bluuebunny/crossref_metadata_2025 huggingface dataset:
Twenty-Four-Hour QT Interval Variability: Increased QT Variability during Sleep in Patients with Panic Disorder
Authors: Yeragani Vikram Kumar , Pohl Robert , Balon Richard , Jampala V.C. , Jayaraman Anusha
Published: April 2003

Recent studies on beat-to-beat QT interval variability (QTV) have shown that it can be used as a noninvasive measure of cardiac repolarization lability. It is also a predictor of sudden cardiac death and is higher in patients with anxiety and depression. This study examined the diurnal measures in QTV in 32 normal adults and 22 patients using 24-hour electrocardiogram records. We obtained 8 5-min segments of ECG sampled at 1,000 Hz from the 24-hour records. Our results show that QTV measures at nighttime are significantly higher in patients with panic disorder compared with controls. These findings demonstrate blunted diurnal changes in ventricular repolarization lability in patients resulting in a higher QT variability index during sleep. We speculate that these effects may relate to a relative increase in cardiac sympathetic activity in patients with panic disorder, and may contribute to the increased risk for cardiac mortality in patients with anxiety.
Allelic Variation in the Human Prodynorphin Gene Promoter and Schizophrenia
Authors: Ventriglia M. , Bocchio Chiavetto L. , Bonvicini C. , Tura G.B. , Bignotti S. , Racagni G. , Gennarelli M.
Published: April 2003

Experimental and clinical studies suggest an involvement of the opioid neuropeptide system in schizophrenia. In particular, the prodynorphin (PDYN), the precursor of the dynorphin opioid peptides, has been shown to play an important role in several aspects of human mental diseases. Recently, a functional polymorphism in the promoter of PDYN gene has been described. We studied the possible relationship between this polymorphism and schizophrenia and we found no significant difference in allelic and genotype distributions between schizophrenic patients and control subjects. However, we observed a significant interactive effect with the receptor 3 of dopamine gene (DRD3); in particular, the frequency of subjects carrying PDYN allele 3 being also homozygotes for DRD3 Gly allele (of Ser9Gly polymorphism) was significantly greater in patients than controls. We conclude that PDYN gene polymorphism alone does not alter the risk for schizophrenia but, by an epistatic interaction with the Gly allele of DRD3 gene, may contribute to the susceptibility to this disorder.
Quantitative EEG Changes in Alzheimer Patients during Long-Term Donepezil Therapy
Authors: Rodriguez Guido , Vitali Paolo , de Leo Caterina , De Carli Fabrizio , Girtler Nicola , Nobili Flavio
Published: April 2003

Twenty patients affected with probable mild-to-moderate Alzheimer’s disease (AD; NINCDS-ADRDA criteria; 14 women and 6 men, mean age 75.2 ± 7.1 years) who regularly received an oral acetylcholinesterase inhibitor (AChEI; donepezil 5 mg/day; Dz group) were compared with a control group of 11 AD patients (6 women and 5 men, mean age 73.5 ± 6.0 years) diagnosed and followed up in the pre-AChEIs era (C group). At basal evaluation (t₀), the 2 groups were comparable for age, education, and severity of disease (Global Deterioration Scale). All patients underwent quantitative EEG (qEEG, average reference, 10–20 International System), and were reexamined about 1 year later (t1; i.e., after 12.3 ± 3.6 months the Dz group, and after 13.7 ± 3.9 months the C group). Log-transformed values of two qEEG bands, i.e. 2–6 and 6.5–12 Hz, were averaged between adjacent channels (frontal F3 and F7, F4 and F8; parietotemporal P3 and T7, P4 and T8) to obtain a qEEG ratio (6.5–12/2–6 Hz.) from one frontal and one temporoparietal region in each hemisphere. Neuropsychological impairment was summarized by the Mini-Mental Status Examination (MMSE). At t₀, both the MMSE score and the qEEG ratio values were somewhat higher in the C than in the Dz group, although nonsignificantly. Between t₀ and t1, the MMSE score decreased significantly (p < 0.01) more in the C group (–4.36 ± 2.25) than in the Dz group (–1.45 ± 2.16), as did the qEEG ratio in the right frontal region (p < 0.01), whereas in the left frontal region the significance level was not reached (p = 0.02). Between t₀ and t1, the qEEG ratio difference in both frontal regions and in the right temporoparietal region significantly correlated with the MMSE difference (p < 0.01), but neither with time between examinations nor with the difference on the Visual Search Test score. Long-term treatment with Dz led to a lesser deterioration of qEEG, paralleling a milder neuropsychological decline. The effect was significant in frontal regions, possibly because they are relatively spared during the mild-to-moderate phases of the disease.
Treatment Approaches to Major Depressive Disorder Relapse
Authors: Fava Maurizio , Schmidt Mark E. , Zhang Shuyu , Gonzales Jill , Raute Nancy J. , Judge Rajinder
Published: April 2003

