bluuebunny/crossref_metadata_2025 huggingface dataset:
Quantitative analysis of trophoblast invasion in preeclampsia
Authors: Naicker Thajasvarie , Khedun Shaun M. , Moodley Jagidesa , Pijnenborg Robert
Published: December 2004

Background.  The process of physiological conversion of spiral arteries is dependent on the invasion of the interstitium and spiral arteries of the uterine wall by invasive extravillous trophoblast thereby creating a high flow–low resistance vessel. Quantitative data on restriction of trophoblast invasion and failure of spiral artery transformation are limited in preeclampsia.

Aim.  This study morphometrically analyzes interstitial trophoblast cells and trophoblast cells embedded in the wall of the converted spiral arteries within the decidua and myometrium of normotensive and preeclamptic Black African pregnant women.

Methods.  Placental bed biopsies were obtained from 25 normotensive pregnant women and 30 pregnant women complicated with hypertensive disorders. Biopsies were processed and immunostained for trophoblast cell identification, using anti‐MNF 116 antibody. Image analysis of the trophoblast population within the decidua, myometrium and the spiral arteries was performed in the normotensive and in the severe proteinuric hypertensive groups.

Results.  The mean field area percentage of trophoblast cells observed in the decidua of the normotensive women was 22.79 ± 2.1% in comparison to 18.14 ± 1.53% in the severe hypertensive group (p < 0.01). In the myometrium, the mean field area percentage of interstitial trophoblast cells (both mononuclear and multinuclear) was 10.04 ± 2.1% of the field area of the normotensive group compared to 2.81 ± 0.67% in the severe hypertensive group (p < 0.001). The mean field area percentage occupied by trophoblast cells in myometrial spiral arteries was 10.15% in the normotensive group compared to none in the severe hypertensive group. The latter group displayed medial disorganization, hyperplasia and endothelial vacuolation.

Conclusion.  This study demonstrates restricted invasion of the trophoblastic cells in preeclampsia. This inadequate invasion may influence vascular remodeling required for delivering adequate volumes of maternal blood to the placenta.
Typing of human papillomavirus in Zimbabwean patients with invasive cancer of the uterine cervix
Authors: Stanczuk Grazyna A. , Kay Patti , Sibanda Elopy , Allan Bruce , Chirara Mike , Tswana Sam A. , Bergstrom Staffan , Williamson Anna‐Lise
Published: December 2004

Background.  Cervical cancer affects 1 in 2000 Zimbabwean women. We investigated the type‐specific distribution of human papillomavirus (HPV) infection in Zimbabwean women with invasive cervical cancer.

Methods.  We conducted a descriptive study on 98 women with invasive cervical cancer. The methods used were a nested polymerase chain reaction (PCR) for amplification of HPV‐DNA and restriction fragment length polymorphism (RFLP) to characterize the HPV types.

Results.  HPV‐DNA was identified in 97% of the cases. HPV types 16, 33, 18 and 31 were identified in 61%, 39%, 18% and 4% of the patients, respectively. We typed one case each of HPV types 35 and 58. Multiple HPV infections were present in 24%. All patients (n = 3) with adenocarcinoma of the cervix were infected with the HPV. Patients infected with HPV‐16 alone presented at a median age of 46 years while those infected with HPV‐33 alone presented at 43 years. However, patients coinfected with both HPV‐16 and HPV‐33 were between 10 and 13 years older (median age of 56 years) than patients with either HPV‐16 or HPV‐33 as single infections. These differences were marginally significant (p = 0.08) or significant (p = 0.02), respectively.

Conclusion.  We present the first prevalence data on HPV types in patients with cervical cancer in Zimbabwe and show that, provided appropriate techniques are employed, HPV infection can be identified in a majority of the patients. The distribution of HPV types should be taken into consideration in tailoring locally relevant vaccines against HPV.
Detection of connective tissue growth factor (CTGF) in human tear fluid: preliminary results
Authors: Van Setten G. B. , Blalock Timothy D. , Grotendorst Gary , Schultz Gregory S.
Published: December 2004

Purpose:  Connective tissue growth factor (CTGF) is one of the main regulators of fibrosis. We aimed to evaluate its presence in the human tear fluid of healthy individuals.

Methods:  A total of 70 tear fluid samples were collected from eight volunteers prior to and after stimulation of reflex tears with onion vapour. Specific ELISA analysis was performed with goat IgG against human CTGF.

Results:  Connective tissue growth factor was detected in seven samples (10%), with maximum levels of 17 ng/mL in basal tears. Induction of reflex tearing resulted in a fast and significant decrease of CTGF concentrations (r = − 0.95). No CTGF was detected in 90% of the samples.

Conclusion:  Connective tissue growth factor may occur in tear fluid in healthy human eyes. This indicates a possible role for tear fluid CTGF in ocular surface fibrosis and wound healing.
Astigmatic axis and amblyopia in childhood
Authors: Abrahamsson Maths , Sjöstrand Johan
Published: December 2004

Purpose:  This study is part of a larger project whose aim is to evaluate the relationship between refractive errors and amblyopia. In an earlier study, we showed that there is a substantial increase in the prevalence of amblyopia among children with oblique astigmatism. To further evaluate this relationship, we examined children with astigmatisms of 1 dioptre or more and varying directions of the astigmatic axes.

