bluuebunny/crossref_metadata_2025 huggingface dataset:
Habituation and Sensitization Processes in Depressive Disorders
Authors: Miquel Marta , Fuentes Inmaculada , Garcia-Merita Marisa , Rojo Luis
Published: April 2003

The aim of the present study was to investigate further into habituation and sensitization processes in depressive disorders. The depressive subjects were 27 outpatients. All of them were diagnosed according to DSM-III-R criteria. Controls were 27 normal subjects. The amplitudes of electrodermal responses and the basal levels were recorded during a stimuli series of 15 80-dB tones and of 1 100-dB tone in the 11th trial. The depressive patients displayed lower basal conductance levels and lower conductance amplitudes in orienting responses to the first stimulus and to stimulus change. No differences were found in conductance response amplitudes of stimuli series, although a tendency towards smaller conductance amplitudes in depressive patients was observed before stimulus change. A trend towards habituation was detected in both groups, but no differences between them were present, neither the habituation velocity of depressives was found to be unlike normals. Our results display lower responsivity in depressive patients, which reflects alterations in the sensitization process.
Full and Partial Syndromes in Eating Disorders: A 1-Year Prospective Study ofRisk Fa ctors among Female Students
Authors: Santonastaso Paolo , Friederici Silvia , Favaro Angela
Published: April 2003

The present study is an investigation into the risk factors and natural history of full and partial syndrome eating disorders in a sample of 394 16-year-old female students. We used a two-stage procedure (screening and clinical interviews) and the same procedure was repeated after a 1-year follow-up. A stepwise multiple regression analysis showed that drive for thinness and tendency towards somatization are associated with an increased risk of later developing an eating disorder. Use of hypocaloric diets and a desire to be thinner characterized those asymptomatic subjects who were later to develop a partial syndrome. Perfectionism appeared to be a maintenance factor for subjects who presented a full or partial eating disorder at baseline.
Life Events in Late Paraphrenia and Depression
Authors: Fuchs Thomas
Published: April 2003

38 patients with late paraphrenia and 38 with endogenous depression of late onset were examined and various premorbid characteristics and biographical data compared. The main objective of the study was to look for differential risk factors and for biographical experiences that suggested a specific premorbid vulnerability in paranoid and depressive patients. In the paranoid group, a significantly higher frequency of discriminating, humiliating or threatening experiences during earlier life was found. These included expulsion from home in the years 1944–46 (53%), somatic handicaps such as amputations (13%), illegitimate birth (11%) or illegitimate children (13%), and others. In the depressed group, severe early loss prevailed (29%). The significance of these results for the etiology of late-life mental disorder is discussed.
Is Paranoid Schizophrenia the Most Common Subtype?
Authors: Tateyama Masato , Kudo Ikuo , Hashimoto Motohide , Abe Yasuyuki , Kainuma Akira , Yoshimura Kimio , Asai Masahiro , Bartels Mathias , Kasper Siegfried
Published: April 2003

We compared the subtype diagnoses of schizophrenia (ICD-10) of 58 Japanese and 61 European psychiatrists matched for clinical experience using 10 case summaries. As a result, there are marked differences between Japanese and European psychiatrists in the mode of subtype diagnoses of schizophrenia rather than in the clinical pictures of the patients themselves; the hebephrenic type (F20.1) was more likely to be diagnosed by Japanese psychiatrists, while the paranoid type (F20.0) was more frequently diagnosed by European psychiatrists. Japanese psychiatrists take into account the patient’s age at onset and the clinical course of the disease in identifying the subtype, while European psychiatrists tend to focus on the presenting symptoms, particularly paranoid symptoms.
Ethics in Psychiatry and Psychoanalysis
Authors: Lothane Zvi
Published: April 2003

Ethics plays a dual role in psychiatry. The extrinsic role is in defining the rules of ethical conduct for the psychiatrist as a professional dealing with patients, peers and society at large. The intrinsic role is in defining ethical or moral conflict as a determining component in the construction of symptoms of mental disorder. Ethical considerations play a role in the truthful description of the disorder, diagnosis, dynamic formulation and the doctor-patient relationship in treatment. In treatment, there is a need to acknowledge 2 dimensions of psychological conflict: (1) an appraisal of the actual realistic moral conflicts due to symptomatic unethical conduct that goes against one's normative conscience, and (2) resolution of past conflicts arising from unconscious or repressed aspects of the neurotic conscience or superego, i.e. a holdover of unreflected obedience to parental authority. The resolution of past and ongoing conflicts promotes growth toward autonomy of moral judgment, free choice and moral responsibility.
Anhedonia in the Deficit Syndrome of Schizophrenia
Authors: Loas Gwenolé , Boyer Patrice , Legrand Alain
Published: April 2003

Previous studies have shown that anhedonia characterizes the deficit syndrome of schizophrenia. Anhedonia is also one of the main symptoms of the depressive state. The purpose of this study was to examine the relationships between anhedonia and depression in the deficit syndrome of schizophrenia. Self-evaluations of anhedonia and depression were performed by three groups of subjects (32 deficit schizophrenics, 32 major depressives, 35 healthy subjects) matched for sociodemographic variables. Deficit schizophrenics and major depressives are more anhedonic than controls, but there is no difference between the two study groups. Contrarily to what is evidenced for major depressives and for healthy subjects, the depressive symptomatology correlates with anhedonia in deficit schizophrenics. When deficit schizophrenics are dichotomized into depressed versus non-depressed patients, no difference is observed concerning anhedonia. These results suggest that anhedonia in the deficit syndrome of schizophrenia has no specificity but appears independent of coexisting depression and covaries with several characteristics of depression (retardation, cognitive distortions). Our results support the hypothesis that the deficit syndrome of schizophrenia could constitute a non-depressive mood disorder.
An Unusual Case of Delusional Misidentification: ‘Delusional Hermaphroditism’
Authors: Mulholland Ciaran , O’Hara Arthur G.
Published: April 2003