Background: Anecdotal reports concerning mood disorder patients suggest restarting drug treatment in patients who prematurely discontinue it may be associated with a diminished chance of response upon rechallenge. We evaluated the likelihood of response to reinitiation of fluoxetine treatment in patients relapsing after switching to placebo during a long-term efficacy study of two different dosing regimens of fluoxetine. Method: Patients who met the DSM-IV major depressive disorder criteria with modified HAMD17 scores ≧18 and CGI-Severity scores ≧4 were treated with open-label 20 mg/day fluoxetine for 13 weeks in a multicenter US study. Responders (n = 501) were randomized to placebo, 20 mg fluoxetine daily, or 90 mg enteric-coated fluoxetine weekly for 25 weeks of double-blind continuation treatment. Patients relapsing during the continuation phase were offered 25 weeks of double-blind rescue treatment during which the study medication dose was increased as follows: (1) patients on placebo had treatment with fluoxetine 20 mg/ day reinitiated; (2) patients on fluoxetine 20 mg/day had their dose increased to 40 mg/day, and (3) patients on a 90-mg weekly dose had their dose increased to 90 mg twice a week. Only the results of the rescue phase for the group who relapsed while on continuation treatment with placebo are reported here. Analyses included percentage of responders (50% reduction of modified HAMD17 and CGI-Severity ≤2) and assessments of change from baseline to endpoint (HAMD, CGI-Severity). Safety measures included assessment of vital signs, laboratory measures, and treatment-emergent adverse events. Results: Of 122 patients assigned to placebo, 57 (47%) relapsed during continuation treatment. Fifty-five (96%) of these elected to enter double-blind rescue treatment. Overall, patients who relapsed upon switching to placebo responded well to reinitiation of fluoxetine (62%). The mean modified HAMD17 score decreased from 20 to less than 9 and was maintained for up to 6 months. Thirty-eight percent of patients either did not respond or initially responded but again relapsed after reinitiation of medication. Conclusion: This study suggests that patients who, after an initial response to fluoxetine, relapse upon switching to placebo have a relatively high probability of responding to the reinitiation of fluoxetine treatment. These results challenge the view that the efficacy of an agent prematurely discontinued is diminished when such an agent is restarted. They also generally support reinitiation of the same antidepressant as a ‘first-line’ treatment strategy in patients who relapsed after stopping a previously effective antidepressant.
Psychological, Allergic, and Toxicological Aspects of Patients with Amalgam-Related Complaints
Authors: Gottwald Birgit , Kupfer Jörg , Traenckner Isabel , Ganss Carolina , Gieler Uwe
Published: April 2003

Background: To deepen the understanding of the numerous unspecific complaints which are related to the dental material amalgam both in patients and physicians, an interdisciplinary case-control study regarding toxicological, allergic, psychological and psychiatric aspects was conducted. Forty patients with amalgam-associated complaints were compared to a well-matched group of 40 amalgam bearers without complaints. Methods: Patients and controls underwent a dental examination, which included recording of the quantity, surface area and quality of amalgam fillings, a determination of the mercury load in blood and urine, an allergy examination including patch testing with amalgam and a psychometric assessment with questionnaires noting coping strategies (ABI-UMW-P), interpersonal problems (Inventory of Interpersonal Problems) and self-consciousness (SAM), the NEO Five-Factor Inventory, Symptom Checklist-90-R, Beck Depression Inventory and a screening instrument for somatoform disorders. Results: Patients and controls did not differ with respect to mercury concentrations in body fluids. Only 1 patient was found to have a positive amalgam patch test; various other allergies could be determined in 28% of patients (n = 11). Patients had higher levels of psychic distress, a higher incidence of depression and somatization disorders as well as different styles of coping with anxiety compared to controls. Conclusions: No indication for mercury intoxication or amalgam allergy as a cause of the patients’ complaints could be found. The theory of amalgam-related complaints as an expression of underlying psychic problems is supported. Treatment should focus on somatization and changing coping and attribution styles.
Circulating Adhesion Molecules in Patients with Internal Carotid Artery Stenosis
Authors: Okulla Thorsten , Gass Sabine , Böhme Katja , Tiemann Klaus , Harbrecht Ursula , Klockgether Thomas , Pohl Christoph
Published: April 2003

To study the association of plasma concentrations of soluble adhesion molecules (sICAM-1, sVCAM-1 and sE-selectin) with atheroslerotic lesions at the origin of the internal carotid artery (ICA). 179 subjects were investigated by color Doppler ultrasound of whom 133 had and 46 had no plaques at the ICA origin. Stepwise logistic regression analysis revealed that hypertension (p < 0.001), sICAM-1 concentrations (p < 0.01) and smoking (p < 0.05) were independently associated with the presence of ICA plaques. Multivariate regression analysis revealed that sICAM-1 concentrations in subjects with plaque were negatively associated with the degree of ICA stenosis (p < 0.01) and positively associated with previous cerebral ischemia (p < 0.01), coronary heart disease (p < 0.05) and peripheral artery disease (p < 0.05). In conclusion, elevated sICAM-1 concentrations are independently associated with atherosclerosis of the ICA origin and are predominantly increased in patients with low-grade lesions and with clinical manifestations of vascular disorders.
The Medieval Kidney
Authors: Ziegler Joseph
Published: April 2003

This article surveys the various perceptions of the kidney and its pathologies by encyclopedists, preachers, nat- ural philosophers, surgeons and academic physicians around 1300. It focuses on the medical works of Arnau de Vilanova (d. 1311) and shows the medical discourse about the kidney in all its complexity. It draws attention to the incorporation of the medical nephrological debate into the scholastic frame, and to the close links between nephrology and astrology as well as alchemy.
Scientific Achievements of John P. Peters
Authors: Seldin Donald W.
Published: April 2003

