bluuebunny/crossref_metadata_2025 huggingface dataset:
Do captive male meadow voles experience acute stress in response to weasel odour?
Authors: Fletcher Q.E. , Boonstra R.
Published: June 2006

The hormonal stress response is adapted to deal with acute (short-term) stressors; however, chronic (long-term) stressors have negative effects on survival and fitness. Field and laboratory evidence suggest that voles respond behaviourally to predator odours. However, it is unknown whether voles mount an acute hormonal stress response to predator odour. We determined whether reproductively active, captive male meadow voles ( Microtus pennsylvanicus (Ord, 1815)) mounted a more pronounced hormonal stress response to weasel odour (ermine, Mustela erminea L., 1758), one of their principal mammalian predators, than to nonpredator and control odours. We compared the corticosterone response of captive voles to weasel, jumping mouse ( Zapus hudsonius (Zimmermann, 1780)), and control odours following acute (20 min) exposure. The hormonal stress response to the treatment odours did not differ, indicating that captive male voles in the reproductive season do not mount an acute stress response to predator odour. We hypothesize that voles do not respond to weasel odour because, independent of other stimuli, olfactory signals are not reliable enough to outweigh the costs, such as suppression of reproduction and reproductive behaviour, associated with a response.
Hatching plasticity in two temperate anurans: responses to a pathogen and predation cues
Authors: Touchon J.C. , Gomez-Mestre I. , Warkentin K.M.
Published: June 2006

Water molds are widespread in aquatic environments and are important causes of mortality in amphibian and fish eggs. We tested the ability of two species of North American anurans with different breeding phenologies ( Rana sylvatica LeConte, 1825 and Bufo americanus Holbrook, 1836) to alter their hatching timing in response to three indicators of environmental risk: infection with a water mold, exposure to simulated egg predation cues, or exposure to simulated larval predation cues. When infected with water mold (Saprolegniaceae), B. americanus eggs hatched, on average, 44% earlier than the controls and R. sylvatica eggs hatched 19% earlier than the controls. In addition, B. americanus but not R. sylvatica eggs hatched significantly earlier than the controls when exposed to simulated egg and larval predation cues. Bufo americanus embryos hatched before developing muscular response, suggesting that hatching occurs through enzymatic egg capsule degradation combined with ciliary movement, not through behavior. Bufo americanus breeds later than R. sylvatica and responded to infection and simulated predation cues more strongly. This may reflect a history of stronger selection by pathogens and predators that accumulate in ponds as the breeding season progresses. To our knowledge, these are the first examples of induced hatching of amphibians in response to aquatic pathogens.
Prostaglandins mediate tonic contraction of the guinea pig and human gallbladder
Authors: Cong Ping , Xiao Zuo-Liang , Biancani Piero , Behar Jose
Published: June 2006

The gallbladder (GB) maintains tonic contraction modulated by neurohormonal inputs but generated by myogenic mechanisms. The aim of these studies was to examine the role of prostaglandins in the genesis of GB myogenic tension. Muscle strips and cells were treated with prostaglandin agonists, antagonists, cyclooxygenase (COX) inhibitors, and small interference RNA (siRNA). The results show that PGE2, thromboxane A2(TxA2), and PGF2αcause a dose-dependent contraction of muscle strips and cells. However, only TxA2and PGE2(E prostanoid 1 receptor type) antagonists induced a dose-dependent decrease in tonic tension. A COX-1 inhibitor decreased partially the tonic contraction and TxB2(TxA2stable metabolite) levels; a COX-2 inhibitor lowered the tonic contraction partially and reduced PGE2levels. Both inhibitors and the nonselective COX inhibitor indomethacin abolished the tonic contraction. Transfection of human GB muscle strips with COX-1 siRNA partially lowered the tonic contraction and reduced COX-1 protein expression and TxB2levels; COX-2 siRNA also partially reduced the tonic contraction, the protein expression of COX-2, and PGE2. Stretching muscle strips by 1, 2, 3, and 4 g increased the active tension, TxB2, and PGE2levels; a COX-1 inhibitor prevented the increase in tension and TxB2; and a COX-2 inhibitor inhibited the expected rise in tonic contraction and PGE2. Indomethacin blocked the rise in tension and TxB2and PGE2levels. We conclude that PGE2generated by COX-2 and TxA2generated by COX-1 contributes to the maintenance of GB tonic contraction and that variations in tonic contraction are associated with concomitant changes in PGE2and TxA2levels.
Spontaneously tonic smooth muscle has characteristically higher levels of RhoA/ROK compared with the phasic smooth muscle
Authors: Patel Chirag A. , Rattan Satish
Published: June 2006

The internal anal sphincter (IAS) tone is important for the rectoanal continence. The RhoA/Rho kinase (ROK) pathway has been associated with the agonist-induced sustained contraction of the smooth muscle, but its role in the spontaneously tonic smooth muscle is not known. Present studies compared expression of different components of the RhoA/ROK pathway between the IAS (a truly tonic SM), the rectal smooth muscle (RSM) (a mixture of phasic and tonic), and anococcygeus smooth muscle (ASM) (a purely phasic SM) of rat. RT-PCR and Western blot analyses were performed to determine RhoA, ROCK-II, CPI-17, MYPT1, and myosin light-chain 20 (MLC20). Phosphorylated CPI-17 at threonine-38 residue (pThr38-CPI-17), MYPT1 at threonine-696 residue (pThr696-MYPT1), and MLC20at threonine-18/serine-19 residues (pThr18/Ser19-MLC20) were also determined in the basal state and after pretreatment with the ROK inhibitor Y 27632. In addition, we compared the effect of Y 27632 on the basal isometric tension and ROK activity in the IAS vs. the RSM. Our data show the highest levels of RhoA, ROCK-II, CPI-17, MLC20, and of phospho-MYPT1, -CPI-17, and -MLC20in the IAS followed by in the RSM and ASM. Conversely, MYPT1 levels were lowest in the IAS and highest in the ASM. In the IAS, Y 27632 caused a concentration-dependent decrease in the basal tone, levels of phospho-MYPT1, -CPI-17, and -MLC20, and ROK activity. We conclude that RhoA/ROK plays a critical role in the basal tone in the IAS by the inhibition of MLC phosphatase via the phosphorylation of MYPT1 and CPI-17.
Targeted disruption of peroxiredoxin 6 gene renders the heart vulnerable to ischemia-reperfusion injury
Authors: Nagy Norbert , Malik Gautam , Fisher Aron B. , Das Dipak K.
Published: June 2006

