bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors Influencing the Pre- and In-Hospital Management of Acute Stroke – Data from a Greek Tertiary Care Hospital
Authors: Koutlas Evangelos , Rudolf Jobst , Grivas Georgios , Fitsioris Xenophon , Georgiadis Georgios
Published: December 2003

In a prospective observational study, data on pre- and in-hospital management of acute stroke patients were collected from 100 consecutive patients admitted to the emergency room (ER) of Papageorgiou Hospital, a tertiary health care facility in Thessaloniki, Greece. Public emergency services were used by 58% of the patients, and 42% were brought by their relatives. 27% of the patients arrived within 1.5 h, 45% within 3 h, and 71% within 6 h from symptom onset. The median interval from ER arrival to examination by a board-certified neurologist was 20 min (range 5–40 min). Time from ER arrival until brain CT scan ranged from 17 min to 28 h, with a median of 1.7 h. The majority (57%) of acute stroke patients reached hospital and received adequate diagnostic and treatment within 6 h, and approximately 30% even within 3 h from symptom onset. Thus, and in contrast to widespread perception, there is a time window for hyper-acute stroke treatment in Greek public hospitals. However, the fraction of patients eligible for acute treatment may be increased by shortening both the interval from symptom onset to hospital arrival, and also the door-to-CT interval.
Subtypes of Depressive Episodes According to ICD-10: Prediction of Risk of Relapse and Suicide
Authors: Kessing Lars Vedel
Published: December 2003

Background: The long-term predictive ability of the ICD-10 subtypes of depression with melancholic syndrome and depression with psychosis has not been investigated. Sampling and Methods: All patients in Denmark who had a diagnosis of a single depressive episode at their first ever discharge during a period from 1994 to 1999 were identified. The risk of relapse leading to readmission and the risk of committing suicide were compared for patients discharged with an ICD-10 diagnosis of a single depressive episode with and without melancholic syndrome and for patients with and without psychotic symptoms, respectively. Results: In all, 1,639 patients had a diagnosis of depressive episode without psychotic symptoms, 1,275 patients a diagnosis with psychotic symptoms, 293 a diagnosis without melancholic syndrome, and 248 a diagnosis with melancholic symptoms at first discharge. The risk of relapse leading to readmission was greater for patients with psychotic symptoms than for patients without, but no difference was found between the two groups in the risk of committing suicide during follow-up. No differences were found in the risk of relapse leading to readmission or suicide between patients with and without melancholic syndrome. Conclusions: The ICD-10 categorization into depression with and without psychotic symptoms seems to be clinically and prognostically useful, whereas the ICD-10 subtyping into melancholic and non-melancholic syndrome does not seem to have any long-term predictive value.
A Retrospective Comparison of Inpatients with Mixed and Pure Depression
Authors: Ducrey Séverine , Gex-Fabry Marianne , Dayer Alexandre , Pardos Emna Ragama , Roth Loraine , Aubry Jean-Michel , Bertschy Gilles
Published: December 2003

Some authors advocate a broadening of the narrow concept of mixed episodes in the direction of mania leading to the concept of mixed mania, and in the direction of depression leading to the concept of mixed depression. The latter has been little investigated so far. In the present article, we retrospectively compare 49 patients with pure depression with 51 patients with mixed depression in terms of socio-demographic and clinical variables in order to contribute to the validation of the distinction between mixed and pure depression. Supporting this distinction, we observed that mixed depressive patients more frequently had past histories of bipolar disorder and alcohol abuse and had longer durations of hospital stay. These last two points remain significant even when we control for the effect of the association with bipolarity.
Establishing the Reliability of a Verbal Self-Monitoring Paradigm
Authors: Johns Louise C. , Gregg Lynsey , Vythelingum Nanda , McGuire Philip K.
Published: December 2003

Background: Auditory hallucinations in schizophrenia are associated with defective monitoring of inner speech. This process can be examined using a computerised task of verbal self-monitoring. Cognitive therapy for voices aims to improve the patients’ self-monitoring ability, and changes in self-monitoring could be assessed using this task. Before using the paradigm in this way, we sought to determine its test re-test reliability. Sampling and Methods: 20 normal volunteers were tested on the paradigm on two occasions, 3 months apart. The task involved reading single adjectives under the following randomized conditions: reading aloud; reading aloud with acoustic distortion of their own voice; reading aloud with alien feedback (someone else’s voice), and reading aloud with distorted alien feedback. Immediately after articulating each word, the participants were required to identify the source of the speech they heard (‘self’/‘other’/‘unsure’) via a button press. Response choice and reaction time were recorded. Results: There was no change in error rate over the two testing occasions; however, participants had faster reaction times when tested for the second time. This reduction in reaction time was not specific to type of response (correct, error, unsure). Conclusions: Participants showed no evidence of practice on the paradigm in terms of making fewer errors or responding faster for correct responses. The overall reduction in reaction times on the second occasion may reflect increased familiarity with the task. The verbal self-monitoring paradigm appears to be a reliable measure, which could be used to evaluate changes in self-monitoring ability in hallucinators following psychological therapy.
Antenatal Depression and Maternal-Fetal Attachment
Authors: Honjo Shuji , Arai Shiori , Kaneko Hitoshi , Ujiie Tatsuo , Murase Satomi , Sechiyama Haya , Sasaki Yasuko , Hatagaki Chie , Inagaki Eri , Usui Motoko , Miwa Kikuko , Ishihara Michie , Hashimoto Ohiko , Nomura Kenji , Itakura Atsuo , Inoko Kayo
Published: December 2003