After the First World War in the United States, studies of water and electrolyte metabolism that were based in clinical departments were usually centered on patients with diseases which disrupted normal homeostatic functions. Renal abnormalities figured prominently, but liver disease, diabetes mellitus, various pituitary disorders, the edematous states and similar disorders – to the extent that they disturbed the volume or composition of the extracellular fluid – were also a fertile field of investigation. In general, the studies were confined to long-term observation of patients: there were few experimental manipulations and almost no animal work. The focus was a detailed analysis of the chemical composition of the blood and urine, and a relentless attempt to identify how these were disturbed under the impact of disease. The laboratory of Dr. John P. Peters at Yale typified this approach.
Ippolito Albertini and Michael Albertus: Disparate Old and Innovative Theories on Dropsy and Edema
Authors: Timio Mario , Capodicasa Enrico
Published: April 2003

The concept of edema and dropsy as a part of heart and renal failure developed in the 17th and 18th centuries with the observations of Albertini, who realized that two clinical entities were derived from the blood rather than the tissues. Albertus, who lived in the same period, was the last physician to interpret fluid accumulation according to the old, scholastic and dogmatic procedures of medicine. The fundamental concepts of Albertus held little in addition to the classification and categories of the physicians of the Middle Ages. Bloody congestions were distinguished from stagnation: the former have the purpose of reducing superfluites of blood and occurred in plethoric patients. Plethora in turn is caused by the ancient villain, inculpated since Hippocrates and Galen: suppressed hemorrhoids, suppressed menstrual evacuation and cutaneous eruption driven inward. Because of its suppression, transfer of blood occurs toward the chest, which impedes thoracic expansion and contraction, then asthma and dyspnea occur. On the contrary, Albertini with his clinical and autoptic observations and pronouncements filled in the anatomical and clinical picture of fluid accumulation and created the rudiments of diagnostic criteria. Edema, dropsy, asthma, dyspnea were, according to Albertini, the signs and symptoms of heart and renal failure. Albertini was the first to point out that dyspnea is apt to arise with special rapidity when a lesion occurs in the left atrial chamber and ventricle and by implication the mitral valve. In modern physiopathological terms, he discovered the picture of pulmonary edema. To this important discovery, he added a number of extremely important comments: changes in the respiratory organs are secondary to changes in the cardiovascular system; edema that is accompanied by dyspnea also affects the viscera, most especially the lungs, and finally dropsy of the lungs must be differentiated anatomically and clinically from dropsy of the chest (hydrothorax). In other words, he depicted the anatomical and clinical picture of congestive heart failure in modern terms.
Development of the Idea of Chronic Renal Failure
Authors: George C.R.P.
Published: April 2003

Ancient literature contained suggestions of references to people whom we might now speculate suffered from chronic renal failure; however, the first glimmerings of an understanding of the subject arose out of the clinico-pathological correlations that a number of 18th and 19th century observers drew. The concurrent studies by chemists of circulating and urinary levels of urea, creatinine, urate, phosphate, potassium, sodium and hydrogen ions expanded those correlations to a pathophysiological domain, especially in the late 19th and early 20th centuries. With the subsequent development of ideas about circulating hormones and the development of techniques for their measurement during the 20th century, the contemporary idea of chronic renal failure developed. The development of methods for quantifying tests of renal function enhanced that undertaking. Then, in the latter half of the 20th century, the development of effective dialytic techniques for the treatment of patients who suffer from chronic renal failure brought a renewed focus upon the mechanisms involved and problems posed by existing ideas. Nevertheless, the continuing high morbidity and mortality of patients who require such treatment suggest that existing ideas remain quite imperfect.
Increased Expression of Dipeptidyl Peptidase IV in Human Mesothelial Cells by Malignant Ascites from Ovarian Carcinoma Patients
Authors: Kajiyama Hiroaki , Kikkawa Fumitaka , Maeda Osamu , Suzuki Takahiro , Ino Kazuhiko , Mizutani Shigehiko
Published: April 2003

Cell surface aminopeptidases play an important role in biological processes through degradation of small peptides. There are many bioactive peptides in ascites and these peptides are involved in carcinoma cell dissemination and infiltration. In human mesothelial cells dipeptidyl peptidase IV (DPPIV) shows the highest expression mostly in four cell surface aminopeptidases: aminopeptidase A, neutral endopeptidase 24-11, aminopeptidase N and DPPIV. Since mesothelial cells are always in contact with ascites, we examined the influence of malignant ascites on DPPIV. DPPIV enzyme activity in mesothelial cells was enhanced by the addition of ascites obtained from ovarian carcinoma patients in a time- and concentration-dependent manner, and flow cytometry and immunocytochemistry also revealed an increased expression of DPPIV on the cell surface of mesothelial cells. The <3-kD fraction of malignant ascites increased the DPPIV enzyme activity to the same level as the total ascites. Northern hybridization demonstrated that DPPIV mRNA was increased 3-fold by the addition of the <3-kD malignant ascites. In conclusion, DPPIV is highly expressed in human mesothelial cells and was regulated by ascites.
Stepwise Hook Extension Technique for Radiofrequency Ablation Therapy of Hepatocellular Carcinoma
Authors: Kobayashi Masahiro , Ikeda Kenji , Someya Takashi , Akuta Norio , Suzuki Fumitaka , Tsubota Akihito , Suzuki Yoshiyuki , Saitoh Satoshi , Arase Yasuji , Kumada Hiromitsu
Published: April 2003