A 44-year-old man presented with an unusually colourful and complex form of delusional misidentification. He demonstrated Fregoli syndrome, environmental reduplication and the delusional belief that he and a female friend had been incorporated into the same body. This latter phenomenon has not been described before and adds a new dimension to the rich variety of these syndromes. It is suggested that the term ‘delusional hermaphroditism’ be used to describe this form of delusional misidentification.
Dissociative Symptoms in Obsessive-Compulsive Dimensions
Authors: Grabe H.J. , Goldschmidt F. , Lehmkuhl L. , Gänsicke M. , Spitzer C. , Freyberger H.J.
Published: April 2003

Previous studies have described co-occurrence between obsessive-compulsive disorder (OCD) and dissociation. We intended to evaluate the phenomenological association between different obsessive-compulsive and dissociative symptoms more precisely. Seventy patients with OCD (DSM-IV) were evaluated with the Hamburg Obsessive-Compulsive Inventory (HZI) and the Dissociation Experience Scale. Correlation and discriminant analysis were performed. The dimensions ‘Checking’ and ‘Symmetry and Ordering’ were significantly related to dissociative symptomatology. A clear-cut lack of association was found in ‘Washing and Cleaning’, ‘Counting and Touching’ and ‘Aggressive Impulses and Fantasies’. HZI dimensions significantly discriminated patients with high from patients with low dissociative symptomatology. Psychodynamic and therapeutical aspects of these findings are discussed.
Obsessive-Compulsive Disorder with Delusions
Authors: Fear Christopher , Sharp Helen , Healy David
Published: April 2003

Obsessive-compulsive (OCD) and delusional disorders (DD) have been recognised with increased frequency in recent years, and the propensity of some OCD subjects to become deluded has become a focus of interest. This study reports illness-specific demography along with measures of symptom severity and tests to assess schizotypal ideation, dysfunctional attitudes, attributional and attention bias in 30 patients with OCD, 29 with DD, 16 with OCD with delusions (OC-DD) and a 30-subject control group (CG). Obsessional features appeared before delusions in the OC-DD group, suggesting that OCD was the primary pathology. Delusions were more likely in subjects obsessional about one rather than multiple themes. There was some support for proposals that depression and schizotypy may bring out delusions in OCD and some evidence for the utility of categorising OCD according to the number of obsessions a subject has.
Clinical Dimensions of Delusional Beliefs: A Factor-Analytic Study
Authors: Oulis P. , Mamounas J. , Hatzimanolis J. , Christodoulou G.N.
Published: April 2003

We investigated the factorial composition as well as the demographic, anamnestic and clinical correlates of 13 features of delusional beliefs in a sample of 127 psychiatric inpatients with active delusions at the time of their assessment: Six factors were extracted, jointly accounting for 67.3% of the variance, which were interpreted as the dimensions of cognitive disintegration, volitional dyscontrol, doxastic strength, distress, incongruence and expansiveness, respectively. Moreover, most factors exhibited distinctive profiles of demographic, anamnestic or clinical correlates. Overall, our findings provide supportive evidence for both the clinical multidimensionality of delusional beliefs at the factor-analytic level and the – at least partial – external validity of the factorial solution obtained.
Screening for DSM-IV Somatoform Disorders in Chronic Pain Patients
Authors: Bankier Bettina , Aigner Martin , Krones Sandra , Bach Michael
Published: April 2003

Background: The Screening Instrument for Somatoform Symptoms (SOMS) has been developed for selecting subjects with various somatoform disorders. To date, this instrument has not been used for pain patients. The purpose of this study was, therefore, to apply the SOMS to chronic pain patients, and to compare different SOMS cutoff item scores with regard to their sensitivity, specificity and (positive and negative) predictive value for selecting subjects with DSM-IV somatoform disorders among pain patients. Methods: In a consecutive sample of 105 chronic pain outpatients, the SOMS was administered in addition to an operationalized psychiatric assessment according to DSM-IV. Results: Patients with a somatoform disorder reported significantly more SOMS symptoms than patients without somatoform disorders (p < 0.02). As shown, a cutoff score of ≥4 somatoform items appeared useful for determining a somatoform disorder. However, only a limited number of cases could be correctly classified by the SOMS (range 53–66%). Conclusion: Therefore, the applicability of the SOMS as a screening instrument for somatoform disorders in chronic pain patients awaits further clarification.
The Concept of Anger: Universal or Culture Specific?
Authors: Kövecses Zoltán
Published: April 2003