Peroxiredoxin 6 (Prdx6) is a novel peroxidase enzyme belonging to the Prdx family, which in mammals contains five more peroxiredoxins (Prdx1–Prdx5). Like glutathione peroxidase (GSHPx) and catalase, Prdx6 possesses H2O2-scavenging activities, and, like the former, it also removes hydroperoxides. Since significant amounts of catalase and GSHPx are present in the heart contributing toward the attenuation of H2O2 and hydroperoxides formed during ischemia-reperfusion injury and thereby providing cardioprotection, we asked whether Prdx6 also has any role in this process. In the present study we used Prdx6−/− mice to assess the role of Prdx6 in ischemic injury. Western blot analysis revealed the absence of any Prdx activity in the Prdx6−/− mouse heart, while the GSHPx-1 and catalase levels remained unchanged. Randomly selected hearts from Prdx6−/− mice and wild-type mice were subjected to 30 min of global ischemia followed by 120 min of reperfusion at normothermia. The hearts from the Prdx6−/− mice were more susceptible to ischemic reperfusion injury as evidenced by reduced recovery of left ventricular function, increased myocardial infarct size, and higher amount of apoptotic cardiomyocytes compared with wild-type mouse hearts. These Prdx6−/− hearts were also subjected to a higher amount of oxidative stress as evidenced by the presence of higher amount of malondialdehyde. The present study thus indicates a nonredundant role of Prdx6 in myocardial ischemic reperfusion injury as catalase, and GSHPx could not make up for the deficiency of Prdx6 activities.
Glucan phosphate attenuates cardiac dysfunction and inhibits cardiac MIF expression and apoptosis in septic mice
Authors: Ha Tuanzhu , Hua Fang , Grant Daniel , Xia Yeling , Ma Jing , Gao Xiang , Kelley Jim , Williams David L. , Kalbfleisch John , Browder I. William , Kao Race L. , Li Chuanfu
Published: June 2006

Myocardial dysfunction is a major consequence of septic shock and contributes to the high mortality of sepsis. We have previously reported that glucan phosphate (GP) significantly increased survival in a murine model of cecal ligation and puncture (CLP)-induced sepsis. In the present study, we examined the effect of GP on cardiac dysfunction in CLP-induced septic mice. GP was administered to ICR/HSD mice 1 h before induction of CLP. Sham surgically operated mice served as control. Cardiac function was significantly decreased 6 h after CLP-induced sepsis compared with sham control. In contrast, GP administration prevented CLP-induced cardiac dysfunction. Macrophage migration inhibitory factor (MIF) has been implicated as a major factor in cardiomyocyte apoptosis and cardiac dysfunction during septic shock. CLP increased myocardial MIF expression by 88.3% ( P < 0.05) and cardiomyocyte apoptosis by 7.8-fold ( P < 0.05) compared with sham control. GP administration, however, prevented CLP-increased MIF expression and decreased cardiomyocyte apoptosis by 51.2% ( P < 0.05) compared with untreated CLP mice. GP also prevented sepsis-caused decreases in phospho-Akt, phospho-GSK-3β, and Bcl-2 levels in the myocardium of septic mice. These data suggest that GP treatment attenuates cardiovascular dysfunction in fulminating sepsis. GP administration also activates the phosphoinositide 3-kinase/Akt pathway, decreases myocardial MIF expression, and reduces cardiomyocyte apoptosis.
3D-Ultrasound Detection of Fetal Grasping of the Umbilical Cord and Fetal Outcome
Authors: Habek Dubravko , Kulaš Tomislav , Selthofer Robert , Rosso Mićo , Popović Zoran , Petrović Davor , Ugljarević Margareta
Published: June 2006

A case of persistent fetal palmar grasping of the umbilical cord in a 23-year-old primigravida is described. Palmar grasping was detected with three-dimensional ultrasound examination after cardiotocographically recorded fetal bradyarrhythmia. Because of acute fetal hypoxia, urgent Misgav-Ladach cesarean section was performed to deliver a hypotrophic female newborn, 2,120 g/43 cm, Apgar score 4/7, pH 7.29. No other pathology was found during the procedure. The postoperative course proceeded uneventfully and the early neonatal neurological status and neurosonographic findings were normal.
Neonatal Mortality and Morbidity after Aggressive Long-Term Tocolysis for Preterm Premature Rupture of the Membranes
Authors: Wolfensberger Aline , Zimmermann Roland , von Mandach Ursula
Published: June 2006