Objective: Our study was designed to examine the efficacy of stepwise hook extension technique for radiofrequency ablation (RFA) therapy of hepatocellular carcinoma in a randomized controlled study. Method: Twenty patients with hepatocellular carcinoma measuring <25 mm were divided randomly into two equal groups. RFA was applied using our new stepwise hook extension technique in patients of group 1, and the full extension method in group 2. The 10-hook electrode of LeVeen needle was deployed in four steps to full extension during ablation in group 1, and full extension at start of treatment in group 2. Results: Roll-off was achieved in all 10 patients of group 1, indicative of sufficient tumor coagulation, but only in 3 of 10 patients of group 2. The median time to completion of treatment was 6 min and 55 s (range 3 min to 14 min and 3 s) and 15 min (6–15 min), respectively. The total power output used for RF was lower in group 1 than in group 2 (median 271 vs. 1,045 W·m). The diameters of RFA-induced lesions were not significantly different between the groups (group 1: 27, range 23–37 mm; group 2: 23, 0–42 mm). Conclusions: Application of RFA using stepwise hook extension technique is superior to the full extension method since it produces the same therapeutic effects within a short period using a lower energy.
Phase II Study with Docetaxel and Cisplatin in the Treatment of Recurrent and/or Metastatic Squamous Cell Carcinoma of the Head and Neck
Authors: Gedlicka C. , Formanek M. , Selzer E. , Burian M. , Kornfehl J. , Fiebiger W. , Cartellieri M. , Marks B. , Kornek G.V.
Published: April 2003

Purpose: Since the combination of cisplatin and docetaxel have demonstrated activity in squamous cell carcinomas of the lung and oesophagus before, promising results in recurrent metastatic head and neck cancer were expected. Patients and Methods: Between September 1998 and October 2000, 40 patients entered this trial, 38 of whom were evaluable. Six patients were previously untreated, 24 had surgery and/or radiotherapy and 13 had received chemoradiation and/or surgery. Therapy consisted of 75 mg/m2 docetaxel (1-hour infusion) and 75 mg/m2 cisplatin (90-min infusion) on day 1, repeated every three weeks for a maximum of 6 courses. All patients received corticosteroids routinely, 5-HT3-antagonists, and hydration. Results: The overall response rate was 52.5% (95% confidence interval, 36.1 to 68.5%) including 7 complete (17.5% complete response; CR) and 14 partial remissions (35% partial response; PR). The overall response rate in patients who had no prior treatment (n = 6) was 100%, including 3 CR and 3 PR. In patients who had prior surgery and/or radiotherapy (n = 21) an overall response rate of 42.8% was observed, including 2 CR and 7 PR; 8 patients (38.1%) had stable disease, while disease progressed in 3 (14.3%). Six of 13 patients (46.2%) who had prior chemoradiation ± surgery responded, including 2 CR (15.4%) and 4 PR (30.8%), no change was seen in 4 patients (30.8%) and tumour progressed in 2 (15.4%). The median response duration for all patients was 10 months (range, 3–20), the median overall survival was 11 months (range, 1–30). Myelosuppression was commonly observed; WHO grade 3 or 4 neutropenia occurred in 12 patients (30%) each, and was complicated by septicaemia in 5 cases. WHO grade 3 anaemia was observed in only 3 patients (7.5%). Severe non-hematologic toxicity except for alopecia was rarely observed, and included diarrhea in 2 (5%), nausea/vomiting in 2 patients (5%) and stomatitis in 1 patient (2.5%). Conclusion: Our data suggest that docetaxel and cisplatin in combination is an effective and fairly well tolerated regimen for the treatment of head and neck cancer with an excellent response rate in previously untreated patients.
A Case of Estrogen-Producing Brenner Tumor with a Stromal Component as a Potential Source for Estrogen
Authors: Hiroi Hisahiko , Osuga Yutaka , Tarumoto Yoshiko , Shimokama Tatsuro , Yano Tetsu , Yokota Harushige , Taketani Yuji
Published: April 2003

Background: Although Brenner tumors with endocrine activities have been reported, the source or mechanisms for hormone production is poorly known at present. Case Report: A 66-year-old Japanese woman presented with atypical vaginal bleeding. A left ovarian tumor was detected on ultrasonography and CT scanning. Her serum estradiol level was elevated (73.5 pg/ml). We performed total hysterectomy, bilateral salpingo-oophorectomy and partial omentectomy. The ovarian tumor was diagnosed as a benign Brenner tumor associated with simple hyperplasia of the endometrium. Postoperatively, the serum estradiol level decreased. Immunoreactivity of cytochrome P-450 aromatase was detected in stromal cells. Conclusion: Stromal contribution to the secretion of estrogen was shown in this case. Considering the known source of estrogen production being tumor cells in certain cases of Brenner tumor, there seem to be two types of estrogen-producing Brenner tumors depending on the source of estrogen, i.e. tumor cells or stromal cells.
The Prognostic Value of p27 in Gastric Cancer
Authors: Wiksten Jan-Patrik , Lundin Johan , Nordling Stig , Kokkola Arto , von Boguslawski Kristina , Haglund Caj
Published: April 2003