Methods:  Two groups of astigmatic children, with oblique and orthogonal astigmatism, respectively, were selected for the study at 1 year of age via a general health screening programme. The most emmetropic axis was identified in each child and used in the study. Visual acuity (VA) was tested when the children were between 4 and 4.5 years of age. The presence of amblyopia, defined as difference in VA between the eyes of 0.1 log unit or more, and any increase in acuity following occlusion therapy were noted.

Results:  The angle of the astigmatic axis strongly relates to the risk of developing amblyopia. Axes ± 15 degrees from the main axes did not affect the risk of amblyopia but oblique astigmatism significantly increased the risk of developing amblyopia (p = 0.0024).

Conclusions:  The results accord with earlier findings that oblique astigmatism increases the risk of developing amblyopia.
Modified pulsed‐field gel electrophoresis protocol for typing of enterococci
Authors: SAEEDI BAHARAK , HÄLLGREN ANITA , JONASSON JON , NILSSON LENNART E. , HANBERGER HÅKAN , ISAKSSON BARBRO
Published: December 2004

Controlling the spread of vancomycin‐resistant enterococci (VRE) is an important task in hospital epidemiology. Pulsed‐field gel electrophoresis (PFGE) has become the golden standard for molecular epidemiological characterisation of enterococcal isolates. For separation of DNA fragments by PFGE, different electrophoresis conditions have been recommended, but none of these protocols allows a satisfactory separation of both small and large DNA fragments of enterococci simultaneously. In this study we have speeded up the preparation of chromosomal DNA and defined new electrophoresis conditions that enhance separation of small and large DNA fragments for subtyping of enterococci with a 24 h PFGE.
Reasons for pregnancy termination, contraceptive habits and contraceptive failure among Swedish women requesting an early pregnancy termination
Authors: Larsson Margareta , Aneblom Gunilla , Odlind Viveca , Tydén Tanja
Published: December 2004

Background. More than 30 000 legal abortions are performed every year in Sweden despite sexual education in schools, widespread youth‐clinics and family planning services that are free of charge. The aim of this study was to investigate reasons for induced abortion, contraceptive habits and reasons for contraceptive failure among women presenting for induced abortion.

Methods. A questionnaire was administered to 591 Swedish‐speaking women consecutively attending three different health care providers concerning an induced abortion during spring 2000.

Results. The response rate was 88% (n = 518). As many as 43%, among daily smokers 53%, had experienced one or more previous legal abortions. The majority of the women (97%) had discussed the decision about abortion with someone. The most cited reasons contributing to their decision were financial concerns, worries about the relationship and bad timing of the pregnancy. Though 85% had used contraception during the previous year, 36% of the women had not used any contraceptive method at the time of conception. The main reason given for not using contraception was the belief that they could not at that time become pregnant (35%). Ninety percent of the women planned to use contraception after the abortion.

Conclusion. Women's decisions regarding induced abortion are multifactorial. One important reason was ‘poor economy’. One out of three did not use any contraception, as they believed they could not become pregnant. Women presenting for induced abortion are a risk‐group for further terminations. Counseling must include information about the fertile window, effective contraceptives and the emergency contraceptive pill.
The role of sonographic assessment of cervical length in the prediction of preterm birth in primigravidae with twin gestation conceived after infertility treatment
Authors: Soriano David , Weisz Boaz , Seidman Daniel S. , Chetrit Angela , Schiff Eyal , Lipitz Shlomo , Achiron Reuven
Published: December 2004

Objective. To identify the risk factors for preterm birth in primigravidae with twin gestation and the role of transvaginal ultrasonographic assessment of the cervix.

Methods. Between January 1996 and December 1996, 54 twin pregnancies were prospectively enrolled. All women were at their first pregnancy. All women conceived following infertility treatments and all had a normal uterine cavity proven by hysterosalpingography (HSG) or hysteroscopy. Multiple logistic regression analysis was used to evaluate the association between the length of the cervix at 18–24 weeks of gestation and outcome variables, controlling for possible confounding factors.

Results. The mean ± SD maternal age was 30.9 ± 5.3 years (range 22–46), and five of them were aged 40 or more. Nine patients (20.5%) delivered prematurely, defined as spontaneous delivery at or before 34 weeks of gestation. There was no statistically significant difference between women who delivered before or after 34 weeks of gestation in regard to maternal age, body mass index (BMI), weight gain in pregnancy, smoking and work during pregnancy. The mean cervical length of patients who delivered before 34 weeks of gestation (30.1 ± 6.1 mm) was significantly shorter than that of women who delivered after 34 weeks of gestation (42.2 ± 6.2 mm; P < 0.001). Cervical length longer than 35 mm predicted delivery after 34 weeks of gestation with sensitivity and specificity of 88.5% and 88.9%, respectively. The positive and negative predictive values were 96.9% and 66.7%.

Conclusion. A transvaginal ultrasonographic measurement of the cervix > 35 mm at 18–24 weeks in twin gestation can identify patients at low risk for delivery before 34 weeks. Maternal age, BMI, weights gain, smoking and work during the pregnancy did not influence the duration of the pregnancy.
Is it possible to recommend an ‘optimal’ postoperative management after hysteroscopic metroplasty? A retrospective study with 52 infertile patients showing a septate uterus
Authors: Nawroth Frank , Schmidt Torsten , Freise Claudia , Foth Dolores , Römer Thomas
Published: December 2004

Background. The aim of the retrospective study was to evaluate the ‘optimal’ postoperative management after hysteroscopic metroplasty.