Background: In recent years, attention has been turned to maternal mental health in relation to the mother-child relationship accompanying a widening in focus, i.e. taking into account not only the puerperium, but also the stage of pregnancy. This applies to studies that have revealed a connection between depression and maternal attachment in the postpartum period and late pregnancy. This study, however, was designed to evaluate the maternal-fetal relationship in the first and second trimesters, being the first one to address this issue in these early stages. Sampling and Methods: Zung’s Self-Rating Depression Scale (ZSDS), the original Antenatal Maternal Attachment Scale (AMAS), and a questionnaire addressing peripheral factors were given to 216 pregnant women (3–6 months of gestation) who visited the Nagoya University Hospital between September 1998 and June 2001. Results: Contrary to reports on the latter stages of pregnancy, no direct association was observed between depression in mothers and maternal-fetal attachment before fetal movement was perceived. Conclusion: However, education, form of employment, planning of pregnancy, and premenstrual mood changes were found to be associated with the ZSDS score (mean: 41.9), while form of employment, feelings regarding pregnancy, and sources of support were extracted as factors associated with the AMAS, which are of interest in terms of the subsequent association between depression and maternal-fetal attachment in the peri- and postnatal periods.
Three Children with Triple A Syndrome due to a Mutation (R478X) in the AAAS Gene
Authors: Yuksel Bilgin , Braun Regina , Topaloglu A. Kemal , Mungan Neslihan O. , Ozer Guler , Huebner Angela
Published: December 2003

Objective: To investigate the phenotype and genotype of 3 unrelated children with triple A syndrome from southern Turkey. Methods: The coding sequence of the AAAS gene was sequenced including exon-intron boundaries. Haplotype analysis using markers from AAAS region was performed in order to assess potential founder effects. Results: In all 3 patients, the identical nonsense mutation (R478X) in exon 16 of the AAAS gene was identified. The patients who may be distantly related appeared phenotypically similar with the classical triad of the triple A syndrome (adrenal insufficiency, alacrima and achalasia) with dermatological manifestations while lacking neurological features except for mild mental retardation. Conclusion: The R478X mutation tends to result in a rather severe phenotype although genotype-phenotype relationships cannot be drawn due to the small number of patients.
1,25-(OH)2-16ene-23yne-D3 Reduces Secondary Hyperparathyroidism in Uremic Rats with Little Calcemic Effect
Authors: Lippuner Kurt , Perrelet Romain , Casez Jean-Paul , Popp Albrecht , Uskokovic Milan R. , Jaeger Philippe
Published: December 2003

Objectives: To compare the effects of vitamin D analogs versus calcitriol on serum levels of Ca, P and parathyroid hormone (PTH). A compound better than calcitriol should increase the Ca x P product less than calcitriol for an equivalent decrease in PTH levels. Methods: Biological activity of 4 vitamin D analogs, 1,25-(OH)2-16ene- D3 (RO1), 1,25-(OH)2-16ene-23yne-D3 (RO2), 1,25-(OH)2-26,27-hexafluoro-16ene-23yne-D3 (RO3) and 1,25-(OH)2-16ene-23yne-26,27-hexafluoro-19nor-D3 (RO4) was tested vs. calcitriol in parathyroidectomized rats. In a second set of experiments, the effects of RO2, RO4 and calcitriol were studied in 5/6 nephrectomized rats with secondary hyperparathyroidism. Results: In parathyroidectomized rats, all analogs (250 pmol/day) led calcemia to rise after 7 days. In uremic rats, all treatments reduced PTH levels. RO4 revealed toxicity. RO2 was as effective as calcitriol in suppressing PTH in a dose dependent manner. Mean plasma ionized calcium did not change from baseline to day 14 and day 28 on RO2 (250 or 500 pmol/day) whereas it increased significantly on RO2 (1,000 pmol/day) and calcitriol (125 or 250 pmol/day). Increasing the dose of calcitriol led Ca × P to rise more dramatically than increasing the dose of RO2, which appears to have a wider therapeutic window than calcitriol. Conclusion: 1,25-(OH)2-16ene-23yne-D3 (RO2) may represent a novel candidate for the treatment of renal osteodystrophy in humans.
Differential Effect of Fetal, Neonatal and Treatment Variables on Neurodevelopment in Infants with Congenital Hypothyroidism
Authors: Alvarez M. , Carvajal F. , Renón A. , Pérez C. , Olivares A. , Rodríguez G. , Alvarez V.
Published: December 2003

Objectives: To identify the influence of fetal, neonatal and treatment variables on neurodevelopment in children with congenital hypothyroidism. Methods: A multiple regression analysis was performed in the neurodevelopmental scores of 26 children with CH who were assessed at 3, 6, 12 and 18 months for postural control, fine eye-hand coordination and language. The independent variables were: duration of fetal hypothyroidism, initial biochemical severity, days at starting treatment, initial dose, and efficiency of treatment. Results: Postural control was predicted by duration of fetal hypothyroidism and language by the biochemical severity of the disease at birth. Fine eye-hand coordination was not predicted by any variable. Conclusion: This pattern of influences suggests that fetal and neonatal hypothyroidism have different effects on brain maturation sites during the first 2 years of life and that some subtle neurocognitive deficits are probably unavoidable.
Catch-Up Growth in Females Born Short for Gestational Age Reduces the Risk of Giving Birth to Short-for-Gestational-Age Infants
Authors: Lundgren E.M. , Cnattingius S. , Jonsson B. , Tuvemo T.
Published: December 2003