Objectives: p27 is a cyclin-dependent kinase inhibitor and a putative tumor suppressor preventing progression of the cell cycle from G1 phase. Recent studies have suggested loss of p27 to correlate with poor prognosis in patients with a variety of solid tumors. Results in gastric cancer are contradictory. We therefore decided to study the potential of p27 as a prognostic marker in a consecutively surgically treated, single-institution series of patients. Methods: Using a monoclonal antibody against p27, immunohistochemistry was performed in paraffin-embedded tumor specimens from 316 patients. Results: Loss of p27 immunoreactivity (≤5% of the cancer cell nuclei positive) was observed in 241 (76%) out of 316 stained tumors. We observed no significant correlation between the expression of p27 and stage of disease, tumor size, depth of tumor invasion, lymph node metastases, distant metastases, Laurén classification, Borrmann type, grade of differentiation, age or gender. There was no significant difference in gastric cancer specific overall survival between patients with low and high p27 expression. Conclusion: Our results add further doubt to the usefulness of p27 as a prognostic marker in gastric cancer.
Cost Analysis of Breath Test versus Endoscopy for Dyspepsia
Authors: Gee I. , Playford R.J. , Turner D. , Sheldon N. , Wicks A.C.B.
Published: April 2003

Background: There is currently much debate on the best way to manage dyspepsia in the community and cost effectiveness is often discussed. We aim to perform a cost analysis of a test and treat strategy for Helicobacter pylori versus endoscopy using data based on the breath test service in Leicester. Methods: Retrospective analysis of data acquired over the 1-year period from March 1, 1999, to February 29, 2000, in a university teaching hospital. The main outcome measure was the cost of each management strategy. Results: Referral to the breath test service cost £84.67 per person with dyspepsia (including treatment of positive patients and endoscopy cost of patients endoscoped). If the breath test service had not existed, referral for endoscopy would have cost £98.35 per person. This equates to a cost saving of £8,276 over the year studied for the 605 patients referred. It also resulted in 353 fewer endoscopies being performed. Conclusion: Direct referral to a H. pylori breath test service saves money, avoids an unpleasant test for many people and reduces the endoscopy waiting list.
Linguistic Analysis of the Speech Output of Schizophrenic, Bipolar, and Depressive Patients
Authors: Lott P.R. , Guggenbühl S. , Schneeberger A. , Pulver A.E. , Stassen H.H.
Published: April 2003

Using speech samples of 100 patients suffering from schizophrenia, bipolar illness and major depression, we addressed the question of the extent to which the linguistic abnormalities in the speech of these patients represent diagnosis-specific characteristics or constitute independent, syndrome-like dimensions of the illnesses. All speech samples were transcribed by a professional linguist who was blind to both identity and diagnosis of the patients. The majority of the deviant linguistic variables was found to be common to all three diagnostic groups under comparison, while only a few linguistic variables exhibited statistically significant between-group differences. On the other hand, when the respective variables were analysed as a multivariate entity, the variety of subtle between-group differences allowed us to discriminate between the diagnostic groups at an overall performance of 72.7% correctly classified patients. There was an almost complete lack of association between linguistic abnormalities and psychopathology syndromes. In particular, we found no correlation between the syndrome ‘formal thought disorder’ and the large variety of linguistic variables used in this investigation. In consequence, we conjecture that linguistically deviant speech characteristics represent an independent syndrome complex manifested at varying intensities across mental illnesses, and that this syndrome complex deserves greater attention, not only with respect to the principal understanding of the underlying disturbances, but also as a potential target of therapeutical intervention.
Expression Systems for Production of Recombinant Allergens
Authors: Schmidt M. , Hoffman D.R.
Published: April 2003

Recombinant allergenic proteins have been produced in a variety of different expression systems. This review gives examples of and compares prokaryotic expression systems, such as Escherichia coli, and eukaryotic systems including the yeasts, Saccharomyces cerevisiae and Pichia pastoris, baculovirus-insect cell systems, mammalian cell systems and plant systems. Important factors to consider in choosing an expression system are discussed and examples of applications are given.
Postantibiotic Effect of Meropenem and Ciprofloxacin in the Presence of 5-Fluorouracil
Authors: Nyhlén A. , Ljungberg B. , Nilsson-Ehle I. , Odenholt I.
Published: April 2003

Background: The postantibiotic effect (PAE) of meropenem and ciprofloxacin was studied in the presence of the antineoplastic agent 5-fluorouracil (5-FU). The purpose of the study was to investigate whether the PAEs of the combinations differed from the PAEs of the antibiotics alone. Methods: The PAEs of the combinations of 5-FU plus meropenem or ciprofloxacin were determined with viable counts against four reference strains of Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa, Escherichia coli and two clinical isolates of S. epidermidis. The results were compared with the PAEs of the antibiotics drugs and 5-FU alone. The gram-positive strains were tested for slime production, both alone and in the presence of 5-FU. Results: Against two of the three tested strains of S. epidermidis, the combination of ciprofloxacin and 5-FU gave a synergistic prolongation of the PAE in comparison with the PAEs induced by the drugs alone. The combinations showed indifference against the other bacteria. The combination of meropenem and 5-FU had a synergistic PAE against one of the three tested strains of S. epidermidis and an additive effect against E. coli but showed indifference against the rest of the strains. Conclusions: The presence of 5-FU did not influence the PAEs of the antibiotics against most of the tested strains, but caused a synergistic prolongation of the PAEs induced by ciprofloxacin and meropenem against some of the tested strains of S. epidermidis. 5-FU inhibited slime production in the same S. epidermidis strains, which might have contributed to the longer PAE.
Effect of Topical Iganidipine on Experimental Elevation of Aqueous Flare Induced by Prostaglandin E2 and EP Agonists in Pigmented Rabbits
Authors: Yanagisawa Shuichiro , Hayasaka Seiji , Zhang Xue-Yun , Hayasaka Yoriko , Nagaki Yasunori
Published: April 2003