I will suggest that the English word ‘anger’ and its counterparts in diverse languages of the world are based on concepts of anger that have a great deal of complexity. This conceptual complexity derives from several sources: (1) the metaphors and metonymies that apply to the concepts in various languages; (2) the prototypes of anger that people share in these cultures, and (3) the many different senses that the word anger and its counterparts have in different languages. We can ask: Are there any universal aspects of the concept(s) of anger? On the basis of linguistic evidence from English, Chinese, Japanese, Hungarian, Zulu and Wolof, I will suggest that there are, but I will also claim that some of the aspects are culture specific. This raises the further important question of why there is both universality and culture specificity in the conceptualization of this emotion. At stake is the issue of which of the following two contradictory claims is valid: (1) that anger is conceptualized in the same way universally, or (2) that anger is a social construction and thus varies considerably from culture to culture. I will propose a compromise view, which can be called ‘body-based social constructionism’, that enables us to see anger and its counterparts as both universal and culture specific.
Dysphoria, Vulnerability and Identity
Authors: Stanghellini Giovanni
Published: April 2003

Compared with the bulk of psychiatric literature dedicated to sadness or euphoria, dysphoric states have received relatively little attention. Perhaps we find ourselves facing a removal of anger from the horizon of contemporary psychopathology. Even less attention is given to the ‘doublets’ of anger. Anger marks off a region of the psyche within which the game of identity is played: as indignation, it defends the limits of that which is tolerable, the border upon which to keep watch, the trench from which to fight. But as fury, in the excess of the absolute affirmation of one’s own existence, it incarnates the wreckage and the bloody fall of identity – i.e. pathology. The topic then collects the interweaving of the subjectivising character of rage on the one side, and on the other the explosive one, which breaks up the unifying and conciliatory direction which rationality enforces upon the subject – ‘anger of life’ and ‘anger of death’. Both dimensions are explored with special concern to the reason for empathising with anger.
Depressive Symptoms and Occupational Role among Female Groups: A Research in a South-East African Village
Authors: Carta M.G. , Carpiniello B. , Dazzan P. , Reda M.A.
Published: April 2003

Background: Although the relationships between social and cultural factors and African psychopathology have largely been considered from a theoretical point of view, empirical studies are still few and far between. This paper reports the results of a mental health survey conducted in the village of Namwera (Malawi, South-East Africa) to explore the link between social conditions, in particular occupational role, and psychopathology. Methods: A modified version of the Self-Reporting Questionnaire translated into Chichewa language was administered to 161 women (23 dressmakers, 46 nurses, 92 housewives). A Socio-Anamnestic Questionnaire and a Clinical Interview were also applied. Results: Dressmakers and housewives appeared more at risk of psychological suffering than nurses. Psychosomatic symptoms are more frequent among housewives, while dressmakers show more typical depressive symptoms, including suicidal thoughts and self-blame. Conclusions: Data confirm that also in an African context, some social factors are related to depression among female groups.
Indices of Respiratory Muscle Endurance in Healthy Subjects
Authors: Fiz José Antonio , Romero Pilar , Gomez Roser , Hernandez M.C. , Ruiz Juan , Izquierdo José , Coll Ramon , Morera José
Published: April 2003

Background: The evaluation of respiratory muscle performance can be described in terms of strength and endurance, the latter usually being measured by means of resistive or threshold inspiratory loads, using devices that are also used for respiratory muscle training. Few authors, however, have published endurance reference values for healthy subjects. To that end, we studied two indices of respiratory muscle endurance in a population of 99 healthy volunteers (50 men, 49 women) divided into five age groups (20–70 years old) applying a modification of the methods of Martyn et al. and Nickerson and Keens. Inspiratory muscle endurance (Tlim) was defined as the time the subject was able to sustain breathing against an inspiratory pressure load equivalent to 80% of the maximum tolerated load (Cmax). Cmax was calculated using a 2-min incremental threshold load. Results: We found that the heaviest inspiratory threshold load tolerated for 2 min and the time a load equivalent to 80% of Cmax (Tlim) could be sustained were not significantly different for male and female subjects. Tlim correlated with Cmax, age, height, and maximum respiratory pressures.
Slow Compartment Features and Gas Exchange Impairment in Mild Asthma: Effects of Beta Agonist Inhalation
Authors: Valente Salvatore , De Rosa Marino , Corbo Giuseppe M. , Carlucci Annalisa , Fumagalli Giorgio , Ciappi Giuliano
Published: April 2003

Static and dynamic lung volumes, arterial blood gases, alveolar ventilation and ventilation-perfusion (v̇A/q̇) relationships were studied in 14 mild asthmatic patients and in 7 normal subjects (as controls) before and after fenoterol inhalation. Multiple nitrogen washout curves were analyzed by a bicompartmental distribution model, in order to assess the distribution of ventilation and v̇A/q̇ mismatch. At baseline, asthmatics showed mild airway obstruction and gas exchange impairment [forced expiratory volume in 1 s (FEV1) = 79% pred; PaO2 = 87.4; alveolar-arterial oxygen tension gradient (AaPO2) = 22.9 mm Hg]. By analysing nitrogen washout curves, an alveolar slow space representing 45.1% of total lung volume (vs. 36.8% in normals; p = 0.044) was identified; its alveolar ventilation per minute per unit lung volume (v̇A2/L2) was lower than in normals (p = 0.01). β-Agonist inhalation by the asthmatics, which reversed airway obstruction (FEV1 = 98% pred.; p < 0.001) and improved gas exchange (PaO2 = 92.6 mm Hg, p < 0.001; AaPO2 = 16.8 mm Hg, p = 0.003), led to a highly significant increase in v̇A2/L2 (p = 0.001). The improvement in PaO2 was associated with the increase in v̇A2/L2 (r2 = 0.39; p = 0.017), but not with the increase in FEV1. Lastly, the changes in FEV1 and v̇A2/L2 were not correlated with each other. We conclude that even in mild stable asthma there is substantial unevenness of ventilation, detectable by bicompartmental analysis of nitrogen washout curves, which is responsible for gas exchange impairment and is not related to common spirometric parameters. In addition, the improvement in gas exchange is probably due to the effect of fenoterol on the tributary airways of the alveolar slow compartment. This effect can be assessed by this simple method, which can be used in clinical pharmacology studies and in the follow-up of asthmatic patients.
Malignant Pleural Effusion: Prognostic Factors for Survival and Response to Chemical Pleurodesis in a Series of 120 Cases
Authors: Martínez-Moragón Eva , Aparicio Jorge , Sanchis José , Menéndez Rosario , Rogado M. Cruz , Sanchis Francisca
Published: April 2003

