy. There is a good rationale for combining antiplatelet agents with different modes of action, since different signalling pathways contribute to platelet activation. Based on the promising results obtained with an adenosine diphosphate receptor antagonist-aspirin combination in coronary stenting, several additional trials with clopidogrel plus aspirin are ongoing. They include CURE (Clopidogrel in Unstable angina to prevent Recurrent Events, in unstable angina and non-Q-wave myocardial infarction) and COMMIT (in acute myocardial infarction), which compare clopidogrel with placebo in patients receiving aspirin, and CREDO (Clopidogrel for Reduction of Events During extended Observation), a 1-year treatment follow-up to the clopidogrel arms of the CLASSICS trial (Clopidogrel Aspirin Stent International Cooperative Study). Planned trials with clopidogrel in neurology include SPS3 (Secondary Prevention of Small Subcortical Strokes, in patients with symptomatic lacunar stroke), and MATCH (Management of Atherothrombosis with Clopidogrel in High-risk patients, in patients with stroke or transient ischaemic attack plus one additional risk factor), which will compare the efficacy of clopidogrel plus aspirin versus clopidogrel in reducing important ischaemic events. Combination therapy with an oral glycoprotein (GP) IIb/IIIa receptor antagonist plus aspirin has so far been less promising. Trials of three compounds – orbofiban, xemilofiban and sibrafiban – in combination with aspirin for secondary prevention in cardiac patients have reported increased mortality compared with aspirin alone. A similar effect was seen when sibrafiban monotherapy was compared directly with aspirin alone. Trials of newer oral GP IIb/IIIa inhibitors are under way or are planned. The combination of dipyridamole plus aspirin appears to be superior to aspirin alone for the prevention of stroke in patients with stroke or transient ischaemic attack; the effectiveness of this combination is being further investigated in ESPRIT (European/Australian Stroke Prevention in Reversible Ischaemia Trial).
Somatostatin, Its Receptors and Analogs, in Lung Cancer
Authors: O’Byrne Kenneth J. , Schally Andrew V. , Thomas Ann , Carney Desmond N. , Steward William P.
Published: April 2003

Despite developments in diagnosis and treatment, lung cancer is the commonest cause of cancer death in Europe and North America. Due to increasing cigarette consumption, the incidence of the disease and resultant mortality is rising dramatically in women. Novel approaches to the management of lung cancer are urgently required. Somatostatin is a tetradecapeptide first identified in the pituitary and subsequently throughout the body particularly in neuroendocrine cells of the pancreas and gastrointestinal tract and the nervous system. The peptide has numerous functions including inhibition of hormone release, immunomodulation and neurotransmission and is an endogenous inhibitor of cell proliferation and angiogenesis. Somatostatin and its analogs, including octreotide (SMS 201–995), somatuline (BIM 23014) and vapreotide (RC-160), act by binding to specific somatostatin receptors (SSTR) of which there are 5 principal subtypes, SSTR-1–5. Although elevated plasma somatostatin levels may be detected in 14–15% of patients, tumor cell expression appears rare. SSTR may be expressed by lung tumors, particularly small cell lung cancer and bronchial carcinoid disease. [111In]pentetreotide scintigraphy may have a role to play in the localization and staging of lung cancers both before and following treatment, and in detecting relapsed disease. The potential role of radiolabelled somatostatin analogs as radiotherapeutic agents in the management of lung cancer is currently being explored. Somatostatin analog therapy results in significant growth inhibition of both SSTR-positive and SSTR-negative lung tumors in vivo. Recent work indicates that these agents may enhance the efficacy of chemotherapeutic agents in the treatment of solid tumors including lung cancer.
Octreotide in the Management of Hormone-Refractory Prostate Cancer
Authors: Vainas Iraklis G.
Published: April 2003

Patients with advanced or metastatic prostate cancer (PC), a partially hormone-resistant disease, will require some form of hormonal manipulations or some new therapeutic modalities. Octreotide, as somatostatin (SST) analogs, has been found to inhibit the growth of experimental PCs via several mechanisms, as indirect antihormonal and direct antimitogenic actions, mainly due to inhibition of SST receptor subtypes (SSTR-1–5). Sporadic clinical trials with octreotide (alone or with a complete antiandrogen blockade) treatment of patients with advanced stage D2 PC demonstrated promising results. Unfortunately, at present these clinical trials have some disadvantages and leave some uncertainty with regard to the trial design, the SSTR subtype determination and tumor localization with SSTR scintigraphy before the start of a selective SST analog, and finally the randomization in groups according to hormone resistance, dosage regimen and route of administration.
Pancreatic Cancer: Does Octreotide Offer Any Promise?
Authors: Rosenberg Lawrence
Published: April 2003