Objective: To test the hypothesis that predischarge morbidity and mortality are not increased for infants admitted to our neonatal intensive care unit and whose mothers had tocolysis for >48 h plus antibiotics and steroids (aggressive long-term tocolysis) after preterm premature rupture of the membranes (PPROM) as compared with gestational age-matched infants born to mothers not treated for PPROM. Methods: A retrospective cohort study was conducted on live preterm births (≤36.0 weeks) admitted to the neonatal intensive care unit between January 1, 1999 and June 30, 2003, comparing singletons born to mothers with PPROM + tocolysis for >48 h (n = 137, group 1) with singletons born to all other mothers matched for group-1 gestational age at delivery (n = 628, group 2), excluding severe maternal complications such as insulin-dependent diabetes and preeclampsia in both groups. Primary outcome was the predischarge mortality and morbidity of the neonates. Results: In the group with post-PPROM tocolysis which lasted for 14.4 ± 14.0 days with a latency of 15.3 ± 15.3 days (time from PPROM to delivery) and 14.4 ± 14.0 days (time from the start of tocolysis to delivery), the predischarge mortality and morbidity was not increased compared to the non-treated group. The 1- and 10-min Apgar scores of between 1 and 7 were less frequent with tocolysis (p < 0.05), and oxygen use was less frequent (26.3 vs. 36.3%, p = 0.03) and shorter (8.7 vs. 19.6 days, p = 0.03). However, amniotic fluid infection syndrome and latency (i.e. >1 week) are the most potential predictors of the respiratory distress syndrome in addition to gestational age at delivery in pregnancies with post-PPROM tocolysis. Conclusions: Amniotic fluid infection syndrome and a latency of >1 week achieved by aggressive post-PPROM tocolysis lessens the advantages of extended gestational age and decreased predischarge neonatal morbidity. These findings may have important implications for the clinical management of PPROM.
Severity of Non-Immune Hydrops Fetalis at Birth Continues to Predict Survival despite Advances in Perinatal Care
Authors: Simpson Judith H. , McDevitt Helen , Young David , Cameron Alan D.
Published: June 2006

Objectives: To describe the aetiology and short-term outcome of live-born infants with non-immune hydrops fetalis (NIH), to identify predictors of mortality and to establish whether there has been any change in mortality over a 14-year period. Methods: A retrospective case note review of all liveborn neonates with NIH. Results: 30 infants were identified. Twenty (66%) had an identifiable aetiology. Ten (33%) survived to discharge. Survivors had significantly higher Apgar scores at 1 and 5 min (both p < 0.001). Mortality did not differ between the time periods 1990–1999 and 2000–2004. Conclusions: NIH continues to be associated with a significant mortality despite advances in perinatal care. Poor condition at birth is a strong predictor of death.
Fetal Anal Atresia Presenting as Transient Bowel Dilatation at 16 Weeks of Gestation
Authors: Kaponis A. , Paschopoulos M. , Paraskevaidis E. , Makrydimas G.
Published: June 2006

Congenital anal atresia is a rare abnormality which in two thirds of the cases is associated with other congenital abnormalities or syndromes. Prenatal diagnosis is usually achieved in cases with coexisting abnormalities. The diagnosis of isolated anal atresia is extremely difficult and can be suspected in the presence of colon dilatation. We present the case of a fetus in which marked dilatation of the colon was diagnosed at 16 weeks of gestation. Four weeks later the sonographic appearance of the bowel was normal and remained normal for the rest of the pregnancy. Anal atresia was diagnosed immediately after birth and corrected surgically. No other abnormalities were present. This case report illustrates that in anal atresia, bowel dilatation may be only transient.
Prenatal and Postnatal Findings in a Case with the Autosomal Recessive Type of Robinow Syndrome
Authors: Guven Melih A. , Batukan Cem , Ceylaner Serdar , Uzel Murat , Ozbek Ayda , Demirpolat Gulen
Published: June 2006

Objective: Our aim was to present a prenatally diagnosed case with Robinow syndrome in a consanguineous couple and discuss possible differential diagnosis in view of the literature. Methods: A 28-year-old pregnant woman gravida 2 para 1 was referred to the obstetric clinic of Kahramanmaras Sutcu Imam University presenting with a fetus having shortened upper and lower limbs at 33 weeks of gestation. Her medical history was unremarkable except for consanguinity. Prenatal ultrasonographic examination revealed a reduced humerus and femur length. Further, shortening of the forearm, frontal bossing, mild hypertelorism, reduced thoracic perimeter and hemivertebrae at the thoracic level were present. Results: Meticulous neonatal examination was performed following an uncomplicated vaginal delivery at 39 weeks of gestation. Distinct facial appearance in addition to the prenatal findings argued in favor of the diagnosis of Robinow syndrome. Additionally, radiological survey revealed and confirmed shortening of the upper extremities and thoracic hemivertebrae. Conclusion: We are documenting the case on the account of its rarity and additional features. The main approach in the differential diagnosis of Robinow syndrome should determine whether hemivertebrae is isolated or part of a syndrome or association.
Umbilical Cord Diameter at 11–14 Weeks of Gestation: Relationship to Nuchal Translucency, Ductus Venous Blood Flow and Chromosomal Defects
Authors: Axt-Fliedner R. , Schwarze A. , Kreiselmaier P. , Krapp M. , Smrcek J. , Diedrich K.
Published: June 2006