Objectives: The aim of the present study was to study the effect of catch-up growth on the offspring’s length at birth among females born short for gestational age. Methods: Data of 1,363 females born short for gestational age (<–2 standard deviation scores) were obtained from the Swedish Birth Register. The females were included in the register both as babies and mothers. The effect of catch-up growth on the offspring’s birth length was studied. Results: Short adult stature was associated with a threefold increase in the risk of giving birth to a short infant [OR 3.08 (CI 1.73–5.50)] and smoking increased the risk in a dose-dependent manner. Overweight was associated with a reduced risk [OR 0.46 (CI 0.22–0.96)] of giving birth to a short infant. Conclusion: Catch-up growth to normal adult stature among women born short for gestational age is associated with a reduced risk of giving birth to a short-for-gestational-age infant.
Altered Kinetics of Pituitary Response to Gonadotropin-Releasing Hormone in Women with Variant Luteinizing Hormone: Correlation with Ovulatory Disorders
Authors: Takahashi Kentaro , Karino Kenji , Kanasaki Haruhiko , Miyazaki Kohji
Published: December 2003

Objective: The LH response of pituitary gland to gonadotropin-releasing hormone (GnRH) stimulation is not well defined in patients with mutant β-subunit (Trp8 to Arg8 and Ile15 to Thr15). Here we compared the relative activities and dynamics of LH secretion in patients with wild-type and variant LH following injection of GnRH. Methods: A GnRH stimulation test was performed in 33 patients with ovulatory disorders (patient group) and 29 women with normal ovulatory cycles (control group) heterozygous for the variant LHβ allele. Blood samples were obtained up to 120 min after GnRH injection. Serum LH response was determined by comparing the results of LH immunoassays using a monoclonal antibody that recognizes wild-type LH only with those of another assay using a polyclonal antibody that recognizes equally both variant and wild-type LH (total LH). The ratio of variant LH to total LH (LH ratio) was used to determine the serum LH status. Results: The LH ratio in the control group showed the peak 15 min after GnRH injection, while that in the patient group showed the peaks 30–60 min after injection. The LH ratio in the patient group at 120 min after injection was significantly lower than that in the control group. The percent increases in LH ratio in both groups showed the peak 15 min after injection. The patient group had significantly lower changes of LH ratio at 15, 60, 90 and 120 min after GnRH injection compared with that in the control group. Conclusion: Differences in circulatory kinetics of the two types of LH may explain the differences in LH function between patients with ovulatory disorders and women with normal ovulatory cycles.
Extreme Short Stature after Intrauterine Growth Retardation: Factors Associated with Lack of Catch-Up Growth
Authors: Edouard T. , Trivin C. , Lawson-Body E. , Pinto G. , Souberbielle J.-C. , Brauner R.
Published: December 2003

The factors associated with lack of catch-up growth after intrauterine growth retardation (IUGR) are unknown. Objective: To identify these factors by analyzing the clinical features and growth hormone (GH)-insulin-like growth factor I (IGF-I) axis. Methods: 95 patients with height <–3 SD after IUGR were assigned to group 1 without (n = 50) or group 2 with (n = 45) malformations. Twenty-one in group 1 and 19 in group 2 were treated with GH. Results: They were seen at 5.3 ± 0.5 and 4 ± 0.5 year (p = 0.02) with heights at –3.4 ± 0.1 and –3.9 ± 0.2 SD (p = 0.03). Group 1 differed from group 2 in having a lower frequency of consanguinity (2 vs. 28.9%, p < 0.001), and higher frequencies of target heights (26.5 vs. 6.7%, p = 0.02) and mothers’ heights (34.7 vs. 8.9%, p < 0.01) <–2 SD, multiparity (26 vs. 8.9%, p < 0.05), prematurity (36 vs. 15.5%, p < 0.05) and cesarean section birth (42 vs. 17.8%, p = 0.01). The GH-IGF-I axis data and the height increases after 3 years of GH treatment (1.6 ± 0.2 in group 1 and 1.1 ± 0.3 SD in group 2) were similar. Conclusion: The short height of the parents, particularly of the mother, is associated with factors limiting the catch-up growth after IUGR of children without malformations, while the high frequency of consanguinity in those with malformations suggests that transmitted fetal factors affect organogenesis or development.
The C105fs114X Is the Prevalent Thyrotropin Beta-Subunit Gene Mutation in Argentinean Patients with Congenital Central Hypothyroidism
Authors: Domené Horacio M. , Gruñeiro-Papendieck Laura , Chiesa Ana , Iorcansky Sonia , Herzovich Viviana C. , Papazian Regina , Forclaz Verónica , Prieto Laura , Sansó Gabriela , Scaglia Paula , Bre Mónica , Chamoux Alfredo , Heinrich Juan J.
Published: December 2003

Background: Congenital isolated thyrotropin (TSH) deficiency is an unusual condition characterized by low levels of thyroid hormones and TSH, usually presenting early typical signs of severe hypothyroidism. Five different β-TSH mutations have been described so far. While 4 of them affect only consanguineous families, a frameshift mutation in exon 3 (C105fs114X) has been found also in nonconsanguineous families. Objective: The aim of the present study was to characterize β-TSH mutations in Argentinean patients with congenital central hypothyroidism (CCH) and to emphasize the importance of early biochemical and molecular diagnosis of this disorder. Patients and Methods: We investigated 8 Argentinean children (3 boys, 5 girls) from 7 unrelated families with CCH based upon low levels of T4 and T3, and low basal and stimulated TSH levels. Mutation characterizations for the β-TSH gene were performed by PCR amplification followed by sequence and restriction enzyme analysis with SnaBI in the patients, 9 parents and in 100 newborn children. Results: All patients presented the same homozygous mutation in exon 3 of the β-TSH gene (C105fs114X), the 9 studied parents were heterozygous for the same mutation and 1 carrier was found in the 100 studied newborns. Conclusion: Our findings show that the C105fs114X mutation is prevalent in our population and may constitute a hot spot at codon 105 in the β-TSH gene. Since this mutation is easily demonstrable by a SnaBI digestion in DNA amplified from dried blood spots, its investigation would be indicated in patients in our milieu with clinical and biochemical features of CCH, allowing early L-thyroxine (LT4) replacement and genetic counseling of the family.
Treatment of Congenital Nephrogenic Diabetes insipidus with Hydrochlorothiazide and Amiloride in an Adult Patient
Authors: Konoshita Tadashi , Kuroda Masahiro , Kawane Takashi , Koni Ichiro , Miyamori Isamu , Tofuku Yohei , Mabuchi Hiroshi , Takeda Ryoyu
Published: December 2003