Chemical pleurodesis is an effective treatment of malignant pleural effusions, but indications must be individualised to optimise its results. The aim of the present study was to investigate the relationship of various prognostic features with both the response rate to pleurodesis and the probability of patient survival. A non-concurrent cohort study was carried out in which 120 evaluable patients with malignant pleural effusion underwent pleurodesis. Lung (40%), breast (26.6%), and unknown primary site (12.5%) carcinomas were the most frequent neoplasms. Clinical data and pleural fluid parameters were analysed. Median overall survival was 9 months. Pleural fluid glucose (<60 mg/dl), Karnofsky performance status (<70), size of the effusion in chest radiographs (massive effusion), pleural fluid pH (<7.20), presence of concomitant alterations in chest radiographs, and pleural lactic acid dehydrogenase levels (>600 U/l) showed a significant association with the probability of failure. Patients with these features, along with those having non-chemosensitive tumours (in particular, non-small cell lung cancer), had a significantly worse actuarial survival. This study confirms that some pretreatment clinical data and pleural fluid parameters can predict both the outcome of pleurodesis and the survival of patients with malignant pleural effusion.
Surfactant Function in Neonates with Respiratory Distress Syndrome
Authors: Griese Matthias , Westerburg Bettina
Published: April 2003

The function of pulmonary surfactant of a group of 14 preterm neonates (birth weight 907 ± 60 g) who suffered from severe respiratory distress syndrome (RDS) and who had received exogenous bovine lipid extracted surfactant on the first day of life was compared to that in a second group of 8 neonates (birth weight 940 ± 110 g) with mild RDS who had not received surfactant treatment. Mechanical respiratory support from day 2 on was the same in both groups. The minimal surface tension (γmin) improved steadily, falling from about 30 mN/m initially to less than 20 mN/m before extubation. A consistent but loose correlation was found between γmin and mechanical respiratory support necessary, as quantitated by the oxygenation index. Total protein was about 0.8 ± 0.2 mg/mg of phospholipids and did not change during the first week of life. There were no correlations between total protein and γmin or the oxygenation index. The data suggest that inhibition of surfactant function by proteins leaked into the airspaces does not play a major role during recovery from RDS. Instead, endogenous remodelling of surfactant might be of greater relevance.
Anaplastic Large Cell Lymphoma Presenting as an Endobronchial Polypoid Mass
Authors: Kim Duck Hwan , Ko Young Hyeh , Lee Mark Hong , Ree Howe J.
Published: April 2003

We present a case of CD30+ anaplastic large cell lymphoma (ALCL) with a unusual endobronchial polypoid mass. There was para-aortic lymphadenopathy on the CT scan. This case illustrates that ALCL should be included in the differential diagnosis of endobronchial mass lesions.
Medical Personnel and Patient Skill in the Use of Metered Dose Inhalers: A Multicentric Study
Authors: Plaza Vicente , Sanchis Joaquin
Published: April 2003

The objective was to evaluate the correctness of the inhalation technique in a nationwide sample of patients and medical personnel, in order to define targeted educational goals. A total of 1,640 volunteers (746 patients, 466 nurses and 428 physicians) were evaluated. Only 9% of patients, 15% of nurses and 28% of physicians showed a correct inhalation technique. Physicians performed significantly better (mean score 77 ± 23) than nurses (71 ± 22) and patients (62 ± 26). Scores in general practitioners and pediatricians were significantly lower than those of chest physicians and allergists. In conclusion, proper use of metered dose inhalers (MDI) in patients and medical personnel is still faulty. Despite the physician’s awareness of the importance of a correct inhalation technique in the use of MDI, this study shows severe deficiencies, showing the need for substantial changes in educational efforts, and particularly addressed to general practitioners.
Salmeterol Enhances the Inhibitory Activity of Dexamethasone on Allergen-Induced Blood Mononuclear Cell Activation
Authors: Oddera S. , Silvestri M. , Testi R. , Rossi G.A.
Published: April 2003