Methods. Fifty‐two  infertile patients with a septate uterus were included. Hysteroscopic metroplasty was performed using electrocautery (dissection needle) with postoperative cyclical hormone replacement therapy (HRT) + intrauterine device (IUD) insertion for 3 months (Group 1, n = 22), or HRT alone for 3 months (Group 2, n = 13), or without postoperative therapy (Group 3, n = 17).

Results. During a median follow‐up of 21±16.9 months 40.9% in Group 1, 53.8% in Group 2 and 41.2% in Group 3 (p > 0.05) resulted in ongoing pregnancies. The rates of delivery at term were 53.3%, 64.4% and 88.9%, respectively.

Conclusions. A postoperative 3‐months HRT + IUD insertion or a HRT alone after hysteroscopic metroplasty are not necessary.
Oestrogen receptor β is expressed in adult human skeletal muscle both at the mRNA and protein level
Authors: Wiik A. , Glenmark B. , Ekman M. , Esbjörnsson‐Liljedahl M. , Johansson O. , Bodin K. , Enmark E. , Jansson E.
Published: December 2004

Aim: 
There are two known oestrogen receptors (ER), oestrogen receptor α (ERα) and the recently cloned oestrogen receptor β (ERβ). ERα mRNA has been detected in mouse, rat, bovine and human skeletal muscle. ERβ mRNA has been detected in bovine skeletal muscle. To our knowledge, no study has investigated the expression of oestrogen receptor β in human skeletal muscle. Therefore, the primary aim of the present investigation was to study ERβ mRNA and protein expression in human skeletal muscle. In addition the ERα expression was also studied.

Methods:  Muscle biopsies were taken from vastus lateralis in six healthy adults (three women and three men). mRNA expression was detected with real‐time PCR (TaqMan) and protein localization by immunohistochemistry.

Results:  A clear expression of ERα and ERβ mRNA was seen in skeletal muscle in all subjects. The ERα mRNA expression was 180 fold higher compared with that of ERβ mRNA. Immunohistochemistry demonstrated positive staining for ERβ, but not for ERα, with localization to the nuclei of skeletal muscle fibres. On average, 70% of all nuclei were ERβ‐positive.

Conclusion:  The present study shows for the first time ERβ mRNA and protein expression in human skeletal muscle tissue in both males and females.
Myocardial vasoactive intestinal peptide and fibrosis induced by nitric oxide synthase inhibition in the rat
Authors: Ye V. Z. C. , Hodge G. , Yong J. L. C. , Duggan K. A.
Published: December 2004

Aims:  In both normotensive and hypertensive rats, the degree of myocardial fibrosis is inversely correlated with the concentration of vasoactive intestinal peptide (VIP) in the myocardium. Treatment with nitric oxide (NO) synthase inhibitors also causes myocardial fibrosis. In this study, we sought to determine whether the myocardial fibrosis induced by treatment with the NO synthase inhibitor N(G)‐nitro‐l‐arginine methyl ester (l‐NAME) was also associated with depletion of VIP in the myocardium.

Methods:  Male Wistar Kyoto (WKY) and spontaneous hypertensive rats (SHR) rats treated with l‐NAME were randomized to low, intermediate or high salt content diets. After 4 weeks, the hearts were harvested, the degree of fibrosis quantified and VIP concentration measured.

Results:  In WKY, systolic blood pressure increased with increasing dietary sodium (P < 0.05). Myocardial fibrosis also increased with increasing dietary sodium (P < 0.005). Myocardial VIP concentration decreased with increasing dietary sodium (P < 0.025). In contrast, in the SHR treated with l‐NAME, systolic blood pressure increased but the increase was not affected by sodium intake. Further, myocardial fibrosis and myocardial VIP were unchanged by increased dietary sodium. Higher doses of l‐NAME in the SHR did not increase the systolic blood pressure, increase the degree of myocardial fibrosis or decrease the myocardial concentration of VIP. These differences in myocardial VIP concentration may reflect differing effects of l‐NAME on VIP metabolism, as l‐NAME increased VIP metabolism in the WKY (P < 0.05) but did not change VIP metabolism in the SHR.

Conclusions:  We conclude that depletion of VIP in the myocardium is associated with increasing myocardial fibrosis in l‐NAME treated WKY. As VIP depletion occurs in other models of myocardial fibrosis, it appears to be a common mechanism. Myocardial VIP depletion may therefore be a new and important factor in the pathogenesis of cardiac fibrosis.
Non‐invasive assessment of cardiac output during exercise in healthy young humans: comparison between Modelflow method and Doppler echocardiography method
Authors: Sugawara J. , Tanabe T. , Miyachi M. , Yamamoto K. , Takahashi K. , Iemitsu M. , Otsuki T. , Homma S. , Maeda S. , Ajisaka R. , Matsuda M.
Published: December 2004

Aims:  The Modelflow method can estimate cardiac output from arterial blood pressure waveforms using a three‐element model of aortic input impedance (aortic characteristic impedance, arterial compliance, and systemic vascular resistance). We tested the reliability of a non‐invasive cardiac output estimation during submaximal exercise using the Modelflow method from finger arterial pressure waveforms collected by Portapres in healthy young humans.