Aim: The effects of treatment with hydrochlorothiazide (HCTZ) combined with amiloride were elucidated and compared to HCTZ treatment alone and combined with acemetacin or triamterene in a Japanese adult patient with congenital nephrogenic diabetes insipidus. Methods: The study was divided into seven periods: (1) HCTZ and acemetacin; (2) control period; (3) HCTZ; (4) a second control period; (5) HCTZ and amiloride; (6) a third control period, and (7) HCTZ and triamterene. Fluid intake, urine volume, urinary Na, K, creatinine, and osmolality and serum Na, K, Cl, CO2, and osmolality were measured, and free water clearance and proximal and distal tubular Na reabsorption rates were calculated. Results: Without drug administration, the urine volume was about 8,000 ml/day. The urine volume was reduced to about 6,000 ml/day with HCTZ. A further urine volume reduction to about 5,000 ml/day was obtained with the second drug administration, and the effects were similar among the three regimens. Serum and urinary osmolality and free water clearance were also similar among the three combinations, whereas the urinary potassium excretion was the least, and the serum potassium concentration was the highest with HCTZ plus amiloride. Besides, no alkalosis was observed only with this combination. Conclusion: HCTZ plus amiloride may be superior to HCTZ plus acemetacin and HCTZ plus triamterene in preventing hyperkaliuria, hypokalemia, and metabolic alkalosis.
High Dose Allergen Stimulation of T Cells from House Dust Mite-Allergic Subjects Induces Expansion of IFN-γ+ T Cells, Apoptosis of CD4+IL-4+ T Cells and T Cell Anergy
Authors: Gardner Leanne M. , O’Hehir Robyn E. , Rolland Jennifer M.
Published: December 2003

Background: During clinically effective allergen-specific immunotherapy a shift in cytokine dominance from IL-4, IL-5 predominant to IFN-γ predominant has been observed. As antigen concentration influences Th cell priming, this study aimed to determine the effect of different allergen concentrations on human house dust mite (HDM)-specific T cell production of IL-4 and IFN-γ, proliferation and apoptosis. Methods: HDM-allergic donor PBMC were cultured for 14 days with different concentrations of HDM extract (1, 10 and 100 µg/ml). T cell intracellular IL-4 and IFN-γ, division (CFSE labelling) and apoptosis (active caspase-3 staining) were analysed by flow cytometry. Proliferation was assessed by 3H-thymidine incorporation. Results: Increased CD4+IFN-γ+ and CD8+IFN-γ+ T cell numbers were observed in high allergen concentration cultures compared with low concentration cultures whereas there were no differences in CD4+IL-4+ and CD8+IL-4+ T cell numbers. CFSE cell labelling revealed that high allergen concentration favours the expansion of IFN-γ-producing CD4+ T cells. The proportion of apoptotic cells increased with allergen concentration and there was preferential apoptosis of CD4+IL-4+ T cells. HDM-induced proliferation was decreased in high allergen concentration cultures; this was reversible by IL-2 consistent with anergy. Conclusion: These results show that T cell division and apoptosis contribute to the cytokine skewing to predominant IFN-γ production by T cells observed at high allergen concentration. Thus the use of hypoallergenic T cell reactive preparations which can be given safely at higher doses than natural extracts may enhance efficacy of allergen-specific immunotherapy.
Injection Immunotherapy with Different Airborne Allergens Did Not Prevent de novo Sensitization to Ragweed and Birch Pollen North of Milan
Authors: Asero Riccardo
Published: December 2003

Background: Previous studies suggest that allergen-specific immunotherapy (SIT) with a single allergen may prevent sensitization to other airborne allergens. Objective: To assess the effectiveness of injection SIT in preventing sensitization to birch and ragweed pollen north of Milan, a geographical area that was recently colonized by these two airborne allergens. Methods: 691 adult patients monosensitized to grass (n = 342), pellitory (n = 76), ragweed (n = 66), birch (n = 112), and house dust mite (n = 95) were studied. 284 (41%) of them received injection SIT as part of routine outpatient care; the remaining 407 (59%) not submitted to SIT, served as controls. All patients underwent follow-up visits after no less than 2 years in order to detect possible new sensitization to birch and/or ragweed. Results: 227 (33%) patients became sensitized to birch and/or ragweed pollen during the follow-up period. Surprisingly, the prevalence of new sensitizations was significantly higher among subjects receiving SIT (132/284; 46%) than among those not receiving SIT (95/407; 23%; p < 0.001). 27 subjects developed new sensitization to birch and/or ragweed pollen while undergoing SIT. These findings were consistent in all subgroups with different airborne allergies. Conclusion: In this study, injection SIT did not exert any preventive effect against denovosensitization to the two novel airborne allergens, birch and ragweed pollen, in adult monosensitized patients.
The Association of Metabolic Disorders with the Metabolic Syndrome Is Different in Men and Women
Authors: Dallongeville J. , Cottel D. , Arveiler D. , Tauber J.-P. , Bingham A. , Wagner A. , Fauvel J. , Ferrières J. , Ducimetière P. , Amouyel P.
Published: December 2003