The incidence of adenocarcinoma of the pancreas has risen steadily over the past 4 decades. Since pancreatic cancer is diagnosed at an advanced stage, and because of the lack of effective therapies the prognosis of such patients is extremely poor. Despite advances in our understanding of the molecular biology of pancreatic cancer, the systemic treatment of this disease remains unsatisfactory. Systemic chemotherapy and the administration of biologically active molecules such as tumor necrosis factor or interferons have not resulted in significant improvements in response rates or patient survival. New treatment strategies are obviously needed. This paper will discuss current advances in the use of somatostatin analogs in the management of pancreatic cancer.
Optimal Treatment Strategies for Community-Acquired Pneumonia: High-Risk Patients (Geriatric and with Comorbidity)
Authors: Carbon Claude
Published: April 2003

The four major factors predisposing individuals to community-acquired pneumonia (CAP) are chronic obstructive pulmonary disease, congestive heart failure, diabetes, and a high alcohol intake. The elderly are also at increased risk of severe infection. The introduction of fluoroquinolones with increased activity against Streptococcus pneumoniae and other CAP pathogens has been an important development, with recent guidelines recommending the use of respiratory fluoroquinolones as a first-line choice in outpatients with modifying factors, nursing home residents, and hospitalised patients in medical wards. Of the fluoroquinolones currently available that have antipneumococcal activity, levofloxacin is well tolerated and effective. It has been approved by the Food and Drug Administration (FDA) for treatment of CAP and widespread use has shown it to be very safe.
Management of Clinical Failures in Non-ICU Patients with Chronic Obstructive Pulmonary Disease Exacerbations
Authors: Habib Michael P.
Published: April 2003

Clinical failure after initial treatment for exacerbations of chronic obstructive pulmonary disease (COPD) occurs in 10–25% of cases. Once the original diagnosis is confirmed, there is a need to optimise therapy, including introducing bronchodilators and corticosteroids. The use of aggressive antibiotic treatment is recommended for patients with risk factors (elderly, more than four exacerbations per year, underlying cardiopulmonary disease) and more severe disease. Fluoroquinolones are a good choice for those patients who failed initial therapy and who require antimicrobials, including those with simple exacerbations, complicated cases with comorbidity, or those with bronchiectasis. Consideration of less common pathogens, such as Pseudomonas aeruginosa infection, should also be considered. Bacteria usually associated with exacerbations are becoming increasingly resistant, and this needs to be considered when deciding on appropriate antibiotic treatment.
Executive Function in Patients with Remitted Bipolar Disorder and Schizophrenia and Its Relationship with Functional Outcome
Authors: Martínez-Arán A. , Penadés R. , Vieta E. , Colom F. , Reinares M. , Benabarre A. , Salamero M. , Gastó C.
Published: April 2003

Background: Recent studies have reported that differences in cognitive performance between schizophrenic and bipolar patients seem to be smaller than expected. Patients with schizophrenia have consistently shown frontal executive dysfunctions, but studies regarding executive abilities in bipolar patients are scarce and discrepant. As executive function has been associated with psychosocial functioning in schizophrenia, we wanted to investigate if such a relationship is also present in bipolar disorder and the differences between the two groups. Methods: Executive function was assessed in 49 euthymic (at least 6 months in remission, Hamilton Depression Rating Scale ≤8 and Young Mania Rating Scale ≤6) bipolar and in 49 schizophrenic, residual-type (with at least 1 year without acute exacerbation and predominant negative symptomatology) patients, by the Wisconsin Card Sorting Test (WCST), FAS Test (COWAT) and Trail Making Test. Baseline clinical and psychosocial variables were controlled and psychopathology evaluated by means of the Positive and Negative Syndrome Scale (PANSS). Results: The two groups showed a similar pattern of cognitive deficits in tests of executive function, except for the number of categories achieved in the WCST, which was significantly lower in the schizophrenic group (F = 7.26; p = 0.009). Functional outcome was predicted by the negative syndrome (PANSSN) and perseverative errors (WCST) in schizophrenic patients, and general psychopathology (PANSSG) was the best predictor of functional outcome in the bipolar group. Conclusion: Executive function was a good predictor of functional outcome in the schizophrenic group, whereas clinical variables were more predictive of the bipolar one. Patterns of cognitive disturbances in tasks of executive function are similar in both groups but quantitatively more marked in schizophrenia.
Locus of Control Orientation in Panic Disorder and the Differential Effects of Treatment
Authors: Bakker Abraham , Spinhoven Philip , van der Does A.J. Willem , van Balkom Anton J.L.M. , van Dyck Richard
Published: April 2003