Objective: To compare the umbilical cord diameter (UCD) in euploid and aneuploid fetuses at 11–14 weeks of gestation. Methods:In 299 fetuses at 11–14 weeks of gestation the UCD, the nuchal translucency and the a-wave of the ductus venosus were measured. Reference ranges for the UCD according to the gestational age and to the crown-rump-length (CRL) were obtained by measuring the UCD by outer-to-outer border of 244 singleton pregnancies with normal karyotype. The fetal karyotype was established by chorionic villus sampling, amniocentesis or in case of suspected chromosomal abnormalities in the newborn. Linear regression was used to determine the significance of the association between the UCD and CRL or gestational age. Results: Two hundred and ninety-nine fetuses were examined. The median fetal CRL was 64.5 mm (range 45–84) and the median gestational age was 13 (range 11–14) weeks. In the chromosomally normal group the UCD significantly increased with the CRL (r = 0.620; p < 0.001) and the gestational age (r = 0.555; p < 0.001). The regression equation for the mean UCD (y) according to the gestational days (x) was: y = –0.604 + 0.051 *x. The regression equation for the mean UCD (y) according to the CRL (x) was: y = 1.962 + 0.029 *x. There were no significant differences in the mean UCD in fetuses without and with chromosomal abnormalities. The proportion of fetuses with an UCD above the 95th centile for CRL was higher in aneuploid compared to euploid fetuses (5/14 vs. 13/285, p < 0.005). In 5/14 (35.7%) fetuses with chromosomal defects the NT and the UCD were above the 95th centile, whereas none of the fetuses with normal karyotype showed this combination. The proportion of fetuses with increased UCD and abnormal DV blood flow was increased in the cases with chromosomal abnormalities (33.3 vs. 1.8%, p < 0.005). Conclusion: Umbilical cord diameter at 11–14 weeks increases with fetal CRL. Fetuses with chromosomal abnormalities are more likely to have an UCD above the 95th centile. Therefore, sonographic evaluation of the umbilical cord during first trimester ultrasound might be of additional value in the assessment of fetuses at risk for aneuploidies.
Optimal Standards for Fetal Biometry: To Each Measurement Its Fitting Model
Authors: Pineau Jean-Claude , Thiebaugeorges Olivier , Guihard-Costa Anne-Marie
Published: June 2006

Objective: To determine the best mathematical model to construct charts of fetal abdominal circumference (AC) and femur length (FL). Methods: Ultrasound measurements were made on 1,336 normal fetuses in one center. Four mathematical models were compared (a linear-quadratic model, a linear-cubic model, the Rossavik model and a new two-phase model, which has been found to best fit fetal head data). Results: The best fitting of AC and FL data was obtained with the linear-quadratic model without separate computing for gender. Centile charts have been computed. Conclusion: Fetal growth of AC and FL is much simpler than that of the head. Therefore, a unique mathematical model should not be used to fit all measurements.
The Role of Platelet-Derived Growth Factor Receptor in Eotaxin Signaling of Eosinophils
Authors: Adachi Tetsuya , Hanaka Satoko , Yano Tomoko , Yamamura Koichi , Yoshihara Hisanao , Nagase Hiroyuki , Chihara Junichi , Ohta Ken
Published: June 2006

Background: Receptor tyrosine kinases (RTKs) such as epidermal growth factor receptor (EGFR) and platelet-derived growth factor receptor (PDGFR) are capable of eliciting kinase activity after ligand binding. In several cells, RTKs are activated via the G-protein-coupled receptor independent of the ligand-RTK interaction. We have previously found that EGFR is transactivated via CC chemokine receptor 3 in bronchial epithelial cells and that this pathway is important for mitogen-activated protein (MAP) kinase activation and cytokine production. It has recently been suggested that hypereosinophilic syndrome results from the fusion tyrosine kinase FIP1L1-PDGFRA. Although it is possible that the PDGFR signal is involved in eosinophil function, the details are still unclear. Methods: Blood eosinophils were purified using Percoll and anti-CD16 antibody-coated magnetic beads. Expression of PDGFR mRNA was examined by RT-PCR. After stimulating eosinophils with eotaxin, the phosphorylation of MAP kinases was examined by Western blotting with the antiphosphospecific MAP kinase antibody. The eotaxin-induced eosinophil chemotaxis was studied using Boyden chambers. Results: Eosinophils expressed PDGFRβ  mRNA in 4 out of 8 donors, while PDGFRα mRNA was expressed in only 1 donor. Protein expression of PDGFR was also detectable in eosinophils from some donors. AG1295, a specific inhibitor of PDGFR, showed dose-dependent inhibition of eotaxin-induced MAP kinase phosphorylation in the eosinophils expressing PDGFRβ mRNA. The chemotaxis of these eosinophils was significantly inhibited by AG1295 (n = 3). Conclusions: Our results suggest that PDGFR modifies the CCR3-MAP kinase signaling pathway and chemotactic response in some donors. The pharmacological targeting of PDGFR may be a new strategy to treat eosinophilic disorders.
Procaterol Upregulates Peroxisome Proliferator-Activated Receptor-γ Expression in Human Eosinophils
Authors: Ueki Shigeharu , Usami Atsuko , Oyamada Hajime , Saito Norihiro , Chiba Takahito , Mahemuti Gulixian , Ito Wataru , Kato Hikari , Kayaba Hiroyuki , Chihara Junichi
Published: June 2006

Peroxisome proliferator-activated receptor-γ (PPARγ) is a nuclear receptor that regulates immune reaction. We have previously demonstrated that human eosinophils express PPARγ and that stimulation with a synthetic agonist for PPARγ attenuated the factor-induced eosinophil activations. However, the modulator of PPARγ expression in eosinophils has not yet been studied. In this study, we investigated the effect of procaterol, the synthetic β2-adrenoceptor agonist widely used as bronchodilators in asthma, on the PPARγ expression in eosinophils. Purified human peripheral blood eosinophil and the eosinophilic cell line EoL-1 were cultured with procaterol. This was followed by PPARγ measurement using flow cytometer and quantitative real-time RT-PCR. We observed that PPARγ was constitutively expressed by EoL-1 and the purified eosinophils and that the therapeutic concentration (10–9M) of procaterol markedly enhanced PPARγ  protein expression, which was reversed by the selective β2-adrenoceptor antagonist ICI-118551. The PPARγ mRNA expression in EoL-1 and eosinophils was also induced by procaterol. These findings suggest that procaterol could modulate the eosinophil function by increasing the expression of PPARγ.
Th2-Cell-Mediated Chemokine Synthesis Is Involved in Allergic Airway Inflammation in Mice
Authors: Mori Akio , Ogawa Koji , Kajiyama Yuichiro , Suko Matsunobu , Kaminuma Osamu
Published: June 2006