Methods:  The Doppler echocardiography method was used as a reference method. Sixteen healthy young subjects (nine males and seven females) performed a multi‐stage cycle ergometer exercise at an intensity corresponding to 70, 90, 110 and 130% of their individual ventilatory threshold for 2 min each. The simultaneous estimation of cardiac output (15 s averaged data) using the Modelflow and Doppler echocardiography methods was performed at rest and during exercise.

Results and Conclusion:  The Modelflow‐estimated cardiac output correlated significantly with the simultaneous estimates by the Doppler method in all subjects (r = 0.87, P < 0.0001) and the SE of estimation was 1.93 L min−1. Correlation coefficients in each subject ranged from 0.91 to 0.98. Although the Modelflow method overestimated cardiac output, the errors between two estimates were not significantly different among the exercise levels. These results suggest that the Modelflow method using Portapres could provide a reliable estimation of the relative change in cardiac output non‐invasively and continuously during submaximal exercise in healthy young humans, at least in terms of the relative changes in cardiac output.
Mechanisms of NH4+ and NH3 transport during hypokalemia
Authors: Wall S. M.
Published: December 2004

Along the collecting duct, secretion of ammonium (NH) is thought to occur through active H+ secretion in parallel with the non‐ionic diffusion of ammonia (NH3). Thus NH3 is secreted into the collecting duct lumen down its concentration gradient. Moreover, the low NH permeability and high NH3 permeability observed in collecting duct epithelia minimizes back diffusion of NH. In general, an increase in the NH3 concentration gradient between the interstitium and the collecting duct lumen correlates with increased NH secretion. However, our laboratory and others have shown an important role of direct NH transport by the Na,K‐ATPase. As K+ and NH compete for a common extracellular binding site on the Na,K‐ATPase, reduced interstitial K+ concentration, such as during hypokalemia, augments NH uptake. Na,K‐ATPase‐mediated NH uptake provides an important source of H+ for net acid secretion during hypokalemia and contributes to the increase in NH excretion and metabolic alkalosis observed in this treatment model.
Human motor compensations for thixotropy‐dependent changes in resting wrist joint position after large joint movements
Authors: Axelson H. W. , Hagbarth K.‐E.
Published: December 2004

Aim:  Resting tension of relaxed skeletal muscle fibres held at a given length varies with the immediate previous history of length changes and contractions. The primary aim of this study was to explore the motor control consequences of this history‐dependency in healthy subjects.

Methods:  Angular position and passive torque were recorded from the intact wrist joint. Integrated surface electromyography (IEMG) was recorded from wrist extensor and flexor muscles.

Results:  In relaxed subjects, wrist joint position was displaced towards dorsiflexion after a single high‐amplitude dorsiflexion movement combined with a strong flexor/extensor co‐contraction (dorsiflexion conditioning), whereas after volarflexion conditioning there was a shift towards volarflexion. These after‐effects could be abruptly cancelled by short periods (∼5 s) of rapid flapping hand movements or forceful isometric co‐contractions, findings indicative of muscle thixotropy. The IEMG‐evaluated motor after‐effects were as follows. A slowly subsiding wrist flexor contraction was needed to restore and maintain the original resting wrist position after dorsiflexion conditioning whereas a slowly subsiding extensor contraction was needed for the same goal after volarflexion conditioning. Furthermore, ongoing wrist extensor IEMG activity required to actively hold the wrist in a moderate dorsiflexed position or to resist a constant volar torque at resting position was temporarily reduced after dorsiflexion conditioning and enhanced (not significantly) after volarflexion conditioning.

Conclusion:  The results provide evidence that during voluntary maintenance of a desired wrist joint position the motor commands to the position‐holding muscles are unconsciously adjusted to compensate for thixotropy‐dependent variations in the resting tension of the muscles.
Increased tissue survival in experimental skin flaps in mast cell‐deficient rats
Authors: Guo Y. , Törkvist L. , Raud J. , Hedqvist P.
Published: December 2004

Aim:  The role of mast cells and their principal mediator, histamine, in surgical skin flap survival was investigated using mast cell‐deficient (Ws/Ws); their congenic littermates wild‐type (+/+), and Wistar rats.

Methods:  A standardized dorsal skin flap was raised and sutured back into position, and 6 days later the percentage of flap survival was assessed. Moreover, endogenous histamine concentration in the dorsal skin during the surgical preparation was determined using in vivo microdialysis technique together with high performance liquid chromatography‐fluorometry. Accumulation of skin flap myeloperoxidase (MPO) (reflecting leucocyte recruitment) was determined spectrophotometrically.

Results:  The experimental skin flaps in genetically mast cell‐deficient rats exhibited increased tissue survival and showed little accumulation of MPO and rather low and stable level of histamine output in comparison with skin flaps in the wild‐type (+/+) littermates or normal Wistar rats. Antihistamine treatment inhibited but did not prevent leucocyte recruitment in the skin flaps post‐surgery in +/+ and Wistar rats.