Background: In this study the effects of treatment with cognitive therapy, antidepressants or pill-placebo on the locus of control orientation in panic disorder patients were analysed, as well as the relation of this panic locus of control with panic frequency and cognitive measures of panic. Methods: A Multidimensional Anxiety Locus of Control scale (MALC) was developed and completed with other measures (ACQ and BSQ) before and after treatment. Patients also kept a panic diary. Results: Four subscales were derived from the MALC: one Internal, and three external (a Chance, a Medication, and a Therapist) locus of anxiety control orientation scales. Cognitive therapy was superior over pill-placebo on most outcome measures whereas antidepressants were only superior in reducing the number of panic attacks. Treatment with cognitive therapy resulted in an increase of ‘internal’ anxiety control orientation and a decrease of ‘chance’ and ‘medication’ orientation, in comparison with antidepressant therapy. The residualized gain scores on the MALC subscales correlated with clinical improvement in subjects treated with cognitive therapy only. Conclusions: Results suggest that the locus of control orientation is important in evaluating the differential effects of treatments in panic disorder. A differential effect on panic locus of control in favor of cognitive therapy in comparison to medication was found.
A Diminished Intrapartum Amniotic Fluid Index Is a Predictive Marker of Possible Adverse Neonatal Outcome when Associated with Prolonged Labor
Authors: Kawasaki Noriyoshi , Nishimura Hiroshi , Yoshimura Toshihiro , Okamura Hitoshi
Published: April 2003

Objective: To determine whether a diminished intrapartum amniotic fluid volume represents a risk of adverse neonatal outcome when it occurs in conjunction with prolonged labor. Methods: The intrapartum amniotic fluid index (iAFI) was measured in 242 parturients over 35 weeks of gestation during 1st-stage labor, and the umbilical artery blood gas was analyzed at delivery. The subjects were divided into group A (n = 99), having a diminished amniotic fluid volume (iAFI ≤8.0 cm) and group B (n = 143), having a normal amniotic fluid volume (iAFI 8.1–20.0 cm), and selected antenatal, delivery, and neonatal variables were compared. In addition, the two groups were subdivided according to the duration of labor. Statistical analysis was performed using independent Student’s t test, Mann-Whitney U test, chi-square analysis, and Fisher’s exact test where appropriate. p < 0.05 was considered significant. Results: The patient characteristics and pregnancy outcomes were similar in groups A and B, as were the incidences of an umbilical artery blood pH <7.20 and/or an Apgar score <7 (group A 9.5%, group B 10.1%). In group A, however, the incidence of an adverse neonatal outcome was 23.5% in cases in whom the duration of labor was longer than 8 h which was significantly higher than in cases in whom the duration of labor was 8 h or less (2.8%; p < 0.01). In group B, the incidence of an adverse neonatal outcome was similar in the two subgroups. Conclusions: The risk of an adverse neonatal outcome is higher in patients with diminished amniotic fluid volume if labor is prolonged. Consequently, determination of the iAFI could be a useful admission test.
Effects of Hormone Replacement Therapy on Plasma Homocysteine and C-Reactive Protein Levels
Authors: Yildirir Aylin , Aybar Funda , Tokgozoglu Lale , Yarali Hakan , Kabakci Giray , Bukulmez Orhan , Sinici Incilay , Oto Ali
Published: April 2003

In order to investigate the effect of hormone replacement therapy (HRT) on plasma homocysteine and C-reactive protein (CRP) levels 46 healthy postmenopausal women were prospectively enrolled. HRT, which was either 0.625 mg/day conjugated equine estrogen (CEE) plus 2.5 mg/day medroxyprogesterone acetate (MPA) or 0.625 mg/day CEE alone were administered. After 6 months, estrogen alone significantly increased serum CRP concentrations (p = 0.039), however, estrogen plus progesterone therapy did not significantly alter serum CRP levels. Both regimens significantly decreased plasma homocysteine levels (CEE group p = 0.034, CEE+MPA group p = 0.007). It was concluded that the reduction in plasma homocysteine levels with both regimens might contribute to the cardiovascular benefit of HRT and the CRP raising effect of estrogen might be partially prevented by the addition of progesterone.
Role of Laparoscopy in the Treatment of Endometriosis-Associated Infertility
Authors: Osuga Yutaka , Koga Kaori , Tsutsumi Osamu , Yano Tetsu , Maruyama Masonori , Kugu Koji , Momoeda Mikio , Taketani Yuji
Published: April 2003