Eosinophilic inflammation in the bronchial mucosa has been recognized as a prominent pathological feature of bronchial asthma. Th2 cells have been implicated in the local infiltration and activation of eosinophils. The migration of eosinophils as well as Th2 cells is controlled by chemokines, suggesting a crucial role of chemokines in the pathogenesis of bronchial asthma. To elucidate the mechanism by which Th2 cells induce eosinophilic inflammation, a Th2-cell-dependent murine model of asthma was employed in this study. Along with the infiltration of eosinophils and antigen-specific Th2 cells, CC chemokine receptor-3-active eotaxin, monocyte chemoattractant protein (MCP)-3 and RANTES, as well as CC chemokine receptor-3-inactive MCP-1 were produced in the lungs of Th2-cell-transferred mice after antigen provocation in vivo. On the other hand, differentiated antigen-specific Th2 cells produced MCP-3 and RANTES but not eotaxin or MCP-1 upon stimulation in vitro. Chemokines synthesized by Th2 cells and other cell types are involved in the development of eosinophilic inflammation in bronchial asthma.
Changing Spectrum of Squamous Cell Abnormalities Observed on Papanicolaou Smears in Mubarak Al-Kabeer Hospital, Kuwait, over a 13-Year Period
Authors: Kapila Kusum , George Sara S. , Al-Shaheen Azza , Al-Ottibi M.S. , Pathan Shahed K. , Sheikh Zafar A. , Haji Bahiya E. , Mallik Mrinmay K. , Das Dilip K. , Francis Issam M.
Published: June 2006

Objective: The aim of this study was to determine the incidence of squamous cell abnormalities in cervical cytology in Mubarak Al-Kabeer Hospital, Kuwait, and to document any change in the pattern of these lesions. Materials and Methods: Over a 13-year period (1992–2004), 86,434 cervical smears were studied in Mubarak Al-Kabeer Hospital, Kuwait. Conventional Pap smears were first examined by cytotechnicians and finally reported by cytopathologists. The smears were classified according to the modified Bethesda system. The age of presentation of squamous cell abnormalities in Kuwaiti women was analyzed. Results: Smears from 83,052 (96.09%) patients were found satisfactory for reporting while the remaining 3.9% was unsatisfactory. Atypical squamous cells of undetermined significance (ASCUS) were seen in 1,790 (2.2%) cases, atypical glandular cells of undetermined significance (AGUS) in 630 (0.8%) cases, low grade squamous intraepithelial lesion including human papillomavirus changes (LSIL) in 824 (1.0%) cases, high grade squamous intraepithelial lesion (HSIL) in 189 (0.2%) cases, and carcinoma in 79 (0.1%) cases of which 44 (0.05%) were squamous cell carcinoma. A comparison of average cases/annum during the study period revealed a significant increase in ASCUS from 1.13 to 2.83% (p < 0.001) and AGUS from 0.33 to 1.08% (p < 0.001). However, the percentage of LSIL, HSIL and carcinoma detected in Pap smears remained the same. Conclusion: A significant linear trend (p < 0.001) was observed in satisfactory smears, ASCUS and AGUS over the years. However, no significant change was found in the detection of LSIL, HSIL and carcinoma. A reduction in the age of LSIL/HSIL and an increasing trend in the number of Kuwaiti women over the years was also observed which makes screening of young women essential in Kuwait.
Evaluation of the Knowledge, Attitude and Practice of Self-Medication among First-Year Medical Students
Authors: James Henry , Handu Shailendra S. , Al Khaja Khalid A.J. , Otoom Sameer , Sequeira Reginald P.
Published: June 2006

Objective: This study was undertaken to determine the knowledge, attitude and practice of self-medication among first-year medical students of the Arabian Gulf University, Bahrain. Subjects and Methods: This was an anonymous, questionnaire-based, descriptive study. A prevalidated questionnaire, containing open-ended and close-ended questions, was administered to the subjects. Data were analyzed using SPSS version 12 and the results expressed as counts and percentages. Results: Out of the 134 respondents, 43 (32.1%) were males and 91 (67.9%) were females; their mean age in years ± SD was 18.01 ± 0.78. The respondents’ knowledge about appropriate self-medication was poor, but knowledge of the benefits and risks of self-medication was adequate. The respondents found self-medication to be time-saving, economical, convenient and providing quick relief in common illnesses. Important disadvantages of self-medication mentioned were the risk of making a wrong diagnosis, inappropriate drug use and adverse effects. The majority (76.9%) of the respondents had a positive attitude favoring self-medication. Self-medication was practiced by 44.8% of the subjects. The most common indications for self-medication were to relieve the symptoms of headache (70.9%), cough, cold and sore throat (53.7%), stomachache (32.8%) and fever (29.9%). Analgesics (81.3%) were the most common drugs used for self-medication. The practice of self-medication was appropriate in only 14.2% of cases. Conclusion: Knowledge about appropriate self-medication was poor, attitude towards self-medication was positive, and the practice of self-medication was common and often inappropriate.
Epididymo-Orchitis and Testicular Abscess Caused by Salmonella enteritidis in Immunocompromised Patients in Kuwait
Authors: Al-Obeid Khalid , Al Khalifan Nawaf N. , Jamal Wafaa , Kehinde Elijah O. , Rotimi Vincent O.
Published: June 2006