Aims: Metabolic disorders depend on genetic, hormonal and environmental factors, whose relations may differ between genders. Therefore, we compared the contribution of metabolic disorders to the metabolic syndrome in women and men. Methods: To this end, we used a hierarchical classification statistical method to classify subjects into similarity groups according to clinical and biological parameters. Data were collected from 3,508 men and women aged 35–64 years, from a cardiovascular disease survey. Results: In both women and men, hierarchical classification identified a cluster corresponding to the metabolic syndrome representing 14 and 15% of the women’s and men’s sample, respectively. In women, elevated body weight (women’s Z-score: 1.59 vs. men’s Z-score: 1.29; p < 0.005), waist girth (1.62 vs. 1.30; p < 0.001) and low HDL cholesterol (–0.95 vs. –0.75; p < 0.05) were significantly larger contributors to the metabolic syndrome than in men. In contrast, systolic (0.59 vs. 0.95; p < 0.0001) and diastolic (0.55 vs. 0.99; p < 0.0001) blood pressure and apolipoprotein B (0.51 vs. 0.71; p < 0.0001) contributed significantly less in women than in men. Finally, insulin (n.s.), glucose (n.s.), triglycerides (n.s.) and LDL-cholesterol (n.s.) contributions were not different between genders. Conclusion: These results are consistent with the concept that a clustering of metabolic disorders occurs frequently in both women and men. However, the contribution of several metabolic disorders to the metabolic syndrome is different in men and women. This finding supports the concept that different criteria are necessary to define the metabolic syndrome in women and men.
Effect of Dietary Docosahexaenoic Acid and Catechins on Maze Behavior in Mice
Authors: Shirai Nobuya , Suzuki Hiramitsu
Published: December 2003

Background/Aims: Docosahexaenoic acid (DHA; 22:6 n–3) and catechins are food components that play an important role in maintaining human health. However, the effect of a simultaneous intake of DHA and catechins on brain function is unknown. The purpose of this study was to investigate the effect of DHA and catechins on maze behavior in mice. Method: Adult (5 months old) and old (15 months old) male mice were fed 5% lard diets containing 0 or 1.5% DHA ethyl ester (DHA-EE), either with or without 0.5% catechins, for 3.5 months. Maze behavior was assessed 3 months after the start of the feeding experiment. The time required and distance traveled to reach the maze exit, and the number of times that a mouse strayed into blind alleys in the maze were measured. The fatty acid compositions of plasma and brain lipids were measured after the maze behavior experiment. Results: Adult mice in the catechin, DHA-EE, and DHA-EE + catechin diet groups required less time and traveled a shorter distance to reach the maze exit, and strayed into blind alleys fewer times than those in the corresponding lard groups. Among old mice, the DHA-EE + catechin diet group showed an improvement in maze behavior. No marked differences in the brain fatty acid composition between lard and catechin diet groups were observed; in the DHA-EE intake groups, the brain DHA percentage was raised. Conclusion: These results suggest that a simultaneous intake of DHA and catechins may certainly enhance brain function in both adult and old mice.
Vitamin B12 Is a Strong Determinant of Low Methionine Synthase Activity and DNA Hypomethylation in Gastrectomized Rats
Authors: Brunaud Laurent , Alberto Jean-Marc , Ayav Ahmet , Gérard Philippe , Namour Farès , Antunes Laurent , Braun Marc , Bronowicki Jean-Pierre , Bresler Laurent , Guéant Jean-Louis
Published: December 2003

Background/Aims: The respective influence of folate and vitamin B12 deficiency on MTR activity and transcription, and on DNA methylation is not clearly established. The aim of this study was to assess the respective influence of folate and vitamin B12 deficiency on MTR transcription and activity, and on DNA methylation. Methods: Sixty-one rats were administered normal diet or diet deficient in choline, methionine, folic acid and vitamin B12. Forty-seven of them underwent total gastrectomy or ileal resection. Results: Low vitamin B12 was observed only in gastrectomized rats. Low folate was observed in rats under deficient diet. Total MTR activity (holo- + apoenzyme) was lowered only with vitamin B12 level <200 pmol/l (p = 0.0002), while the ratios of total vs. holo-MTR activity and of transcripts MTR vs. GAPDH (RT-PCR) were unchanged. Vitamin B12 was the single determinant of low MTR (lower quartile, odds ratio = 15.75, p = 0.0017). Low MTR and low vitamin B12 were the two determinants of DNA hypomethylation (lower quartile) (odds ratio = 17.07, p = 0.0006, and odds ratio = 7.31, p = 0.006, respectively). Conclusion: Vitamin B12 affects MTR expression by a non-transcriptional mechanism different from a protective effect on MTR proteolysis. It is also a strong determinant of DNA hypomethylation.
Rising Incidence of Reflux Oesophagitis in Patients Undergoing Upper Gastrointestinal Endoscopy
Authors: Loffeld R.J.L.F. , van der Putten A.B.M.M.
Published: December 2003

Background: In the literature a lot of epidemiological data is present but little is known on the yearly incidence of oesophagitis and Barrett’s oesophagus. For this reason a cross-sectional study was done to explore the yearly incidence of these conditions in patients sent for upper gastrointestinal endoscopy. Methods: All patients diagnosed with reflux oesophagitis, Barrett’s oesophagus or hiatus hernia in a 10-year period were included. Results: In the period of 10 years 11,691 consecutive patients underwent endoscopic examination. Oesophagitis was diagnosed in 1,633 patients, Barrett’s oesophagus in 275, and hiatus hernia without oesophagitis in 1,407 patients. The number of patients with oesophagitis almost doubled, while the number of patients with hiatus hernia or Barrett’s oesophagus remained constant each year in this time period. The number of men diagnosed with oesophagitis or Barrett’s oesophagus was significantly higher than the number of women. Hiatus hernia occurred significantly more often in women, and was present in 79–88% of patients with active reflux oesophagitis. Conclusion: This study clearly shows that the incidence of reflux oesophagitis shows a marked increase. The incidence doubled in a period of ten consecutive years. This data should be kept in mind in planning future health-care resources. It can be expected that the use of acid suppressive therapy will be rising in the years to come.
Albumin Stimulates the Accumulation of Extracellular Matrix in Renal Tubular Epithelial Cells
Authors: Stephan Jean-Philippe , Mao Weiguang , Filvaroff Ellen , Cai Liping , Rabkin Ralph , Pan Guohua
Published: December 2003