Endometriosis is assumed to be one of the causative factors of infertility, although the mechanism remains to be elucidated. Mechanical factors distorting the pelvic anatomy and/or changes in the biochemical and cellular environment in the peritoneal cavity are possible contributing factors impairing fertility. Laparoscopy is a widely used diagnostic and therapeutic means of treating endometriosis-associated infertility. However, pregnancy outcome after laparoscopy varies depending on preexisting tubal adhesions and endometriosis. Without tubal adhesions, the pregnancy rate is essentially the same irrespective of the presence or stages of endoemetriosis. Minimal/mild endometriosis benefited the most from laparoscopic manipulation when tubal adhesions were present. On the other hand, IVF-ET outcome of patients who previously underwent laparoscopy was not influenced by preexisiting tubal adhesions and endometriosis.
Roberts-SC-Phokomelie- oder Pseudothalidomid-Syndrom
Authors: Musfeld D.A. , Bühler E.M. , Heinzl S.
Published: April 2003

Das SC-Phokomelie- oder Pseudothalidomid-Syndrom (Roberts-Syndrom) ist eine seltene autosomalrezessiv vererbte Krankheit, die sich klinisch mit einer Phokomelie, einer prä- und postnatalen Wachstumsretardierung mit kraniofazialen Dysmorphien und Missbildungen (z.B. Lippen-Kiefer-Gaumenspalte, Mikro[brachy]zephalie) manifestiert, zytogenetisch eventuell mit dem Phänomen des Zentromersplittings. Beobachtet werden ausserdem Nierenmissbildungen, Herzfehler, eine Klitoris- bzw. Penishyperplasie sowie beidseitige Korneatrübungen oder andere Augenanomalien. Geistige Retardierung ist bei überlebenden Patienten häufig.
Increased Monocyte Activation in Elderly Patients after Surgical Stress
Authors: Ono S. , Aosasa S. , Tsujimoto H. , Ueno C. , Mochizuki H.
Published: April 2003

Objective: To investigate age-related changes in the host response to surgical stress. The clinical course, serum interleukin-6 (IL-6) levels, monocyte production of tumor necrosis factor-α (TNF-α), and monocyte expression of CD11b/CD18 were used as markers of the systemic response. Methods: Patients with gastric cancer, undergoing distal gastrectomy were divided into 2 groups: >75 years of age (elderly group) and ≤75 years of age (young group). Serum IL-6 levels, TNF-α production and CD11b/CD18 expression by monocytes, and the postoperative clinical course were compared between the 2 groups. Results: TNF-α production by lipopolysaccharide-stimulated monocytes and CD11b/CD18 expression on monocytes after surgical stress were significantly higher in the elderly than in the young group. Moreover, serum IL-6 levels on the first postoperative day in the elderly group were significantly higher than those in the young group. The incidence and duration of systemic inflammatory response syndrome (SIRS) were significantly greater in the elderly than in the young group. Conclusions: The activation of monocytes and hypercytokinemia occur readily after surgical stress in the elderly and may therefore contribute to SIRS and increased susceptibility to postoperative complications.
Influence of Pentoxifylline and Interferon-Alpha on Prevention of Stricture due to Corrosive Esophagitis
Authors: Apaydın B.B. , Paksoy M. , Artış T. , Şahin D.A. , Akı H. , Uslu E.
Published: April 2003

The effects of pentoxifylline (PTX) and interferon α (IFN-α) in the prevention of strictures due to corrosive esophagitis in rats were investigated. Forty rats were randomly divided into four equal groups. Corrosive esophagitis was induced in all groups by application of 37.5% NaOH to the distal esophagus for a period of 90 s followed by saline rinse. Histopathologic damage was significantly lower in the PTX and IFN-α-treated groups than in the untreated group. During the study period, PTX and INF-α-treated animals showed a significant increase in body weight when compared to controls. However, PTX provided more significant prevention of stricture formation than IFN-α. In the PTX-treated group, the wall thickness and quantity of hydroxyprolin were significantly lower than in the untreated and IFN-α-treated groups. Stenosis index in the PTX group was significantly reduced compared to the control group. PTX prevents the stricture formation due to corrosive esophagitis in this experimental model. IFN-α was also shown to prevent stricture formation when considering amelioration of histopathologic damage and increase in body weight.
Synergistic Effect of CGS16949A and 5-Fluorouracil on a Human Breast Cancer Cell Line
Authors: Tsunoda Y. , Shimizu Y. , Tsunoda A. , Shibusawa M. , Kamiya K. , Kusano M. , Fukuchi K.
Published: April 2003