Objective: To report relatively uncommon presentations of epididymo-orchitis and testicular abscess caused by Salmonella spp. in 2 immunocompromised patients. Clinical Presentation and Intervention: A 56-year-old man, a known case of systemic lupus erythematosus on azathioprine and prednisolone therapy, developed urinary tract infection followed by bacteremia and epididymo-orchitis. Both urine and blood cultures yielded Salmonella enteritidis strains, which were demonstrated by pulsed-field gel electrophoresis typing method to be genotypically identical. The second patient, a 55-year-old diabetic (type II), presented with a testicular abscess from which a pure culture of S. enteritidis was obtained. Both were treated with intravenous piperacillin and amikacin followed by oral ciprofloxacin, responded well to the therapeutic regimen and were discharged home well. Their follow-ups were uneventful. Conclusion: This report shows that it is important to consider Salmonella infection in the differential diagnosis of inflamed and tender testis in immunocompromised patients and to include blood, urine and stool cultures in all cases.
Leg Textiloma
Authors: Mouhsine Elyazid , Garofalo Raffaele , Cikes Alec , Leyvraz Pierre François
Published: June 2006

Objective: To report and highlight the potential diagnostic pitfalls and consequences of leg textiloma. Case Report and Intervention: A soft tissue pseudotumor of the left leg diagnosed in a 58-year-old man is described. The lesion was caused by a retained surgical gauze after surgery for varicose veins. The surgical gauze had remained in the subcutaneous tissue for 3 years and led to the formation of a 3-cm, well-circumscribed, pseudotumoral foreign body granuloma which appeared like a soft tissue tumor. A surgical intervention was performed and the mass was excised. During the procedure an old surgical gauze was found. The histologic examination revealed that a large foreign body granuloma (pseudotumor) had developed in contact with foreign material birefracting under polarized light (gauze). No sign of malignancy was noted. Conclusion: Although no fatal complications have been described in the musculoskeletal localization, the diagnosis is difficult and costly. According to clinical presentation, a differential diagnosis should be made between a tumoral lesion, such as a sarcoma, or a pseudotumoral lesion, such as a gossypiboma. Focal myositis or infections should also be suspected.
Ischemia-Modified Albumin Concentrations Should Be Interpreted with Caution in Patients with Low Serum Albumin Concentrations
Authors: Gaze David C. , Crompton Lisa , Collinson Paul
Published: June 2006

Objective: Ischemia-modified albumin (IMA®) is a novel marker for assessing cardiac ischaemia. We assessed the relationship between total albumin concentrations and IMA in serum to investigate whether interpretation of IMA was albumin-dependent. Subjects and Methods: 298 serum samples were assayed for total albumin (albumin), using bromcresol purple, and IMA, using an indirect colorimetric assay. Correlations were investigated for the whole data set and for two subgroups, those samples with low albumin (≤34 g/l) and those with albumin within the reference interval. Results: There was a significant (r = –0.888, p < 0.0001) negative correlation between IMA and albumin both over the entire range of albumin concentrations and in the low albumin concentration subgroup (r = –0.85, p < 0.0001); however, there was less significant correlation in the subgroup with albumin within the reference interval (r = –0.37, p < 0.0001). Conclusion: A negative correlation exists between IMA and albumin concentrations; however, there is less significant correlation when albumin is within the reference interval. IMA concentrations determined in patients with albumin concentrations ≤34 g/l should be interpreted with some caution.
Herpes Zoster and Its Cardiovascular Complications in the Elderly – Another Look at a Dormant Virus
Authors: Ma Tony S. , Collins Tracie C. , Habib Gabriel , Bredikis Audrius , Carabello Blase A.
Published: June 2006

Herpes zoster (shingles) is a reactivation of latent Varicella-zoster virus (VZV). We present a case of pleuropericarditis simulating acute myocardial infarction and another with complete heart block in the setting of acute/recent VZV reactivation. These cases are consistent with a modified concept: (1) the VZV dormancy is comprised of multiple foci of infections in the sensory and autonomic ganglia, and (2) the VZV reactivation could involve co-incident activations of two or more loci. Recognition of this possibility of cardiovascular complications of VZV should be helpful in the clinical management of the elderly, in the differential diagnosis of chest pain, ST elevation, and heart block etiology in the setting of acute or recent VZV reactivation.
Efficacy and Safety of Intraoperative Peritoneal Hyperthermic Chemotherapy for Advanced Gastric Cancer Patients with Serosal Invasion
Authors: Zhu Zheng Gang , Tang Rui , Yan Min , Chen Jun , Yang Qiu Meng , Li Chen , Yao Xue Xin , Zhang Jun , Yin Hao Ran , Lin Yan Zhen
Published: June 2006