Conclusion:  It is suggested that mast cell derived histamine plays an important role in leucocyte recruitment in skin flaps. However, mast cell‐independent factors should be taken into consideration and needs further investigation as even in mast cell‐deficient animals there was some accumulation of leucocytes and tissue necrosis in the skin flaps post‐surgery.
Effect of the cytoskeletal fixation agent phalloidin on transcapillary albumin transport and interstitial fluid pressure following subdermal prostaglandin E1 administration in the rat
Authors: Brønstad A. , Reed R. K. , Berg A.
Published: December 2004

Aim: 
Lowering of interstitial fluid pressure (Pif) facilitates fluid filtration across the capillary membrane and oedema formation in acute inflammation. The cellular mechanism behind this lowering of Pif involves β1‐integrins mediating contact between dermal cells and the extracellular matrix fibres, and also the cell cytoskeleton as disruption of actin filaments using cytochalasin‐D induced a lowering of Pif and oedema formation. Fixation of actin with phalloidin attenuates oedema formation and abolishes lowering of Pif in anaphylaxis in the rat. The objective of this study was to determine whether phalloidin modifies lowering of Pif and albumin extravasation in rat skin also after prostaglandin E1 (PGE1).

Methods:  P
if was measured using micropipettes connected to a servo‐controlled counterpressure system. Microvascular permeability was estimated as the albumin extravasation (Ealb) using radiolabelled human serum albumin.

Results:  Subdermal injection of PGE1 (0.85 mg mL−1) lowered Pif from −0.8 ± 0.8 mmHg (SD) in control to −3.5 ± 0.9 mmHg (P < 0.05) within 30 min. Pre‐treatment with phalloidin (500 μg kg−1) before PGE1 resulted in Pif of −1.7 ± 1.0 mmHg (P < 0.05 compared with PGE1). Ealb after subdermal saline was 0.07 ± 0.04 mL g−1 DW and increased to 0.32 ± 0.32 mL g−1 DW with PGE1 (P < 0.05) but was unaffected by pre‐treatment with phalloidin given before PGE1 0.32 ± 0.35 mL g−1 DW (P > 0.05 compared with PGE1 alone).

Conclusion:  These results are consistent with the concept that the cytoskeleton actin filaments participate in control of Pif.
Inhibition of nitric oxide synthesis potentiates the colonic permeability increase triggered by luminal bile acids
Authors: Sun Y. , Fihn B.‐M. , Jodal M. , Sjövall H.
Published: December 2004

Aim:  Experiments were performed in anaesthetized rats to clarify the role of nitric oxide (NO) in the control of colonic permeability.

Methods:  Colonic luminal pressure, the transmucosal potential difference (PD) and the clearance of [3H] mannitol and [14C] urea from blood to lumen were measured. NO synthesis was blocked with Nω‐nitro‐l‐arginine (l‐NNA) i.v. and mucosal permeability was increased by deoxycholic acid (DCA, 4 mm). The involvement of histamine in the response was studied by giving the histamine H1 receptor blocker pyrilamine.

Results:  In proximal colon, l‐NNA per se increased luminal pressure and PD but had no significant effect on clearance. DCA per se increased luminal pressure, had no significant effect on PD, but increased mannitol and urea clearance and the clearance ratio. l‐NNA and pyrilamine both blocked the luminal pressure effect of DCA but l‐NNA had no significant effect on the clearance response to DCA. In distal colon, l‐NNA per se had no significant effect on pressure and clearance, but increased PD like in proximal colon. DCA had no significant effect on luminal pressure, but markedly reduced PD and increased both clearance and clearance ratio. In this segment, l‐NNA significantly potentiated the clearance response to DCA, and further increased clearance ratio to a value not significantly different from unity (1.00 ± 0.05).

Conclusion:  The data suggest that in vivo, moderate concentrations of bile acids increase colonic permeability in rats via a mechanism that is inhibited by NO in distal but not in proximal colon. In distal colon, NO may contribute to the maintenance of epithelial barrier function.
Evidence for intestinal oxidative stress in obstructive jaundice‐induced gut barrier dysfunction in rats
Authors: Assimakopoulos S. F. , Vagianos C. E. , Patsoukis N. , Georgiou C. , Nikolopoulou V. , Scopa C. D.
Published: December 2004

Aim:  An important factor that promotes bacterial and endotoxin translocation in obstructive jaundice is intestinal injury that causes increased permeability. However, little is known of the submicroscopic biochemical events leading to defects of the intestinal barrier. This study was undertaken to investigate the effect of experimental obstructive jaundice on intestinal lipid peroxidation, protein oxidation and thiol redox state.

Methods:  Rats were randomly divided into controls, sham operated and bile duct ligated (BDL). After 10 days, intestinal barrier function was assessed by measuring endotoxin in portal and aortic blood. Tissue samples from the terminal ileum were examined histologically and morphometrically, while other samples were homogenized for the determination of lipid peroxidation, protein oxidation and thiol redox state [reduced glutathione (GSH), oxidized glutathione (GSSG), total non‐protein mixed disulphides (NPSSR), protein thiols (PSH) and protein disulphides (PSSP)].

Results:  Obstructive jaundice compromised intestinal barrier function leading to significant portal and systemic endotoxaemia. The intestinal mucosa in jaundiced rats was atrophic with significantly decreased villous density and total mucosal thickness. Determination of biochemical parameters of oxidative stress in the intestine showed increased lipid peroxidation and protein oxidation in BDL‐rats. Thiol redox state revealed the presence of intestinal oxidative stress in jaundiced rats, indicated by a decrease in GSH and increased GSSG, NPSSR and PSSP.