The effects of the aromatase inhibitor, CGS16949A, and the fluoropyrimidine, 5-fluorouracil (5-FU), on cell cycle distribution and growth were studied using FACS analysis and MTT assay in the human breast cancer cell line, SK-BR-3. CGS16949A induced an increase in the G0–G1 fraction on SK-BR-3 cells, and the growth inhibition rate of the combination of both (65.7 ± 3.0%) was significantly higher than 10 nM CGS16949A (37.9 ± 6.9%) or 100 µg/ml 5-FU (45.6 ± 4.5%); p < 0.01). Administering 5-FU after preincubation with CGS16949A significantly increased the combined cytotoxic efficacy, suggesting that clinical therapy using this combined therapy may be more efficient.
Effects of Enalapril and L-158809 on Myocardial Beta-Adrenergic Receptor Density in Transplanted Rat Hearts
Authors: Nakame T. , Iguchi A. , Tabayashi K.
Published: April 2003

Background: We compare the effects of angiotensin-converting enzyme (ACE) inhibitor or angiotensin II type 1 (AT1) receptor blocker on density of myocardial beta-adrenergic receptors (beta-ARs) in a heterotopic heart transplantation model. Methods: Hearts of F344 rats were heterotopically transplanted into Lewis rat recipients immunosuppressed with cyclosporine (10 mg/kg/day). Recipients were treated orally with the AT1 receptor blocker L-158809 (3 mg/kg/day, n = 6), enalapril (3 mg/kg/day, n = 6), or vehicle only (n = 6) for 90 days. Density of myocordial beta-ARs was determined with an autoradiographic technique using [3H]CGP-12177. Results: Graft status, the sum of the functional score and the score for color, was preserved better in the L-158809-treated group (5.8 ± 0.9) and in the enalapril-treated group (5.6 ± 0.8) than in the vehicle-treated group (3.8 ± 0.9, p < 0.05). The grades of graft coronary artery disease in the L-158809-treated group and in the enalapril-treated group were significantly less than that seen in the vehicle-treated group. The density of myocardial beta-AR (fmol/mg of protein) was 3.5 ± 0.5 in the L-158809-treated group (p < 0.05 vs. vehicle-treated group) and 3.2 ± 0.5 (p < 0.05) in the enalapril-treated group but was 2.2 ± 0.4 in the vehicle-treated group. Conclusion: L-158809 is as effective as enalapril in restoring myocardial beta-AR density in immunosuppressed rat transplant model, and this efficacy, as well as the prevention of graft coronary arteriosclerosis, is probably associated with the preservation of graft status.
Adenovirus-Mediated Gene Transfer into Selected Liver Segments Using a Vascular Exclusion Technique
Authors: Scholl Beatrix , Gervaz P. , Martinet O. , Ksontini R. , Krueger T. , Sahli R. , Gillet M.
Published: April 2003

Adenovirus-mediated gene therapy is hampered by severe virus-related toxicity, especially to the liver. The aim of the present study was to test the ability of a vascular exclusion technique to achieve transgene expression within selected liver segments, thus minimizing both viral and transgene product toxicity to the liver. An E1-E3-deleted replication-deficient adenovirus expressing a green fluorescent protein (GFP) reporter gene was injected into the portal vein of BDIX rats, with simultaneous clamping of the portal vein tributaries to liver segments II, III, IV, V, and VIII. GFP expression and inflammatory infiltrate were measured in the different segments of the liver and compared with those of the livers of animals receiving the viral vector in the portal vein without clamping. The GFP expression was significantly higher in the selectively perfused segments of the liver as compared with the non-perfused segments (p < 0.0001) and with the livers of animals that received the vector in the portal vein without clamping (p < 0.0001). Accordingly, the inflammatory infiltrate was more intense in the selectively perfused liver segments as compared with all other groups (p < 0.0001). Fluorescence was absent in lungs and kidneys and minimal in spleen. The clinical usefulness of adenovirus-mediated gene transfer to the liver largely depends on the reduction of its liver toxicity. Clamping of selected portal vein branches during injection allows for delivery of genes of interest to targeted liver segments. Transgene expression confined to selected liver segments may be useful in the treatment of focal liver diseases, including metastases.
Physical Characteristics of Vivostat® Patient-Derived Sealant
Authors: Velada J.L. , Hollingsbee D.A.
Published: April 2003