Aims: This study was undertaken to investigate the clinical effects and safety of intraoperative peritoneal hyperthermic chemotherapy (IPHC) for advanced gastric cancer (AGC) patients. Methods: A total of 118 AGC patients with serosal invasion were enrolled in this study from 1998 to 2001, 52 underwent IPHC after gastrectomy and 66 were treated with gastrectomy only. Among these cases, 96 patients without macroscopic peritoneal metastases were selected for the prophylactic study, 22 with peritoneal metastases were selected for the therapeutic study. Postoperative survival, recurrence pattern and incidences of postoperative complications between patients with and without IPHC were analyzed and compared. Results: For the prophylactic study, the IPHC procedure improves postoperative survival rate and decrease the incidence of peritoneal recurrence, and is an independent prognostic factor for these patients. For the therapeutic study, postoperative survival times were longer if IPHC was undertaken. No surgery-related death occurred. The incidence of renal dysfunction was higher in the IPHC group, but all patients recovered without hemodialysis. Conclusion: IPHC is a safe procedure that improves the survival prognosis for AGC patients with serosal invasion. It is especially beneficial for patients without peritoneal metastasis due to the reduction of postoperative peritoneal recurrence.
Multivariate and Univariate Analysis of Prognostic Factors following Resection in HCC: The Birmingham Experience
Authors: John Abraham R. , Khan Saboor , Mirza Darius F. , Mayer A. David , Buckels John A.C. , Bramhall Simon R.
Published: June 2006

Background: The aim of this study was to look into our experience of resection for hepatocellular carcinomas (HCCs) in a tertiary Hepatobiliary and Liver Transplant Unit in the UK. Methods: A retrospective analysis of our prospective database was carried out. Results: 715 cases of HCC were seen. 100 (13.9%) underwent hepatic resection and 159 (22.2%) orthotopic liver transplant. The 1-, 3- and 5-year overall survival following resection was 75.3, 37.0 and 21.5% respectively. Factors affecting long-term survival included resection margin (p < 0.001), recurrence (p < 0.007), α-fetoprotein >50 (p < 0.001) and serum albumin (p < 0.03). On multivariate analysis, recurrence (p < 0.001) and histological grade (p < 0.044) were significant. The 1- and 3-year recurrence rates were 27.3 and 72.5% respectively. Histological grade (p < 0.007), α-fetoprotein >50 (p < 0.033), female gender (p < 0.016) and portal vein involvement (p < 0.016) were significant in recurrence. Conclusions: Resection data from the East may not be comparable to the West owing to the higher transplant activity in the latter. Liver function tests and imaging would be sufficient to assess liver function prior to hepatic resection. HCC with cirrhosis should be assessed by a transplant unit prior to any treatment. The MELD (Model for End-Stage Liver Disease) score would be a valuable preoperative tool in the assessment of cirrhotics.
A Functional Polymorphism in the Promoter Region of the Monoamine Oxidase A Gene Is Associated with the Cigarette Smoking Quantity in Alcohol-Dependent Heavy Smokers
Authors: Wiesbeck Gerhard A. , Wodarz Norbert , Weijers Heinz-Gerd , Dürsteler-MacFarland Kenneth M. , Wurst Friedrich-M. , Walter Marc , Boening Jobst
Published: June 2006

Tobacco smoking represents a leading cause of morbidity and mortality with a strong dose-response relation between the amount of smoking and the risks of tobacco-related diseases and death. The quantity that is smoked is determined predominantly by genetic factors. The present study examined whether there is an association between the quantity of cigarettes smoked and length variation of a functional 30-bp repeat polymorphism in the promoter region of the monoamine oxidase A (MAO-A) gene. The number of 30-bp repeats, which is associated with enzyme activity was assessed in 121 Caucasian men suffering from both alcohol and tobacco dependence. Analysis revealed that the highly active long allele (4 repeat) is associated with a significantly greater amount of cigarette smoking in comparison with the less active short allele (3 repeat). In a logistic regression model (dichotomized), smoking quantity was significantly predicted by MAO-A genotype while no other variable (age, height, body weight, frequency of smoking, quantity and frequency of alcohol consumption) met the significance level. Since tobacco smoke is a potent inhibitor of MAO-A, this result could be regarded as a genotype-related dosage effect. Taken together, in alcohol-dependent heavily smoking men there is evidence for a MAO-A gene-associated effect on the quantity that is smoked as reflected by the daily number of cigarettes consumed.
Differential Regulation of the Left and Right Coronary Arteries of Swine
Authors: Crespo Maria J. , Quidgley José , Dunbar Donald C.
Published: June 2006

Coronary artery disease is one of the leading causes of myocardial infarction. Despite the predominant role of the coronary arteries in the induction of myocardial infarction, the precise contribution of each artery to this process is not well established. The present work evaluates the histological characteristics and functional properties of the left (LCA) and right (RCA) coronary arteries in swine in order to establish if the arteries are differentially regulated. To investigate this possibility, concentration-response curves for serotonin (5-HT, from 0.1 nmol/l to 100 µmol/l) and KCl (from 5 to 40 mmol/l) were performed on both arteries to determine the receptor-dependent and independent responses, respectively. The specific subtype of the 5-HT receptor involved in the contraction of both arteries was evaluated using DL-propranolol hydrochloride (5-HT1 and nonselective β-adrenergic receptor antagonist) and ketanserine (5-HT2 antagonist) and immunohistochemical assays. The Emax from the 5-HT concentration-response curves was 24% higher in the LCA than in the RCA (n = 59, p < 0.05). EC50 values from both curves were also significantly different (LCA 0.150 ± 0.005 µmol/l and RCA 0.171 ± 0.010 µmol/l, n = 59, p < 0.05). Similarly, the Emax for KCl was 36% higher in the LCA than in the RCA (n = 9, p < 0.05), and the EC50 values also differed (LCA 15.30 ± 0.06 mmol/l and RCA: 14.30 ± 0.11 mol/l, n = 9, p < 0.05). Ketanserine reduced the Emax by 63% in the LCA and by 67% in the RCA. DL-propranolol hydrochloride decreased Emax by 24% in the LCA and by 26% in the RCA. The dry weight and media area were larger in the LCA than in the RCA (17%, n = 40, p < 0.05, and 3%, n = 40, p < 0.05, respectively). Immunohistochemical assay results reveal that the average density of 5-HT2A receptor subtype was also higher in the LCA (41.24 ± 1.35) than in the RCA (18.49 ± 1.14; n = 20, p < 0.05). Together, the findings of this study suggest that a differential physiological regulation exists between the LCA and RCA in swine. This differential regulation may have arisen as a mechanism for maintaining an adequate perfusion pressure in the wall of the left ventricle, favoring a greater oxygen delivery to match the increased oxygen demand of the left ventricle.
Screening for Pax8 Mutations in Patients with Congenital Hypothyroidism in South-West Germany
Authors: Lanzerath Kirsten , Bettendorf Markus , Haag Christine , Kneppo Caroline , Schulze Egbert , Grulich-Henn Jürgen
Published: June 2006