Conclusions:  This study shows that experimental obstructive jaundice induces intestinal oxidative stress, which may be a key factor contributing to intestinal injury and leading to endotoxin translocation.
Immune system alteration in response to two consecutive soccer games
Authors: Malm C. , Ekblom Ö. , Ekblom B.
Published: December 2004

Aim:  Changes in leucocyte and monocyte subpopulations were investigated in 10 elite male soccer players aged 16–19 years. The purpose was to perform a descriptive study of immunological alterations in elite soccer players in response to two consecutive games separated by 20 h. It was hypothesized that in response to two games the players would show signs of short‐term immunosuppression.

Methods:  Blood samples were taken before the first soccer game, immediately after the second game and after 6, 24, 48 and 72 h. Cell surface antigens, testosterone and cortisol were investigated.

Results:  During the first 6 h after the second game there was a significant increase in number of circulating neutrophils, mature (CD20+ CD5+) B cells and CD4/CD8 ratio. A significant decrease was observed in the number of natural killer (NK) cells, monocytes and adhesion on lymphocytes and monocytes. In a delayed phase, 48 h after the second game the expression of both adhesion and signalling molecules increased on lymphocytes and monocytes. Changes in adhesion and signalling molecules at 48 h correlated negatively to the subjects VO2max, suggesting larger immunological response to similar exercise in subjects with lower aerobic exercise capacity.

Conclusion:  In response to competitive soccer exercise some immunological variables are enhanced while others are depressed. Observed changes may serve a purpose in adaptation to exercise by signalling via adhesion.
Effect of knee flexion angle on active joint stiffness
Authors: McHugh M. P. , Hogan D. E.
Published: December 2004

Aim:  The purpose of this study was to determine if active joint stiffness measured during maximum voluntary knee extension contractions was affected by knee flexion angle.

Methods:  Eighteen subjects volunteered (11 male, seven female). A stretch was imposed on isometric knee contractions performed at 30°, 50°, 70°, 90°, and 110° of knee flexion. Active joint stiffness was computed from the increase in torque relative to the change in knee flexion angle for the first 50 ms of the stretch (approximately 1.5°) and corrected for effects of gravitational component due to leg mass and passive tension.

Results:  There was a plateau in knee extension torque between 70° and 90° with lower values at all other angles (P < 0.05). Peak active joint stiffness occurred at 70° with lower values (P < 0.05) at all other angles except 50°. Stiffness at 70° (441.1 ± 189.9 Nm rad−1) was 49% higher than at 30° and 45% higher than at 110°.

Conclusion:  Active joint stiffness was dependent on knee flexion angle. Peak joint stiffness during maximal contractions occurred at, or prior to, the optimal angle for torque production for all subjects.
Arteriolar dilations induced by contraction of hamster cremaster muscle are dependent on changes in endothelial cell calcium
Authors: Murrant C. L. , Duza T. , Kim M. B. , Cohen K. D. , Sarelius I. H.
Published: December 2004

Muscle contraction initiates microvascular arteriolar dilation in regions directly overlapping the active fibres but the cells (vascular smooth muscle cells, endothelial cells) responsible for producing the dilation and the underlying signalling mechanisms are unknown.

Aims:  We tested the hypothesis that changes in endothelial cell calcium (Ca2+) are involved in this dilation.

Methods:  Four to five muscle fibres lying approximately perpendicular to arterioles (maximum diameter ∼40 μm) were stimulated (4 Hz, 4–20 V, 0.4 ms duration) and observations were made at the site of muscle fibre/arteriole overlap.

Results:  Chelation of endothelial cell Ca2+ (with BAPTA) abolished dilations to 120 s of muscle contraction (5.6 ± 1.5 μm in controls vs. 0.51 ± 1.2 μm with BAPTA, n = 6), indicating that changes in endothelial cell Ca2+ are required for the response. To determine the time frame of the Ca2+ signal, we monitored whole endothelial cell Ca2+ (with Fura‐PE3) prior to and following either 120 (n = 13), 30 (n = 9) or 10 (n = 9) s of muscle contraction. In all instances, no changes in Ca2+ were observed despite typical dilator responses.

Conclusions:  These data indicate that (i) the initiation of muscle contraction‐induced arteriolar dilations depends on a change in endothelial cell Ca2+, which must be a transient event that takes place early/during stimulation, and (ii) maintenance of the dilation after contraction occurs via mechanisms that are independent of changes in global Ca2+ within the cell.
Regulatory gene expression in skeletal muscle of highly endurance‐trained humans
Authors: Wittwer M. , Billeter R. , Hoppeler H. , Flück M.
Published: December 2004

Aim and background:  Changes in regulatory and structural gene expression provide the molecular basis for the adaptation of human skeletal muscle to endurance exercise.

Hypothesis:  The steady‐state levels of multiple mRNAs mainly involved in regulatory functions differ between highly endurance‐trained and untrained subjects in a muscle heavily recruited during the exercise.