The possibility that salmeterol could interfere with the inhibitory effect of glucocorticosteroids on allergen-induced activation of leukocytes was assessed in cultures of human blood mononuclear cells (BMCs). BMCs, recovered from 27 patients (21 ± 4 years of age) sensitized to Dermatophagoides pteronyssinus (Der p), were incubated with a purified Der p extract (10 µg/ml) for 7 days in the presence of salmeterol (10–8 and 10–7 M) and/or dexamethasone (10–10 and 10–9 M). BMC proliferation and cytokine release were respectively tested by [3H]thymidine incorporation and EASIA. Stimulation with Der p extract induced a significant BMC proliferation (Der p 18.7 ± 1.9 cpm × 103, control 1.8 ± 0.3 cpm × 103, p < 0.01) which was significantly inhibited both by salmeterol and dexamethasone (p < 0.05, each comparison). The inhibition of BMC proliferation induced by dexamethasone (10–9 M) was significantly enhanced by salmeterol 10–7 M (p < 0.05). Evaluation of cytokine levels in BMC supernatants showed that Der p extract significantly increased the release of granulocyte-macrophage colony-stimulating factor (GM-CSF), interferon-γ (IFN-γ), tumor necrosis factor-α (TNF-α), interleukin (IL)-1β and IL-2 (p < 0.001, each comparison). Salmeterol (10–7 M) or dexamethasone (10–9 M) induced a similar, statistically significant, downregulation of GM-CSF release (p < 0.05, each comparison) and induced a slight, not significant, decrease in the production of IFN-γ, TNF-α, IL-1β and IL-2 (p > 0.05, each comparison). Interestingly, salmeterol (10–7 M) significantly enhanced the inhibitory activity of dexamethasone (10–9 M) on the release of GM-CSF, TNF-α, IL-1β and IL-2 (p < 0.05, each comparison) but not of IFN-γ (p > 0.05). Thus β2-adrenoceptors may enhance the inhibitory activity of low doses of corticosteroids on allergen-induced BMC activation.
Methacholine Bronchial Hyperresponsiveness inChronic Sinusitis
Authors: Okayama Michiko , Iijima Hideya , Shimura Sanae , Shimomura Akira , Ikeda Katsuhisa , Okayama Hiroshi , Shirato Kunio
Published: April 2003

The coexistence of chronic sinusitis (CS) may deteriorate the clinical condition of lower airway diseases such as bronchial asthma (BA) or chronic bronchitis (CB). However, the bronchial hyperresponsiveness (BH) in CS without any apparent lower airway disease is not fully understood nor are the effects of treatment. We examined lower airway hyperresponsiveness to methacholine (MCh) in 42 subjects with CS but without allergic rhinitis (AR) who had normal lung functions without any pulmonary symptoms, comparing it with that of 50 subjects with stable BA, 50 subjects with simple CB and 40 subjects with AR, and further examined the effect of endoscopic sinus surgery in 7 CS subjects with BH. The BH to MCh was measured in terms of the minimum dose (Dmin), defined as the cumulative dose at the point where respiratory conductance began to decrease. A Dmin <50 units was defined as BH. Seventy-one percent of CS subjects showed BH without relation to the severity or duration of CS, or atopic status. BH in CS subjects, which was less than that in BA subjects, was similar to that in simple CB or AR in both its prevalence and degree. After the surgical treatment of CS, BH significantly decreased (p < 0.01) with improvements in both nasal symptoms and sinus lesions. These findings suggest that CS itself induces BH to a degree similar to simple CB and AR without any relationship to the clinical background, and that adequate treatment of CS reduces BH.
Pulmonary Defence Mechanisms
Authors: Nicod LaurentP.
Published: April 2003

Lung defence involves a wide array of mechanisms needed to remove inhaled particles and organisms. The various innate immune processes which take place either in the central or in the more distant airways are reviewed. The recruitment and the development of an adaptive immunity following the innate response are described. This entails the production of secretory immunoglobulins in the airways and either the influx of polymorphonuclear neutrophils in the alveoli to phagocytose more or less opsonized organisms or the activation of the T lymphocyte response to improve the removal of intracellular pathogens.
Diabetes mellitus Induces a Thickening of the Pulmonary Basal Lamina
Authors: Weynand B. , Jonckheere A. , Frans A. , Rahier J.
Published: April 2003

Long-term diabetes mellitus (DM) is characterized by widespread alterations of basal lamina (BL). The purpose of the present work was to verify whether the lung is also a target organ damaged in DM. Electron microscopy was performed on lung and kidney samples (autopsic material) from 6 diabetics and 6 control subjects studying the thickening of BL of different structures (alveolar epithelial BL, endothelial capillary BL, both fused BL, BL of the glomerular capillary endothelium and BL of the renal tubules). The results were as follows: (1) alveolar epithelial BL (mean ± SD) = 121 ± 11 nm in controls and 176 ± 27 nm in diabetics (p < 0.01), (2) endothelial capillary BL = 164 ± 14 nm in controls and 223 ± 27 nm in diabetics (p < 0.001), (3) both BL fused = 222 ± 23 nm in controls and 316 ± 62 nm in diabetics (p < 0.01), (4) BL of the glomerular capillary endothelium = 374 ± 44 nm in controls and 626 ± 249 in diabetics (p < 0.05) and (5) BL of the renal tubules = 602 ± 94 nm in controls and 1,083 ± 376 nm in diabetics (p < 0.05). All parts of the lung are equally affected by DM. The thickening of BL is of the same magnitude in lung and kidney. There is no relationship between the thickening of the lung BL and the known duration and type of DM.
Lung Abscess Caused by Paecilomyces lilacinus
Authors: Ono Nobuhiro , Sato Kiyoshi , Yokomise Hiroyasu , Tamura Koichi
Published: April 2003

We report the case of a 57-year-old man who was referred to our department for further investigation of an abnormal chest shadow. Radiography on admission demonstrated a coin lesion in the right hilum. To make a final diagnosis, right middle lobectomy was performed and the mass was revealed to be a fungal abscess. Further examination confirmed that the fungus was Paecilomyces lilacinus. This is the first reported case of lung abscess caused by P. lilacinus in an otherwise healthy person.
Suppression of Airway Inflammation by Theophylline in Adult Bronchial Asthma
Authors: Horiguchi Takahiko , Tachikawa Soichi , Kasahara Junichi , Doi Masashi , Shiga Mamoru , Miyazaki Junichi , Sasaki Yasushi , Hirose Masahiro , Imazu Moritaka
Published: April 2003