Aims: To study the frequency of mutations in the Pax8 gene in a cohort of patients with congenital hypothyroidism (CH) in South West Germany. Methods: A cohort of 95 patients with CH (60 females, 35 males), identified in our newborn screening program, was analyzed for mutations in Pax8 by single-stranded conformational polymorphism (SSCP) and DNA sequencing. Results: SSCP analysis and direct sequencing of exon 3 of a female patient with a hypoplastic thyroid gland revealed two heterozygous mutations in Pax8 resulting in a transition of T to C (codon 34) and G to A (codon 35), replacing isoleucine by threonine and valine by isoleucine. Using allele-specific PCR we could demonstrate that both mutations are located on the same allele. Furthermore, a polymorphism was documented in 24 patients with thyroid hypoplasia in intron 6 at nucleotide +51 (CC, GG, CG). Comparison of the polymorphisms between hypothyroid patients and controls revealed no significant differences suggesting that this polymorphism does not play a role in the pathogenesis of hypothyroidism. No further mutations or polymorphisms were found in the cohort. Conclusions: These findings confirm the contribution of mutations in the Pax8 gene to the etiology of thyroid dysgenesis with a variable penetrance, but also demonstrate the rare overall incidence in CH.
Urinary Proteome of Steroid-Sensitive and Steroid-Resistant Idiopathic Nephrotic Syndrome of Childhood
Authors: Woroniecki Robert P. , Orlova Tatyana N. , Mendelev Natasha , Shatat Ibrahim F. , Hailpern Susan M. , Kaskel Frederick J. , Goligorsky Michael S. , O’Riordan Edmond
Published: June 2006

The response to steroid therapy is used to characterize the idiopathic nephrotic syndrome (INS) of childhood as either steroid-sensitive (SSNS) or steroid-resistant (SRNS), a classification with a better prognostic capability than renal biopsy. The majority (∼80%) of INS is due to minimal change disease but the percentage of focal and segmental glomerulosclerosis is increasing. We applied a new technological platform to examine the urine proteome to determine if different urinary protein excretion profiles could differentiate patients with SSNS from those with SRNS. Twenty-five patients with INS and 17 control patients were studied. Mid-stream urines were analyzed using surface enhanced laser desorption and ionization mass spectrometry(SELDI-MS). Data were analyzed using multiple bioinformatic techniques. Patient classification was performed using Biomarker Pattern SoftwareTM and a generalized form of Adaboost and predictive models were generated using a supervised algorithm with cross-validation. Urinary proteomic data distinguished INS patients from control patients, irrespective of steroid response, with a sensitivity of 92.3%, specificity of 93.7%, positive predictive value of 96% and a negative predictive value of 88.2%. Classification of patients as SSNS or SRNS was 100%. A protein of mass 4,144 daltons was identified as the single most important classifier in distinguishing SSNS from SRNS. SELDI-MS combined with bioinformatics can identify different proteomic patterns in INS. Characterization of the proteins of interest identified by this proteomic approach with prospective clinical validation may yield a valuable clinical tool for the non-invasive prediction of treatment response and prognosis.
Association of Weather Conditions with Childhood Admissions for Wheezy Bronchitis or Asthma in Athens
Authors: Priftis Kostas N. , Paliatsos Athanasios G. , Panagiotopoulou-Gartagani Polytimi , Tapratzi-Potamianou Polyxeni , Zachariadi-Xypolita Asimina , Nicolaidou Polyxeni , Saxoni-Papageorgiou Photini
Published: June 2006

Background: The association between asthma morbidity and meteorological conditions is well documented, but it is not clear to what extent more specific meteorological variables are implicated. Objectives: This study was aiming to investigate whether there is any association between specific meteorological conditions and the seasonal variation and the rate of asthma admissions among children in Athens. Methods: Data were obtained retrospectively from hospital registries of the three main Children’s Hospitals in Athens during a 23-year period (1978–2000). The meteorological database consisted of mean monthly values of eight meteorological variables. The whole period studied was divided into three time periods: 1978–1987, 1988–1993 and 1994–2000. Results: A clear seasonal trend with a permanent pattern was detected. There were more monthly asthma admissions in winter-spring and autumn for younger children, as well as a lower peak in winter and autumn and a major one in May for older children, without significant differences in between the three time periods. The results of a multiple regression analysis revealed that relative humidity and atmospheric pressure were predictors of up to 56.7% (1988–1993) and 59.2% (1994–2000) monthly asthma admissions among younger children. No relation of the time trend in asthma admissions during the periods studied for any age group with any of the meteorological variables was detected. Conclusions: Our results indicate a constant seasonal variability in asthma admissions among children in Athens, whereas relative humidity and atmospheric pressure are the more implicated meteorological variables for younger asthmatic children.