We evaluated the role of topical iganidipine on experimental aqueous flare elevation in rabbits. Transcorneal diffusion of prostaglandin E2 (PGE2), 25 µg/ml or 7.09 × 10–2 mmol/l, or highly selective agonists for prostaglandin E2 receptor subtypes (EP), 25 µg/ml, was achieved with the use of a glass cylinder to produce aqueous flare elevation in pigmented rabbits. Iganidipine was topically administered before application of PGE2 or EP agonists. Aqueous flare was measured with a laser flare cell meter. Topical instillation of 0.1% iganidipine once or twice inhibited 64 ± 8% (p < 0.01) and 84 ± 9% (p < 0.01) of PGE2-induced aqueous flare elevation, respectively. Two instillations of 0.1% iganidipine inhibited 95 ± 5% (p < 0.01) of EP2-agonist(ONO-AE1-259-01)-induced flare elevation and 98 ± 3% (p < 0.01) of EP4-agonist(ONO-AE1-392)-induced flare rise. Topical iganidipine may have anti-inflammatory activity in the eye.
Is There a Reproductive Safety Risk in Male Patients Treated with Acitretin (Neotigason®/Soriatane®)?
Authors: Geiger J.-M. , Walker M.
Published: April 2003

Review of preclinical data including genotoxicity assays and a male rat reproduction toxicology study demonstrates that acitretin (Neotigason®/Soriatane®) does not affect the reproductive outcome in naive females mated with treated males. Prospective studies of teratogenic risk or impairment of fertility cannot be ethically conducted in humans. However, it is highly unlikely that any fetal malformation could be induced by an ejaculate containing traces of acitretin. Indeed, worldwide postmarketing surveillance has not revealed any cases of retinoid embryopathy associated with paternal treatment with acitretin. Birth defects seen in pregnancies fathered by male acitretin patients were all events expected to occur in the general population at known frequencies. In conclusion, therefore, available data do not appear to indicate any reproductive safety risk due to paternal treatment with acitretin.
Survey of Dermatophyte Infections in the Lausanne Area (Switzerland)
Authors: Monod Michel , Jaccoud Sandra , Zaugg Christophe , Léchenne Barbara , Baudraz Florence , Panizzon Renato
Published: April 2003

Background: The dermatophytes are important in the Swiss medical environment since 5–10% of consultations in dermatology concern mycotic infections. Objective: To obtain information about the prevailing species of dermatophytes in the south-west of Switzerland and their pattern of infection. Methods: An analysis was made of the dermatophytes isolated in the Department of Dermatology at the University Hospital of Lausanne and from samples collected in private practices of Switzerland during an 8-year period (1993–2000). The total number of samples sent for mycological analysis was 33,725. Results: 4,193 cultures revealed a dermatophyte. Trichophyton rubrum was the most frequently isolated species accounting for 62.5% of the strains followed by T. mentagrophytes (24.5%) and Microsporum canis (5.0%). Less frequent isolates included Epidermophyton floccosum, M. langeroni, M. gypseum, T. soudanense, T. violaceum, T. verrucosum, T. gourvili and T. tonsurans. Analysis of the localisation of the isolated fungi confirms that the dermatophyte species have a predilection for certain body areas. Conclusions: The relative frequencies of isolation of the dermatophyte species partially depending of the record of the different tinea vary from one country to another. Our study reveals the importance of T. rubrum and the appreciable frequency of M. canis in the Swiss autochthonous population and the apparition of new species with immigrants.
Periorbital Oedema and Erythema as a Manifestation of Discoid Lupus erythematosus
Authors: Braun R.P. , French L.E. , Massouyé I. , Saurat J.-H.
Published: April 2003

Periorbital oedema and erythema are a rare cutaneous manifestation of discoid erythematosus (DLE) which is well known to ophthalmologists but less to dermatologists. We report the case of a 74-year-old female patient with periorbital oedema and erythema. Since swelling of the eyelid is common in the dermatological practice, dermatologists should be aware of the differential diagnosis and its occurrence in patients with DLE.
Causal Patterns of Dental Health in Populations
Authors: Aleksejūnienė J. , Holst D. , Grytten J.I. , Eriksen H.M.
Published: April 2003

In the present investigation we aimed to analyse causally the pattern of determinants leading to the maintenance of functional teeth in adults. Clinical and self-reported information was used. The hypothesis was that socio-economic conditions operate through psychosocial circumstances that influence lifestyle, and are thus related to oral hygiene and levels of remaining teeth. Testing of the patterns for adults residing in high- and low-fluoride areas did not reveal any principal differences in dental health, therefore further testing was combined for both fluoride areas. Further analysis also indicated that testing should be performed separately for each gender. Social structure and dental health-related lifestyle were important in an overall pattern of maintaining functional teeth, but general lifestyle and psychosocial conditions were not found to be part of the pattern influencing dental health. Gender-specific patterns were revealed. New hypotheses may be suggested for further research with regard to studying patterns of dental health in Lithuanian adults.
Digital Fluorographic Video-Urodynamics in the Long-Term Morphofunctional Evaluation of Alcini’s Ileocecourethrostomy and Ileal Reservoir
Authors: Carbone A. , Racioppi M. , Trucchi A. , Parascani R. , Gezeroglu H. , Delicato G. , Piccolotti D. , Alcini E.
Published: April 2003