Background: Chronic continuous airway inflammation caused by eosinophils has been noted to play critical roles in the pathophysiology of bronchial asthma, in addition to reversible obstruction and hypersensitivity of the respiratory tract. Therefore, suppression of chronic airway inflammation has become more important in asthma treatment. Although theophylline has been a conventionally used bronchodilator, it has been recently reported to have concurrent anti-inflammatory effects. Objective: Accordingly, we studied the effects of a slow-release theophylline preparation, Theolong®, on airway inflammation. Methods: Administration of Theolong 400 mg/day to 24 patients with mild or moderate asthma and measuring eosinophil cationic protein (ECP), a marker of airway inflammation, and eosinophils in sputum and peripheral blood at 4 and 8 weeks. Results: As a result, sputum ECP, serum ECP and sputum eosinophil count (%) were significantly lowered after 4 and 8 weeks. Conclusion: Thus, in the theophylline-administered group, slow-release theophylline, Theolong®, was effective in treating asthma, with anti-inflammatory effects on inflammatory cells besides its bronchodilator action.
Invasive Thymoma with Long-Term Survival by Extensive Reoperation
Authors: Sakada Takashi , Sugio Kenji , Nishioka Kenichi , Tsukamoto Shuichi , Ushijima Chie , Yamazaki Koji , Okamoto Tatsuro , Kase Shinichiro , Koga Takaomi , Sugimachi Keizo
Published: April 2003

The recurrence of invasive thymoma is often observed; however, no accepted treatment of recurrent invasive thymoma has yet been established. We herein report a 41-year-old woman with invasive thymoma and pleural dissemination who demonstrated long-term survival after undergoing 4 operations. Based on our findings, reoperation is thus suggested in patients with intrathoracic recurrence and long-term survival can be expected.
Pulmonary Alveolar Proteinosis in a Patient with Chronic Myelogenous Leukemia
Authors: Tsushima Kenji , Koyama Shigeru , Saitou Hirosi , Takematsu Hayato , Ichiyoshi Takeo , Kubo Keishi
Published: April 2003

We describe the case of a 53-year-old Philadelphia-chromosome-positive woman with chronic myelogenous leukemia, who developed pulmonary alveolar proteinosis (PAP). The possible mechanism involved in the pathogenesis of PAP are discussed based on the clinical and laboratory data for this patient as well as on experimental and clinical data reported in the literature.
The Number of Interleukin 1 Receptors on Lung Fibroblasts in Patients with Idiopathic Pulmonary Fibrosis
Authors: Takeuchi M. , Nagai S. , Tsutumi T. , Mio T. , Izumi T.
Published: April 2003

Background: We investigated the expression of the IL-1 receptor on lung fibroblasts in patients with idiopathic pulmonary fibrosis (IPF) the histology of which was diagnosed as usual interstitial pneumonia. Methods: 125I-labeled IL-1α bound to lung fibroblasts in a specific and saturable manner in lung fibroblasts obtained from both IPF patients and control subjects. Results: Scatchard plot analysis revealed a single type of binding site in both groups. In total, 8,600 ± 1,450 (mean ±SD) sites/cell with a dissociation constant (Kd) of 1.83 ± 0.28 (mean ±SD) nM in patients with IPF and 7,920 ± 1,470 sites/cell with a Kd of 2.43 ± 0.49 nM in control subjects were counted. Furthermore, affinity cross-linking experiments revealed that the IL-1 receptor on lung fibroblasts in patients with IPF and control subjects had a molecular size of 80 kD. Conclusion: In conclusion, type I receptor was present on human lung fibroblasts, but there were no differences in number or affinity between IPF patients and controls.
Static Lung Volumes: Reference Values from a Latin Population of Spanish Descent
Authors: Cordero Pedro J. , Morales Pilar , Benlloch Eduardo , Miravet Luis , Cebrian Javier
Published: April 2003

Background and Objectives: The aim of this study was to develop a set of prediction equations and 90% confidence intervals for static lung volumes using the multibreath helium equilibration method from a sample of asymptomatic Caucasian subjects of Spanish descent. Moreover, these equations were compared with those of previous studies. Methods: Measurements of static lung volumes using techniques recommended by the American Thoracic Society and the European Community for Steel and Coal were carried out on a selected sample of 591 healthy nonsmoking volunteers (305 men and 286 women) aged 18–88 years, living in the metropolitan area of Valencia, on the east coast of Spain. Multiple regression analysis using height, age and weight as independent variables were used to provide predicted values for both sexes. These reference values were compared with other sets of prediction equations reported in the literature using an independent sample of 69 subjects (32 men and 37 women). Results: Simple linear regression equations using age, height and body weight predicted all the subdivisions of lung volumes (vital capacity, expiratory reserve volume (ERV), inspiratory capacity, functional residual capacity (FRC), residual volume (RV), total lung capacity (TLC), FRC/TLC and RV/TLC) as well as more complex equational models. The distribution of residuals fulfilled the assumptions of multiple regression analysis (independence, homoscedasticity and Gaussian distribution of residuals), except for ERV, using simple linear models. The derived equations did not differ significantly from most of the previously reported equations and were usually superior in their ability to predict the lung volumes. Conclusions: The use of the present prediction equations is recommended in the Latin population of Spanish descent and in populations with similar Caucasian characteristics.
Maximum Static Respiratory Pressures in Healthy Elderly Men and Women: Issues of Reproducibility and Interpretation
Authors: McConnell A.K. , Copestake A.J.
Published: April 2003