This study compared the physical characteristics of Vivostat® patient-derived sealant with two conventional fibrin sealants, Tissucol® and Beriplast®. Vivostat sealant exhibited greater elasticity without compromising tensile strength. Vivostat sealant polymerised at low temperatures (4 and 25°C) or at high temperature (70°C) exhibited similar viscoelastic properties as when polymerised at normal physiological temperature (37°C). Vivostat fibrin I solution can be stored at room temperature for up to 8 h without affecting the mechanical properties of the derived sealant. These physical characteristics of Vivostat patient-derived sealant suggest that it may have suitable stability and performance characteristics for use in a wide range of surgical procedures.
Growth Hormone Secretion after Baclofen Administration in Different Phases of the Menstrual Cycle in Healthy Women
Authors: Orio Jr F. , Palomba S. , Colao A. , Tenuta M. , Dentico C. , Petretta M. , Lombardi G. , Nappi C. , Orio F.
Published: April 2003

Aim: The aim of this study was to investigate the effect of baclofen administration on growth hormone (GH) secretion during different phases of the menstrual cycle. Methods: Twelve healthy women (33.6 ± (SD) 2.8 years; range 23–40 years) with regular menstrual cycles were enrolled. The phases of the menstrual cycle were determined using transvaginal ultrasonography (TV-US) and detecting hormonal serum levels. Plasma GH levels were evaluated during the early follicular, periovulatory and luteal phases of the cycle before and after the baclofen challenge test. Results: After acute baclofen administration, GH levels increased significantly (p < 0.001) compared to basal values during the periovulatory and luteal phases, while no significant variation was detected during the early follicular phase. In addition, plasma GH levels resulted significantly (p < 0.001) higher during the luteal phase than during the periovulatory phase. Conclusion: Acute baclofen administration induces a significant increase in plasma GH levels in healthy females during the periovulatory and luteal phases, but not during the early follicular phase. These data suggest a modulator role of plasma sex steroids levels on GH release induced by baclofen.
Antipituitary Antibodies in Patients with Lymphocytic Hypophysitis
Authors: Takao Toshihiro , Nanamiya Wakako , Matsumoto Reiko , Asaba Koichi , Okabayashi Tomoaki , Hashimoto Kozo
Published: April 2003

Background: Lymphocytic hypophysitis is one of the causes of hypopituitarism, which is considered an autoimmune reaction in the anterior pituitary. Method: We examined antipituitary antibodies in patients with lymphocytic hypophysitis and related diseases by immunoblotting method. Results: Autoantibodies to a 22-kDa human pituitary cytosolic protein were identified in significantly higher frequencies in sera from patients with lymphocytic hypophysitis (11 of 15, 73.3%) and isolated ACTH deficiency (7 of 9, 77.8%) compared with Hashimoto thyroiditis, Basedow’s disease and normal control subjects. Also, reactivity against a 49-kDa human pituitary cytosolic protein was seen in 6 of 15 patients (40%) with lymphocytic hypophysitis. N-terminal amino acid sequences of 22-kDa human and rat pituitary cytosolic protein were FPTIPLSVL and FPAMPLSSLFAN, respectively, suggesting that they are human and rat growth hormone, respectively. The pituitary dysfunction (at least one hormone dysfunction) was observed in 11 of 14 patients. Nine of them (82%) showed 22 kDa antibody but 2 of them (18%) did not. Conclusion: The present study demonstrated that pituitary autoantibodies could be involved in the pathogenesis of lymphocytic hypophysitis and could be a positive marker for the disease.
Positive Peritruncal Nodes for Esophageal Carcinoma
Authors: Hulscher J.B.F. , Buskens C.J. , Bergman J.J.G.H.M. , Fockens P. , van Lanschot J.J.B. , Obertop H.
Published: April 2003

Background/Aims: For esophageal carcinoma, positive truncal nodes are considered distant metastases, and might be a contraindication for potentially curative surgery. With the development of new diagnostic tools more/smaller peritruncal nodes may be found positive preoperatively. We evaluate whether it is justified to exclude all patients with positive peri-truncal nodes from curative surgery. Methods: Retrospective study of all patients undergoing transhiatal resection for a mid-/distal esophageal carcinoma between 1993 and 1997. Results: 110 patients underwent transhiatal resection for esophageal carcinoma. Sixteen patients had tumor-positive, resectable peritruncal lymph nodes not identified preoperatively, changing preoperative stage III into postoperative stage IV (M1a). After follow-up of 2.9 years (0.07–7.6), 49 patients (45%) were alive. On multivariate analysis radicality and lymph node status were independent prognostic factors. There was no significant difference in survival between stage III and stage IV (M1a) tumors: 1.7 and 1.5 years, respectively (p = 0.87). At the end of follow-up, 4/16 patients (25%) with stage IV (M1a) disease were alive without evidence of disease. Conclusion: The presence of malignant cells in small, resectable peritruncal nodes does not preclude long-term survival. The results of new diagnostic modalities should be interpreted cautiously, until firm criteria for irresectability/incurability of positive truncal nodes are established.
Small Bowel Perforation after Extracorporeal Shockwave Lithotripsy of an Ureter Stone
Authors: Klug R. , Kurz F. , Dunzinger M. , Aufschnaiter M.
Published: April 2003