Methods:  Biopsies from musculus vastus lateralis of seven untrained (UT) subjects [maximal oxygen consumption (VO2max) = 39 mL kg−1 min−1] and seven trained (T) professional cyclists (VO2max = 72 mL kg−1 min−1) were analysed for the contents of 597 different mRNAs using commercially available cDNA arrays (Clontech no. 7740‐1). Intra‐individual expression profiles were compared by least‐square linear regression analysis. Differences in gene expression between the two groups were tested for statistical significance using L1 regression analysis combined with the sign test on all permutations of scatter plots of log raw values from UT vs. T subjects.

Results:  Transcripts for 144 of 597 genes were sufficiently abundant to be analysed quantitatively. The expression profiles of the T group had a better intragroup correlation (R2) than those of the UT group (0.78 vs. 0.65, P < 0.05). An intergroup (T vs. UT) correlation of expression profiles gave an R2 of 0.71. Statistical analysis at a false discovery rate of 5% identified differential expression of nine cell‐regulatory genes between T and UT. The mRNA levels of eight genes, including two DNA repair enzymes, transcription factors, signal transducers, a glycolytic enzyme and a factor involved in steroid hormone metabolism were increased in T vs. UT. Conversely, the mRNA of the tumour suppressor APC was downregulated with endurance training. Selective reverse‐transcriptase polymerase chain reaction experiments confirmed the signal estimates from the array analysis.

Conclusions:  The repetitive impact of the complex exercise stimuli in professional cyclists attenuated the interindividual differences in regulatory gene expression in skeletal muscle. Long‐term nuclear reprogramming of regulatory gene expression seems to be characteristic of human musculus vastus lateralis in a highly endurance‐trained steady state.
Effects of fatigue on depolarization‐ and caffeine‐induced contractures of skinned fibres
Authors: Williams J. H.
Published: December 2004

Aims:  Fatigue has been shown to cause intrinsic alterations in sarcoplasmic reticulum (SR) Ca2+ release.

Methods:  In this investigation, frog semitendinosus muscles were stimulated to fatigue, in vitro (80 Hz, 100 ms, 1 train s−1, 5 min). Immediately after stimulation, single fibres were removed and skinned using either chemically or mechanically skinning. Contralateral muscle were treated similarly but were not stimulated.

Results:  In fatigued, saponin skinned fibres, contracture responses to low [caffeine] (4–8 mm) were depressed compared with control. However, responses to high concentrations (10–15 mm) were not different between conditions. In the fatigued, mechanically skinned fibres, responses to chloride depolarization were depressed at all [chloride] (20–100 mm) compared with control.

Conclusions:  These results suggest that fatigue causes intrinsic alterations in both the SR Ca2+ release channel as well as communication between the transverse‐tubule and the SR.
Clenbuterol treatment affects myosin heavy chain isoforms and MyoD content similarly in intact and regenerated soleus muscles
Authors: Bricout V.‐A. , Serrurier B. D. , Bigard A. X.
Published: December 2004

Aims:  Pharmacological treatment with the β2‐adrenoceptor agonist clenbuterol is known to induce a slow‐to‐fast fibre type and myosin heavy chain (MHC) isoform transition in intact muscle. This study examined the sensitivity of regenerated soleus muscle to 4 weeks of clenbuterol treatment (2 mg kg−1 day−1).

Methods:  Female Wistar rats were divided into two groups: vehicle treated (n = 8) and clenbuterol treated (n = 8). The clenbuterol effects on MHC and MyoD expression were examined in soleus muscles either intact, or previously degenerated by venom of the Notechis scutatus scutatus snake.

Results:  Post‐treatment body weights and skeletal muscle weights were not affected by clenbuterol treatment. Muscle protein concentration was higher, and body fat lower in clenbuterol‐treated rats than in vehicle‐treated animals (P < 0.05). Polyacrylamide gel electrophoresis of soleus myofibrillar protein indicated a clenbuterol‐induced decrease in the relative percentage of type I MHC with a concomitant increase in type IIa MHC (31%, P < 0.001). No degeneration effect was observed after 28 days of recovery on the MHC isoform content, and regenerated soleus muscles exhibited the same phenotypical profile as intact soleus muscles, whether or not they were treated with clenbuterol. In intact and in regenerated soleus muscles, MyoD protein levels were significantly increased by clenbuterol treatment (90 and 77%, respectively, P < 0.001).

Conclusion:  These results show that regenerated soleus muscles, comprising a homogeneous population of fibres deriving from satellite cells, have a similar response to clenbuterol as intact muscle arising from at least two discrete populations of myotubes; it is suggested that the activity of signalling pathways involved in the effects of clenbuterol on MHC transitions is not related to the developmental history of myofibres.
Medical Practitioners and Their Families as Patients
Authors: Williams Anne Sved
Published: December 2004

Objective: To explore diagnoses, treatment methods, compliance and outcome in a cohort of medical practitioners and their families seen in a private practice setting to identify characteristics of this group.

Methods: A systematic retrospective case-note review was conducted of all medical practitioners, their partners and children seen in a private practice setting over 15 years, documenting mode of referral, diagnosis, attendances, mode of treatment, and outcome.

Results: Seventy-seven medical families were identified, including 45 doctors, 21 partners and 11 offspring as the primary patient; 38 of the doctor group were self-referred. Doctors and their families were likely to accept treatment guidelines as recommended and to continue until a joint decision was made to terminate.