The accumulation of a large amount of plasma proteins in the urine, previously regarded as a marker of glomerular damage, is now recognized as a mediator of tubulointerstitial damage. Using an in vitro approach, several key extracellular matrix (ECM) proteins were analyzed after treatment of primary human renal proximal tubular epithelial cells with fatty acid free human albumin. We demonstrate that human albumin stimulates the accumulation of ECM proteins by proximal tubular epithelial cells through a post-transcriptional mechanism. Albumin induced a significant increase in tissue inhibitor of metalloproteinases (TIMP)-1 and TIMP-2. Taken together, our data suggest that ECM protein accumulation in response to albumin resulted partly from inhibition of ECM degradation. Addition of transforming growth factor beta (TGF-β)-specific neutralizing antibody failed to alter ECM protein levels after albumin treatment, indicating that the albumin-induced increase in ECM is TGF-β independent. In conclusion, we have shown that exposure of cultured human proximal tubular cell to albumin leads to the TGF-β-independent accumulation of ECM proteins, suggesting that albumin may be a contributing factor to the progression of kidney fibrosis in proteinuric states.
Sequelae of Syndrome X in Children Born Small for Gestational Age
Authors: Veening Margreet A. , van Weissenbruch Mirjam M. , Delemarre-van de Waal Henriette A.
Published: December 2003

Objective: Low birth weight is associated with the presence of syndrome X in adults. We studied the components of this syndrome in prepubertal children born SGA (small for gestational age) and children born AGA (appropriate for gestational age). Methods: Twenty-nine SGA children, age (mean ± SD) 9.1 ± 1.1 years and 24 AGA children, age 9.0 ± 1.1 years were studied. Fasting serum lipid concentrations were determined. A hyperinsulinemic euglycemic clamp was performed to measure insulin sensitivity. Ambulatory monitoring was performed to obtain 24-hour recordings of blood pressure. Results: Prepubertal SGA children are less insulin sensitive and have a higher nighttime systolic blood pressure (SBP) after correction for BMI than children born AGA. No differences were found in lipid concentrations between the 2 groups. Conclusions: Not all components of syndrome X can yet be found in 9-year-old children born SGA; follow-up of this cohort is required.
Increased MIB-1/Ki-67 Labeling Index as a Predictor of an Aggressive Course in a Case of Prolactinoma
Authors: Zornitzki Taiba , Knobler Hilla , Nass Dvora , Hadani Moshe , Shimon Ilan
Published: December 2003

Secondary resistance to dopamine agonists is a rare phenomenon in patients with a prolactinoma. We describe a 55-year-old male with a macroprolactinoma initially responding favorably to bromocriptine treatment with normalization of prolactin levels and tumor shrinkage. Two years later, he developed resistance to bromocriptine treatment and subsequently to cabergoline. The aggressive course of the disease necessitated three surgical interventions. Staining of the pituitary tissue revealed a very high MIB/Ki-67 labeling index that increased further in specimens derived from repeated surgery. This case demonstrates that high and increasing levels of the MIB/Ki-67 labeling index may indicate an aggressive course associated with secondary dopamine resistance.
Organic Hydroperoxide-Induced Chemiluminescence of Follicular Fluid and Blood Serum Samples Obtained from Women Pretreated for in vitro Fertilization
Authors: Török A. , Németh P. , Török B. , Berki T. , Tinneberg H.-R. , Bódis J.
Published: December 2003

The organic hydroperoxide-induced chemiluminescence of follicular fluid obtained from in vitro fertilized patients and its differently separated fractions were evaluated. Peroxidative stress causes a different photo-emission in the samples which alludes to some factors playing a role in the maintenance of the pro-oxidant/antioxidant balance. Interactions between the protein compounds of the samples and the organic hydroperoxide associate with formation of excited species contributing to the distinctive light emission processes. The technique offers a special re-interpretation of the scavenger state relating to the components of follicular fluid.
Electro-Acupuncture Reverses Nerve Growth Factor Abundance in Experimental Polycystic Ovaries in the Rat
Authors: Bai Young Hoon , Lim Sung Chul , Song Chang Hun , Bae Chun Sik , Jin Cheon Sik , Choi Bum Chae , Jang Chul Ho , Lee Seung Hoo , Pak Sok Cheon
Published: December 2003