A 60-year-old man was treated by extracorporeal shock wave lithotripsy (ESWL) for an impacted ureterstone. Two days after the procedure he developed an acute abdomen. On laparotomy, a small bowel perforation in the area of an adhesion to the abdominal wall was found. The adherent intestinal segment was located exactly in the range of the ESWL field, so that excluding further reasons the shockwave lithotripsy must be assumed to be causative.
Extracorporal Resection of the Rectum in the Treatment of Complete Rectal Prolapse Using a Circular Stapling Device1
Authors: Schütz G.
Published: April 2003

Background and Patients: The technique of the extracorporal resection of the rectum using a circular stapler in the treatment of complete rectal prolapse is described on the basis of 31 successfully applied operations at the Surgical Unit in Düsseldorf-Gerresheim. Results: The easy-to-perform operation does not require general anaesthesia, the incidence of peri-operative complications (5/31) and lethality (1/31) is acceptable and post-operative recovery is fast due to less physiologic insult as compared to transabdominal procedures. The recurrence rates (0/22) stand the comparison with transabdominal procedures. The operation can be re-performed in the case of a recurrent prolapse. Conclusions: Our good results show that the perineal rectosigmoidostomy using a circular stapler is a safe and efficient means of controlling rectal prolapse. Many advantages in comparison with transabdominal procedures make it an attractive option for many patients suffering from rectal prolapse.
Immunocytochemical Detection of Tumour Cells in the Thoracic Duct of Patients with an Adenocarcinoma of the Oesophagus
Authors: Lemaire Lucienne C.J.M. , ten Kate Fiebo J.W. , van Sandick Johanna W. , Obertop Huug , van Lanschot J. Jan B.
Published: April 2003

Background: Compared to other hollow viscus organs, the oesophagus has a unique anatomy in which lymphatic channels are abundantly present in the mucosa and submucosa. It has been hypothesized that tumour cells can directly disseminate from these superficial layers into the thoracic duct without passing juxta-tumoral lymph nodes. We investigated whether tumour cells of an oesophageal carcinoma could be detected in the thoracic duct during operative manipulation. Methods: In patients with an adenocarcinoma of the oesophagus and/or gastro-oesophageal junction, undergoing a transthoracic resection with two-field lymphadenectomy, lymph was collected and cells were immunostained. Results: Tumour cells could be detected in the thoracic duct lymph of only 1 out of 19 patients during operative manipulation. Conclusion: Peroperative data from this study do not support the hypothesis that oesophageal carcinoma readily metastasizes directly into the thoracic duct.
Clinicopathological Findings in Patients with Gastric Adenocarcinoma with Familial Aggregation
Authors: Ikeguchi Masahide , Fukuda Kenji , Oka Shin-ichi , Hisamitsu Kazunori , Katano Kuniyuki , Tsujitani Shun-ichi , Kaibara Nobuaki
Published: April 2003

Background/Aims: The clinicopathological characteristics of gastric cancer (GC) with a positive family history of site-specific GC have not been well discussed. The aim of this study was to estimate the risk of familial aggregation of GC in a hospital-based case-control study and to analyze the clinicopathological characteristics of GC with familial aggregation of GC. Methods: Our series was comprised of 926 histologically confirmed patients with GC (588 males and 338 females) and 2,052 non-cancer outpatients between 1985 and 1996. The odds ratios (ORs), as estimators of relative risks, together with the corresponding 95% confidence intervals (CIs) for a family history of GC and for a family history of other cancers were calculated. Moreover, the clinicopathological findings of patients with GC who had a GC family history were compared with those of patients with GC who had no GC family history. Results: A positive family history of GC was associated with a statistically significant increase in the risk of GC (OR = 2.15; 95% CI = 1.77–2.63), while no association was observed between the risk of GC and a family history of other cancers (OR = 1.11; 95% CI = 0.91–1.36). The incidence of a multifocal occurrence of GCs was higher in patients with a family history of GC (19.4%) than in patients without a family history of GC (12%, p = 0.005). The risk (OR) of occurrence of multiple cancers in the stomach in patients who had a family history of GC was 1.77 (95% CI = 1.19–2.64). Conclusions: Our results suggest that a family history of GC seemed to be a risk factor for the development of GC. Further, a family history of GC was found to be associated with a multifocal occurrence of GC.
Angiotensin II-Induced Renal Vasodilation Mediated by Cytochrome P-450 Arachidonic Acid Metabolites
Authors: Marcelin G. , Sanchez A. , Vasquez B. , Escalante B.
Published: April 2003