Introduction: The authors present the functional long-term follow-up by means of digital fluorographic video-urodynamics (DFVUDM) of two different surgical urinary diversions. Materials and Methods: 64 of 101 patients submitted to radical cystectomy from 1983 to 1999 for infiltrating bladder cancer, were diverted by means of an Alcini’s ileocecourethrostomy (ICUS+T), and the remaining 37 patients by means of an ileal reservoir (IR). All of those orthotopically diverted patients were submitted to an accurate follow-up which included DFVUDM 1, 3, 6, and 9 years after the surgical procedure (mean follow-up 51 ± 42 months). Results: All the evaluated patients showed a neobladder with good function during both the filling and the voiding phases. In 88.8% of the DFVUDM examinations, it was possible to find a residual peristaltic activity of the neobladder walls. Such a residual peristaltic activity caused urinary leakage during the examination in 11.1% of cases, while vesico-ureteral reflux was detected in 12.5%. The patients voided by relaxing the perineal floor and/or by contracting the abdominal muscles: the emptying of the reservoir was often excellent with average residual urine of 28.5 ml. None of the patients needed clean intermittent catheterization. EMG evaluation of the pelvic floor in some of patients showed a peculiar EMG pattern characterized by an insufficient voluntary control of the perineal musculature with a slight increase of EMG activity during bladder filling. Moreover, an insufficient relaxation of the pelvic floor muscles in the beginning of and during the micturition has been seen. This particular EMG pattern was present in 22.22% of all patients included in this study while it was particularly high (81.81%) in patients with leakage. Conclusion: DFVUDM evaluation represents a highly sophisticated tool which allows an accurate long-term morphofunctional evaluation of the urinary diverted patients. In this study, it is shown that the functional results of the two studied surgical procedures, namely Alcini’s ICUS+T and IR, are quite similar, demonstrating that the taeniotomies on the cecal tract may have almost the same functional effects of detubularization. Although DFVUDM revealed imperfect functional performances in some patients, the quality of life of diverted patients in our series seems to be satisfactory.
Comparison of Long-Term Results according to the Primary Mode of Management and Type of Injury for Posterior Urethral Injuries
Authors: Ku Ja Hyeon , Jeon Youn Soo , Kim Min Eui , Lee Nam Kyu , Park Young Ho
Published: April 2003

Background: We retrospectively reviewed the records of patients with traumatic posterior urethral injuries, analyzed postoperative findings to compare the results of the primary mode of management, and evaluated whether the Colapinto and McCallum classification system was valuable for predicting the complications. Methods: 55 patients with traumatic posterior urethral injuries were included in the study. A total of 35 patients underwent immediate realignment over a Foley catheter including direct Foley catheter insertion (group 1) and 20 underwent initial suprapubic tube placement followed by delayed urethroplasty (group 2). Urethral injuries were interpreted using the Colapinto and McCallum classification based on the retrograde urethrographies. Results: 44 (80.0%) of the patients were classified to type III in both groups (group 1, 29 [82.9%]; group 2, 15 [75.0%]). Of group 1, mild, moderate and severe urethral strictures developed in 7 (20.0%), 8 (22.9%) and 6 (17.1%), respectively, and developed in 6 (30.0%), 2 (10.0%) and 5 (25.0%), respectively, of group 2. Six (17.1%) and 2 (20.0%) had decreased potency and 4 (11.5%) and 1 (5.0%) were impotent in group 1 and 2, respectively. Of group 1, incontinence developed in 3 patients but 1 did not need treatment, and developed in 2 (10.0%) but 1 (5.0%) did not need treatment of group 2. The score test for trend demonstrated that there were no significant differences of these results. Conclusions: Our findings suggest that complications in patients with posterior urethral injuries are not related to the primary mode of management. Because most injuries are type III, the evolution toward the classification system is needed.
Serial Evaluation of High-Resolution Computed Tomography Findings in Patients with Idiopathic Pulmonary Fibrosis in Usual Interstitial Pneumonia
Authors: Nagao Taishi , Nagai Sonoko , Hiramoto Yoshihide , Hamada Kunio , Shigematsu Michio , Hayashi Michio , Izumi Takateru , Mishima Michiaki
Published: April 2003