Background: Respiratory muscle strength is assessed using the static pressure generated at the mouth during a maximal inspiratory or expiratory effort [PImax and PEmax, respectively (MSRPs)]. Interpretation of MSRPs relies upon comparison with ‘normal’ values, but MSRPs show very weak associations with predictors such as physical characteristics. The influence of habitual physical activity upon MSRPs remains undefined. Objectives: We examined measurement reproducibility, as well as the influence of physical characteristics and habitual physical activity upon MSRPs in healthy elderly people. Methods: MSRPs were assessed in 41 healthy subjects using a portable mouth pressure meter on two occasions, 1 week apart. Physical activity was assessed in 10 subjects by diary record. Pearson product-moment correlation coefficients were used to assess the association of MSRPs with other measured variables. Results: There was good measurement reproducibility of MSRPs, with coefficients of reproducibility of 10.2 and 12.8% for PImax and PEmax, respectively. MSRPs showed statistically significant negative correlations with age, but correlations with physical characteristics were poor. In contrast, MSRPs were highly correlated with physical activity. Conclusions: We conclude that MSRPs can be measured reproducibly and that they decline with advancing age. Physical characteristics are not good predictors of MSRPs; this may be due to a strong confounding influence of physical activity making interpretation of measurements problematic. We suggest that the poor predictive power of physical characteristics indicate that reference to ‘normal’ values be made with caution and that it may be more appropriate to consider functional interpretations of MSRPs based upon factors such as lung and chest wall elastance.
Prevalence of Sleep Disordered Breathing and Sleep Apnea in 50- to 70-Year-Old Individuals
Authors: Zamarrón C. , Gude F. , Otero Y. , Alvarez J.M. , Golpe A. , Rodriguez J.R.
Published: April 2003

Purpose: To determine the prevalence of sleep disordered breathing (SDB) and sleep apnea syndrome (SAS) in a general population aged from 50 to 70 years. Subjects and Methods: We recruited 76 individuals aged between 50 and 70 years, chosen at random from the electoral census. They were invited to the clinic where a detailed medical history was taken and physical examination, ENT examination, pulmonary function tests and night time recording of respiratory variables performed. Results: The prevalence of SDB (apnea-hypopnea index ≥ 5) was 28.9%, and there were no differences between men (28%) and women (30%). However, the prevalence of SAS was 6.8%, and there were differences between men (5 cases) and women (0 cases) (p = 0.0521). Subjects in the SDB group had higher systolic blood pressure than in the non-SDB group (p < 0.05). Conclusions: SDB and SAS are common among 50- to 70-year olds. The prevalence of SDB was 28.9% and the prevalence of SAS was 6.8%.
Inhaled and Systemic Corticosteroid Therapies: Do They Contribute to Inspiratory Muscle Weakness in Asthma?
Authors: Akkoca O. , Mungan D. , Karabiyikoglu G. , Mısırlıgil Z.
Published: April 2003

Background: Patients with asthma incur the risk of steroid-induced myopathy, which is a well-known side effect of treatment with corticosteroids. However, the adverse effect of long-term steroid treatment on respiratory muscle function remains controversial. Objective: We aimed to evaluate the effects of long-term moderate dose of systemic corticosteroids and high-dose inhaled beclomethasone on maximal inspiratory and expiratory pressures (PImax and PEmax, respectively) in two groups of asthmatic patients exhibiting comparable levels of hyperinflation. Methods: Twelve steroid-dependent asthmatic patients requiring 10–20 mg/day of prednisone-equivalent corticosteroids for an average of 9.83 ± (SD) 9.86 years; 14 subjects with moderate to severe asthma who have used inhaled beclomethasone for at least 1 year at a daily dose higher than 1,000 μg and 15 healthy controls were included to the study. Results: No significant difference in pulmonary function tests and arterial blood gases appeared between two asthmatic groups with different treatment modalities. PImax as an absolute value was significantly lower in steroid-dependent asthmatics than in patients treated with inhaled beclomethasone and controls (p < 0.01). %PImax was also lower in steroid-dependent asthmatics than in control groups (p < 0.01). A significant correlation was found between %PImax and hyperinflation assessed by %RV, %FRC, %FRC/TLC (p < 0.05) in all asthmatic patients. Conclusions: We believe that hyperinflation plays a major role in inspiratory muscle dysfunction in asthma, but the finding of significantly decreased PImax values in steroid-dependent asthmatics when compared with patients on high-dose inhaled beclomethasone with a comparable level of hyperinflation points to a deleterious effect of long-term, moderate-dose systemic corticosteroid but not high-dose beclomethasone on inspiratory muscle function in asthmatics.
Pneumoconiosis among Cretan Dental Technicians
Authors: Froudarakis Marios E. , Voloudaki Argyro , Bouros Demosthenes , Drakonakis George , Hatzakis Kostas , Siafakas Nikos M.
Published: April 2003