Objective: Activation of AT2 angiotensin II receptor release cytochrome P-450 arachidonic acid metabolites (CYP-AA). The presence of the AT2 receptor and its ability to mediate renal vasodilation through CYP-AA metabolites were evaluated. Methods: Vascular response to angiotensin II in the isolated perfused kidney of the rat was evaluated in the absence and presence of angiotensin II AT1 and AT2 receptor blockers. Results: Blockade of the AT1 receptor unmasked a vasodilatory response that was inhibited by AT2 receptor blockade and AA metabolism. Conclusion: The findings indicate that blockade of the AT1 angiotensin II receptor, activation of AT2 receptors, releases CYP-AA metabolites that induce renal vasodilation.
A Survey of Contemporary Philosophies and Techniques of Restoring Endodontically Treated Teeth in Kuwait
Authors: Morgano Steven M. , Bowley John F. , Thalib Lukman , Abdulkarim Ebrahim
Published: April 2003

Objective: Numerous methods of restoring endodontically treated teeth have been advocated, and the prognosis of the treatment varies depending on the materials and techniques used. The objective of this study was to improve the understanding of contemporary philosophies and techniques of restoring endodontically treated teeth in Kuwait to serve as a baseline for continuous quality improvement of dental care in Kuwait. Methods: A questionnaire (English and Arabic versions) that comprehensively reviewed philosophies and techniques of restoring endodontically treated teeth was prepared. A research assistant identified prosthodontists, endodontists and general dentists practicing in government clinics in Kuwait. The sample represented 63% of the prosthodontists employed by the Ministry of Health, 91% of the endodontists and 7% of the general practitioners. Surveys were hand-carried by the research assistant and distributed to all dentists in the study group. Although all responses were anonymous, all surveys were numbered for tracking, and the research assistant returned to the government clinics repeatedly until all questionnaires (100%) were recovered. Data from the returned questionnaires were tabulated and statistical analysis for associations was conducted by using χ2 tests. Results: Almost 60% of dentists in the survey involved in the treatment of endodontically treated teeth believed a post would reinforce the tooth. One third of the respondents used or recommended the use of one-piece dowel crowns (Richmond crowns). One third lacked familiarity with the ferrule effect, and several misconceptions relative to the optimal length of a post were also recorded. The vast majority of general dentists in the survey did not report involvement in the treatment of 30 or more endodontically treated teeth per year. Conclusions: The majority of the respondents misunderstood the purpose of a post, and there were misconceptions regarding the optimal length of a post. One third did not report familiarity with the ferrule effect, which is an important restorative component. One third used or recommended an obsolete method of restoration with a one-piece dowel crown.
The Significance of Radiopharmaceutical Choice on the Estimation of the Absolute Renal Function in Different Stages of Renal Failure
Authors: Ilic S. , Vlajkovic M. , Bogicevic M. , Rajic M. , Stefanovic V.
Published: April 2003

Objective: An abnormal filtration fraction due to divergence between glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) may lead to different estimations of absolute renal function, depending on the radiopharmaceutical administered. The purpose of this study was to estimate GFR and ERPF by measuring the clearances of technetium-99m diethylenetriamine pen- taacetic acid (99mTc-DTPA) and iodine-131 sodium o-iodo- hippurate (131I-OIH) in patients with renal failure and evaluate the significance of these radiopharmaceuticals in the prognosis of the disease. Methods: This study included 25 patients who were followed up during different phases of acute renal failure (ARF) as well as 46 patients with incipient and advanced chronic renal failure (CRF). Results were compared with those obtained in 20 healthy volunteers. Clearance of 99mTc-DTPA and 131I-OIH was measured by the technique of a single blood sample taken 180 and 44 min after administration of the radiotracer, respectively. Results: In the patients with ARF, absolute values of GFR and ERPF decreased during oligoanuric and diuretic phases, but the lower filtration fraction suggested a greater reduction of GFR. In the recovery phase of ARF, both GFR and ERPF improved and an almost normal filtration fraction suggested a more prominent GFR increase. The recovery of ARF patients was in accordance with 131I-OIH clearance values recorded in the oligoanuric phase. The GFR and ERPF decreased concordantly in patients in the incipient stage while in advanced CRF, a slightly greater decrease in GFR was recorded. Conclusions: In ARF, the degree of the initial fall in GFR does not serve as a prognostic indicator whereas the degree of the initial fall of ERPF does have prognostic significance. The decrease in GFR parallels the decrease in ERPF in CRF and a measurement of either parameter should give a comparable estimate of renal function.