Polycystic ovary syndrome (PCOS) remains one of the most common causes of anovulation in women of reproductive age. There is some evidence that nerve growth factor (NGF) is involved in the pathogenesis of PCOS. Therefore, seeking the pathogenesis of PCOS is important for controlling fertility. In traditional Oriental Medicine, acupuncture has been used for the function of ovaries. The present study was designed to determine whether electro-acupuncture (EA) could affect experimentally induced polycystic ovary (PCO) in the rat. The two acupoints Sp-6 and E-128 were stimulated to test for efficacy in the protein expression of NGF. Polycystic ovaries were induced by a single injection of estradiol valerate (4 mg i.m.). During the experimental period of 8 weeks, some of the rats were treated with EA twice weekly; this group was compared with a vehicle-treated control group and an estradiol-injected group not subjected to EA. At day 60, the protein expression of NGF was examined by immunohistochemistry in the ovaries, the adrenal glands and some parts of the brain. The estradiol treatment induced a clear PCO appearance, and was associated with a robust increase in NGF expression in the ovaries, the adrenal glands and the brain. EA treatment partly reversed the NGF abundance, particularly in the ovaries, but not in the brain. Our data show that EA affects the NGF involvement in ovarian dysfunction.
Divalent Cation Levels in Serum and Preovulatory Follicular Fluid of Women Undergoing in vitro Fertilization Embryo Transfer
Authors: Azem Foad , Hanannel Arik , Wolf Yoram , Ben-Yosef Dalit , Wagman Israel , Yovel Israel , Kapustiansky Rita , Lessing Joseph B. , Maclov Mira , Amit Ami
Published: December 2003

In this controlled clinical study, we determined the serum and follicular fluid concentrations of the biologically active fractions of magnesium (Mg) and calcium (Ca) in 39 women undergoing controlled ovarian stimulation (COH) for in vitro fertilization (IVF) embryo transfer (ET). Serum levels of ionized Ca (Ca2+) and ionized Mg (Mg2+) were measured during day 3 of the IVF cycle, on the day of ovum pickup and 12 days following ET. Follicular fluid levels were measured on the day of ovum pickup. Serum levels of Mg2+ decreased and Ca2+ levels increased during the IVF cycle. Mg levels were significantly higher in follicular fluid than in serum. Ca2+ and Mg2+ may play a role in the preovulatory follicle, a possibility that warrants further study.
Endometriotic Uterocutaneous Fistula after Cesarean Section
Authors: Dragoumis K. , Mikos T. , Zafrakas M. , Assimakopoulos E. , Stamatopoulos P. , Bontis J.
Published: December 2003

Endometriosis outside the pelvis is rare and most cases occur in surgical scars after operations involving the female genital tract. Fistulae involving the uterus are also very rare, usually being the result of postpartum and postoperative complications. In the present report, a case of a 44-year-old patient with an endometriotic uterocutaneous fistula is described. The patient presented 6 years after her fourth cesarean section with a painful nodule on the cesarean scar, which was bleeding during menstruation. The lesion extended to the uterine fundus, connecting the endometrial cavity with the skin. This is merely the second case of a uterocutaneous fistula to be reported in the literature and the first case developed on grounds of endometriosis.
Usefulness of Preoperative Chemoradiation in Locally Advanced Cervical Carcinoma
Authors: Shibata Kiyosumi , Kikkawa Fumitaka , Suzuki Yuka , Terauchi Mikio , Kajiyama Hiroaki , Ino Kazuhiko , Mizutani Shigehiko
Published: December 2003

This study investigated response rate, toxicity, and influence on intra- and postoperative complications of neoadjuvant concurrent chemoradiation in locally advanced (Figo IB2–IIIB) cervical carcinomas. Twenty-eight patients (median age 46.5 years, age range 29–73 years), diagnosed as having squamous cell carcinomas (n = 21), adenocarcinomas (n = 6), and undifferentiated carcinoma (n = 1), entered this study. The chemoradiation protocol included external radiotherapy to the pelvis (39.6 Gy), intra-arterial or intravenous infusion of cisplatin (70 mg/m2 on days 1 and 22), and 24-hour continuous intravenous infusion of 5-fluorouracil (700 mg/m2 on days 1–4 and 22–25). Two weeks after the end of chemoradiotherapy, the patients underwent restaging followed by suitable operation including pelvic lymphadenectomy. The median follow-up period in the surviving patients was 13.1 months. The response rate for chemoradiation was 93% (26/28). The 2-year disease free survival was 85.2%. Grade 3–4 neutropenia was observed in 14 patients (50%), 4 patients (14%) showed grade 3 anemia, and 5 patients (17.8%) showed grade 3–4 thrombocytopenia. Nineteen patients (67.8%) could undergo surgery after concurrent chemoradiation. Pathological examination revealed a complete response (pT0) in 7 patients, and 5 patients showed only microscopic residual disease (pTmic). In 4 patients, there were intraoperative complications: vesical lesions in 2 (10%) and small intestine lesions in 2 (10%). Neoadjuvant therapy with concurrent chemoradiation for locally advanced cervical carcinoma is effective, safe, and useful for increasing operability rates as well as decreasing intra- and postoperative complications. Therefore, neoadjuvant concurrent chemoradiation should be considered for treatment in patients with locally advanced cervical carcinomas who could not undergo primary operation.
Lack of Association between Leber’s Hereditary Optic Neuropathy Primary Point Mutations and Multiple Sclerosis in Iran
Authors: Houshmand M. , Sanati M.-H. , Rashedi I. , Sharifpanah F. , Asghari E. , Lotfi J.
Published: December 2003

The hypothesis that mitochondrial genes may implicate susceptibility to multiple sclerosis (MS) is supported by an increasing number of case reports on Leber’s hereditary optic neuropathy (LHON)-associated mitochondrial DNA (mtDNA) point mutations in patients with MS. A number of mtDNA mutations with primary pathogenic significance for LHON, a maternally inherited disease causing severe bilateral visual loss predominantly in young men, have been detected in patients with an MS-like phenotype. To evaluate the link between MS and LHON primary point mutations, we investigated 31 non-related Iranian clinically definite MS patients (23 females and 8 males) with optic nerve involvement, as well as 25 patients (16 females and 9 males) without involvement of the optic nerve as controls. Three patients had severe bilateral visual loss without any recovery. We searched for the presence of LHON mitochondrial mutations at nucleotide positions (np) 11,778, 3,460, and 14,484 by mutation-specific polymerase chain reaction and restriction fragment length polymorphism. Our results suggest that there is no association between Iranian patients with MS and mtDNA point mutations at np 11,778, 3,460, and 14,484.
Advanced Glycation End Products in Clinical Nephrology
Authors: Kalousová M. , Zima T. , Tesař V. , Štípek S. , Sulková S.
Published: December 2003