Background: The development of well-matured fibrosis in usual interstitial pneumonia (UIP) is strongly associated with an unfavorable outcome of patients with idiopathic pulmonary fibrosis (IPF). However, differences in the rates of development are likely to result in variable clinical courses in IPF patients. Objective: We tried to evaluate the progression of honeycombing and ground-glass opacity on CT using a scoring system, and to examine those serial changes in the clinical course of disease. Methods: A hospital-based, retrospective cohort study. Twenty-three patients with IPF diagnosed as UIP by surgical lung biopsy were analyzed during the initial examination by scoring the presence of honeycombing (HC: range, 0–24) and ground-glass opacity (GG: range, 0–24) on CT scan. We also compared the serial changes observed in the CT scores (interval: 2–42 months, 2–6 examinations). Results: (1) The serial change in the HC score in treated patients (n = 10) was similar to that in untreated patients (n = 16); (2) the HC score at the time of the initial examination and the rate of HC progression were both higher in the non-surviving patients (HC 12.3 ± 3.7, mean ± SD; ΔHC 4.2 ± 1.3 per year) than in the surviving patients (HC 5.8 ± 2.7; ΔHC 1.2 ± 0.7 per year) (p < 0.05); (3) the GG score did not correlate with the HC score at any of the examinations; (4) the HC score was higher in the lower lung field than in the upper and middle lung fields. Conclusions: Scoring of the honeycombing and its serial changes using the high-resolution computed tomography scoring method was useful for predicting the prognosis in patients with IPF/UIP. Corticosteroid treatment did not prevent the progression of HC.
Molecular-cytogenetic analysis reveals sequence differences between the sex chromosomes of Oreochromis niloticus: evidence for an early stage of sex-chromosome differentiation
Authors: Harvey S.C. , Masabanda J. , Carrasco L.A.P. , Bromage N.R. , Penman D.J. , Griffin D.K.
Published: April 2003

Sex determination in the Nile tilapia, Oreochromis niloticus, is primarily genetic, with XX females and XY males. A candidate sex-determining region in the terminal region of the largest chromosome pair has been identified by analysis of meiotic chromosomes. This region shows an inhibition of pairing and synapsis in the XY genotype, but not in XX or YY genotypes, suggesting that recombination is inhibited. Here we show that chromosome microdissection and subsequent amplification by degenerate oligonucleotide-primed PCR (DOP-PCR) can be used to produce in situ hybridization probes to this largest pair of O. niloticus chromosomes. Furthermore, analysis of the comparative hybridization of X and Y chromosome-derived probes to different genotypes provides the first demonstration that sequence differences exist between the sex chromosomes of O. niloticus. This provides further support for the theory that this chromosome pair is related to sex determination and further suggests that the sex chromosomes are at a very early stage of divergence.
Adult murine neurons: their chromatin and chromosome changes and failure to support embryonic development as revealed by nuclear transfer
Authors: Osada T. , Kusakabe H. , Akutsu H. , Yagi T. , Yanagimachi R.
Published: April 2003

Fully differentiated neurons in adult mammalian brains do not divide; consequently, their metaphase chromosomes have never been examined. Here we report metaphase chromosome constitutions of cortical neurons in adult mice visualized by a nuclear transfer technique. We found that although some reconstructed oocytes cloned from neuronal nuclei have an apparently normal karyotype, the majority do not. Regardless of chromosome morphology, nuclei of adult neurons totally lack the ability to support embryonic development. These findings support the hypothesis that fully differentiated neurons in adult mammalian brains are genomically altered.
Most X;autosome translocations associated with premature ovarian failure do not interrupt X-linked genes
Authors: Prueitt R.L. , Chen H. , Barnes R.I. , Zinn A.R.
Published: April 2003

Balanced translocations with breakpoints in a critical region of the X chromosome, Xq13→q26, are associated with premature ovarian failure (POF). Translocations may cause POF either by affecting expression of specific X-linked genes essential for maintenance of normal ovarian function or by a chromosomal effect such as inhibition of meiotic pairing or altered X inactivation. We previously mapped seven Xq translocation breakpoints associated with POF to ∼75-kb intervals. One translocation disrupted an aminopeptidase gene, XPNPEP2. We have now refined the map location of the remaining six breakpoints with respect to known genes and transcription units predicted from the draft human genome sequence. Only one of the six breakpoints disrupts a gene, DACH2, the human ortholog of a mouse gene expressed in embryonic nervous tissue, sensory organs, and limbs. DACH2 has no obvious relationship to ovarian function. The other five breakpoints fall in apparently intragenic regions. Our results are most consistent with models for POF associated with X;autosome translocations that involve generalized chromosome effects.
Immunohistochemical Staining for Proliferation Antigen as a Predictor of Chronic Graft Dysfunction and Renal Graft Loss
Authors: Pizov Galina , Friedlaender Michael M.
Published: April 2003

Background: Assessment of proliferation rate (PR%) using monoclonal antibody for Ki-67 antigen has recently been found to have prognostic importance in lung and cardiac allografts. We ascertained whether the same might be true for renal allografts. Methods: Newly cut sections from 20 archival paraffin blocks of renal allograft biopsy material showing acute cellular rejection and/or acute tubular necrosis (ATN) and absence of other pathology were stained using MIB-1 antibody and were further double-stained with anti-CD3, anti-CD20 or anti-CD68 antibodies. Counts of staining of mononuclear interstitial cells were correlated with clinical and pathological data. Results: Mean PR% was significantly greater than that in control renal allografts (13.23 ± 1.94 vs. 2.84 ± 1.66, p < 0.01). PR% of cases with ATN and no or borderline rejection was significantly lower than that of the remaining cases with acute rejection pathology (6.68 ± 1.15 vs. 14.31 ± 1.62, p < 0.05). However, PR% was neither correlated to histological rejection grade nor to long-term graft outcome. Double labelling failed to identify the cell type of most infiltrating MIB-1 positive cells. Conclusion: Positive MIB-1 staining helps to identify the presence of rejection but does not appear to predict prognosis or correlate with the Banff classification of rejection pathology.