Pneumoconiosis among dental technicians has recently emerged as an area of research in interstitial lung disease. This study was carried out to estimate the prevalence of pneumoconiosis in Greek dental technicians on the island of Crete. Fifty-one of the 58 dental technicians of the Heraklion Dental Technicians’ Association completed an exposure history questionnaire and underwent a clinical examination, including chest radiographs, and spirometric assessment of lung volume and diffusing capacity. Values were compared with 51 control subjects. Five dental technicians showed radiological evidence of pneumoconiosis. Mean lung function values of the dental technicians, even in those with pneumoconiosis, were not significantly different from controls. No significant changes in lung function parameters were associated with smoking, exposure to metals and other contaminants. Dental technicians, however, reported more respiratory symptoms than controls (p = 0.008). Symptoms were associated to the absence of a ventilation system. We concluded that occupational exposure in dental technicians in Crete did not affect lung function. The prevalence of pneumoconiosis in this study was 9.8%.
Mediastinal Fibromatosis Presenting with Superior Vena cava Syndrome
Authors: Inase Naohiko , Ichioka Masahiko , Akamatsu Hideki , Usui Yutaka , Miyake Shuji , Yoshizawa Yasuyuki
Published: April 2003

We encountered a fatal case of mediastinal fibromatosis in a 67-year-old female in whom there was aggressive infiltration into the large vessels, nerves and pericardium. She presented with the superior vena cava syndrome, Horner’s syndrome, paralysis of bilateral vocal cords and diaphragm and heart failure. Mediastinoscopical examination revealed an extremely firm tumor adhering to the sternum, trachea and brachiocephalic artery. She died of severe heart failure due to the disturbed dilatation of the heart and ventilatory insufficiency. Although mediastinal fibromatosis is very uncommon and sometimes difficult to diagnose at an early stage, physicians should be aware of this disease for the differential diagnosis of mediastinal tumors.
Modulation of Adhesion Molecule Profiles on Alveolar Macrophages and Blood Leukocytes
Authors: Haugen T.S. , Skjønsberg O.H. , Nakstad B. , Lyberg T.
Published: April 2003

Background: Cell adhesion molecules are believed to be essential for blood cell recruitment to the lung and for the movement of alveolar macrophages (AM) within the lung. Objective: To investigate the expression pattern of L-selectin and β2 integrins on blood leukocytes and AM, including AM of various maturity. Methods: Flow cytometry was used to study the expression of L-selectin (CD62L) and of the β2 integrins CD11a, CD11b, and CD11c on AM (including density-defined subpopulations), monocytes (Mo), polymorphonuclear neutrophils (PMN) and lymphocytes (Ly) sampled from healthy individuals, during incubation with and without lipopolysaccharide (LPS). Results: A significantly different modulation pattern of β2 integrins and L-selectin was demonstrated on Mo and AM, cells of the same differentiation lineage. In contrast to AM, Mo had a marked ability to respond to LPS stimulation by increased expression of CD11a, CD11b and CD11c and decreased expression of L- selectin. These molecules were expressed to a similar degree on AM, whereas the basal levels of CD11b and L-selectin were considerably higher on Mo than on AM. A significantly different expression of CD11a as well as differences in the regulation of L-selectin during incubation were also demonstrated between density-defined subpopulations of AM. CD11a could not be upregulated on PMN, otherwise the modulation patterns of CD11b, CD11c and L-selectin were similar to that on Mo. The expression of CD11a on Ly was 3- to 6-fold higher than on Mo, PMN and AM. The level of CD11b decreased significantly upon incubation (uninfluenced by LPS stimulation), and CD11c was hardly expressed on Ly. The level of L-selectin on Ly was higher than on Mo, AM and PMN and was not decreased during incubation. Conclusion: Developmental origin, degree of cell differentiation (maturity) as well as different environmental conditions all heavily influence the expression and modulation pattern of β2 integrins and L-selectin on leukocytes and Mo-derived AM.
Bronchocentric Granulomatosis as a First Clinical Manifestation in an Adult Patient with p67phox Deficiency
Authors: Barrot E. , Ortega-Calvo M. , Borderas F. , Sanchez J. , Melero-Ruiz J. , Sanchez-Sanchez B.
Published: April 2003

We report on a case of adult chronic granulomatous disease which first manifested as a pulmonary mass, and was histologically diagnosed as bronchocentric granulomatosis associated with aspergillosis in a patient with a deficiency of p67phox and a low oxidative response. Antifungal treatment was required for clinical resolution.
Successful Treatment with Methylprednisolone Pulse Therapy for a Life-Threatening Pulmonary Insufficiency in a Patient with Chronic Granulomatous Disease following Pulmonary Invasive Aspergillosis and Burkholderia cepacia Infection
Authors: Okano Motohiko , Yamada Masafumi , Ohtsu Makoto , Kawamura Nobuaki , Sakiyama Yukio , Aoi Kenichiro , Gandoh Satoshi , Fujita Miri , Kobayashi Kunihiko
Published: April 2003

A 14-year-old boy with X-linked chronic granulomatous disease developed severe invasive pulmonary aspergillosis. He was treated with itraconazole and amphotericin B. However, he deteriorated with progressive pulmonary lesions. Burkholderia cepacia was isolated from his bronchoalveolar lavage. Finally, he was given granulocyte transfusions. Following this procedure, his condition rapidly worsened leading to respiratory failure. His lung biopsy demonstrated organizing pneumonia at his right middle lobe. Then, a methylprednisolone pulse therapy was initiated together with the administration of appropriate antibiotics and adequate amounts of amphotericin B. Dramatically, his condition improved. Therefore, a methylprednisolone pulse therapy with appropriate antimicrobial drugs seems to be beneficial for severe pulmonary insufficiency in this type of patients.