As a result of oxidative and carbonyl stress, advanced glycation end products (AGEs) are involved in the pathogenesis of severe and frequent diseases and their fatal vascular/cardiovascular complications, i.e. diabetes mellitus and its complications (nephropathy, angiopathy, neuropathy and retinopathy, renal failure and uremic and dialysis-associated complications), atherosclerosis and dialysis-related amyloidosis, neurodegenerative diseases, and rheumatoid arthritis. They are formed via non-enzymatic glycation which is specifically enhanced through the presence of oxidative and carbonyl stress, and their ability to form glycoxidation products in peptide and protein structures finally modulating or inducing biological reactivity. Food can be another source of AGEs; however, high serum AGEs in hemodialysis patients might reflect nutritional status better. Several methods of renal replacement therapy have been studied in connection with the AGE removal, but unfortunately the possibilities are still unsatisfactory even if high flux dialysis, hemofiltration, or hemodiafiltration give better results than conventional low flux dialysis. AGEs are currently being studied in the patients on peritoneal dialysis as their precursors can be formed in the dialysis fluid. AGEs can cause damage to the peritoneum and so a loss of ultrafiltration capacity. Many compounds give promising results in AGE inhibition (inhibition of formation of AGEs, inhibition of their action or degradation of AGEs), are tested for these properties, and eventually undergo clinical studies (e.g. aminoguanidine, OPB-9195, pyridoxamine, antioxidants, N-phenacylthiazolium bromide, antihypertensive drugs, angiotensin-converting enzyme inhibitors and angiotensin II receptor-1 antagonists).
Limited Lipid-Lowering Effects of Regular Consumption of Whole Soybean Foods
Authors: Meyer Barbara J. , Larkin Theresa A. , Owen Alice J. , Astheimer Lee B. , Tapsell Linda C. , Howe Peter R.C.
Published: December 2003

Aim: To examine cardiovascular health benefits of foods containing a whole soybean extract. Methods: The study design was a randomized, placebo-controlled crossover trial of consuming soy-based milk and yoghurt (treatment) or equivalent dairy products (control) for 5 weeks each. Twenty-six mildly hypercholesterolaemic and/or hypertensive volunteers were recruited from the community as study volunteers, of which 23 completed. Main outcome measures included clinic and ambulatory blood pressure, arterial compliance, lipids, fatty acids and isoflavones in fasted blood and 24-hour urinary isoflavone excretion. Nutrient intakes were assessed initially and after each 5-week period. Multiple regression analyses were used to determine predictor variables in statistical models; order effects were tested by repeated measures ANOVA. Changes in Lp(a) were determined by Wilcoxon signed ranks tests; other differences between treatment and control were assessed by t tests. Results: Plasma and urinary isoflavones were markedly increased by whole soy supplementation but there were no overall differences in plasma lipids, blood pressure or arterial compliance between the soy and dairy diets. However, in 8 equol-positive subjects (equol detected in either plasma or urine), retrospective analysis revealed significant reductions in total cholesterol (8.5%), LDL cholesterol (10%), LDL:HDL ratio (13.5%), plasma triglycerides (21%) and lipoprotein(a) (11%) with the soy diet. These reductions were independent of changes in polyunsaturated fat and other macronutrient intakes. Conclusions: Regular consumption of whole soybean milk and yogurt products had no effect on plasma lipids, blood pressure or arterial compliance in at-risk subjects, despite substantially increasing isoflavone levels in blood and urine. Retrospective analysis suggests that improvement of plasma lipids may have been limited to equol-positive subjects.
Effects of Caffeine on the Saturated and Monounsaturated Fatty Acids of the Newborn Rat Cerebellum
Authors: Yazdani Malektaj , Ide Kazuya , Asadifar Mehrdad , Gottschalk Sheila , Joseph Jr. Fred , Nakamoto Tetsuo
Published: December 2003

Caffeine (1,3,7-trimethylxanthine) is one of the most commonly consumed drugs in our daily life, and its use is increasing. However, very little attention has been paid to its potential effects on early growth and development. Because of the steady increase in breast feeding of infants and because caffeine diffuses readily into breast milk, the present study examined if caffeine intake by newborn rats during lactation would affect the saturated and monounsaturated fatty acids in the growing cerebellum. A total of 10 timed pregnant rats were purchased from the breeder. At birth litters were combined, and 8 pups were randomly assigned to each dam without regard to the sex of the pups. Dams with litters were divided into 2 groups. Dams of group 1 received a 20% protein diet as a control, and dams of group 2 received a 20% protein diet plus caffeine (4 mg/100 g BW). Pups were killed at day 10. The cerebellums were removed, weighed and homogenized. Gas chromatograph-mass spectrometry was used to identify and quantify free fatty acids. Chronic caffeine exposure from birth to day 10 in pups through the maternal milk resulted in a decrease in cerebellum weight, a significant increase in the saturated fatty acids, and a tendency toward an increase of monounsaturated fatty acids. In addition, there was a slight increase of some of the polyunsaturated fatty acids. However, there was no difference in food intake of the lactating dams and weight gain of the pups between the groups. These data indicate that early caffeine intake by the suckling pups alters the composition of fatty acids of the cerebellum; thus, avoidance of caffeine during lactation is critical. The risks and benefits of caffeine administration in premature infants must be carefully evaluated during this rapid period of brain growth.