Conclusions: Doctors presenting themselves for treatment in a private practice are a highly motivated and compliant group, who make significant changes in therapy. They defy directly the usual findings on ‘impaired physicians’ who may be a different group, the latter generally being referred for psychiatric treatment as ‘impaired physicians’ through statutory bodies such as medical boards. With increasing de-stigmatization and increasing education on the benefits of self-care, doctors may be seeking appropriate early intervention.
Consumer and Service Determinants of Completion of a Consumer Self-Rating Outcome Measure
Authors: Trauer Tom
Published: December 2004

Objective: To study the relative contribution of consumer, clinician and service factors to whether or not consumers completed a self-rating measure in the context of routine outcome measurement.

Methods: Four Victorian mental health services commenced routine outcome measurement in their adult services in mid-2000. Clinician-completed measures (Health of the Nation Outcome Scales (HoNOS) and Life Skills Profile (LSP)) and a consumer self-rated measure (Behaviour and Symptom Identification Scale (BASIS)) were entered into specialized software. Analyses were restricted to assessments conducted at review in the community.

Results: Wide differences were observed between the four agencies in the rates of completion of the self-rating measure. Overall, consumer characteristics associated with greater likelihood of completion were lower age, non-organic diagnosis, lesser severity as measured by the HoNOS, and lesser disability as measured by the LSP. A more focused analysis showed that agency, lower age, and higher compliance were most reliably associated with completion. Significant proportions of clinicians had no recorded instances of consumer self-rating associated with their assessments.

Conclusions: Service and clinician factors appear to be equally important as consumer factors in whether or not a self-rating measure was completed. Information systems designed for outcomes measurement should include indications of whether or not a self-rating was invited, and, if not, why not. The results suggest that consumer self-rating is not yet firmly established in the outcomes measurement culture.
Job Satisfaction and Burnout in Mental Health Services for Older People
Authors: Spear Jonathan , Wood Leanne , Chawla Sudarshan , Devis Antony , Nelson Jim
Published: December 2004

Objective: The objective of the present paper was to identify factors associated with job satisfaction and burnout among staff working in mental health services for older people.

Methods: A postal survey was distributed to staff members from eight mental health services for older people in Western Australia. Staff focus groups identified causes of work stress.

Results: The response rate was 33% (116/349). Teamwork, social support and clear roles had a positive effect on job satisfaction. Community staff members had higher job satisfaction than ward staff. Nurses reported higher burnout and lower job satisfaction than other mental health professionals. Staff members working in newer models of service delivery had higher job satisfaction than those working in more traditional models.

Conclusion: Surveys and focus groups were an effective means of identifying factors associated with job satisfaction in mental health staff members. Newer models of service delivery with team building and supportive management may improve the workplace for staff.
Relevance of Sleep Paralysis and Hypnic Hallucinations to Psychiatry
Authors: Gangdev Prakash
Published: December 2004

Objective: To describe a patient who presented with psychopathology in the wake of sleep paralysis and hypnopompic hallucinations, and to discuss the importance of these phenomena to psychiatric diagnoses.

Methods: Case report.

Results: A 25-year-old black South African woman developed paranoid beliefs and a sad and anxious mood in the wake of her first experience of sleep paralysis and hypnic hallucinations. She had no history of other sleep-related events. Reassurance, explanation of the physiological basis of her experience, and a short course of low-dose diazepam were provided. Her mood and sleep improved promptly and she no longer held paranoid beliefs. She did not experience further episodes of sleep paralysis or hypnic hallucinations and improvement was sustained at 6 months.

Conclusions: It pays to probe for the core experiences or events that patients may be explaining by devising ‘delusions’. Acute, nocturnal-onset, first-time psychopathology warrants inquiry for sleep paralysis and hypnic hallucinations. Sleep-related side-effects of psychotropic medications need to be studied more closely.
Iatrogenic Dependency Disorder
Authors: Straton David
Published: December 2004

Objective: To argue for the direct election of RANZCP officials as a means of ensuring that College statements and political activities correspond as closely as possible to the opinions and interests of the average psychiatrist.

Conclusions: The case to abolish item 319 and restore 5 day-per-week sessions is out of touch with political reality. It wastes limited political capital by the College, or other psychiatric organizations, that would be better used for other purposes.
Synthesis and degradation of type IV collagen in rat skeletal muscle during immobilization in shortened and lengthened positions
Authors: Ahtikoski A. M. , Koskinen S. O. A. , Virtanen P. , Kovanen V. , Risteli J. , Takala T. E. S.
Published: December 2004

Aim:  Type IV collagen is a major protein in basement membranes surrounding and supporting skeletal muscle cells. In the present study, we tested the hypotheses that immobilization down‐regulates synthesis and up‐regulates degradation of type IV collagen in skeletal muscle.

Methods:  mRNA level and concentration of type IV collagen as well as mRNA levels and activities of proteins involved in its degradation were analysed from soleus (SOL), gastrocnemius (GAS) and extensor digitorum longus muscles after immobilization in shortened and lengthened positions for 1, 3 and 7 days.

Results:  Following immobilization, type IV collagen mRNA level was decreased in SOL and GAS suggesting down‐regulated synthesis of this protein. The mRNA level and activity of matrix metalloproteinase‐2 (proMMP‐2) were increased in all muscles, while the activity of tissue inhibitor of metalloproteinase‐2 was decreased in SOL and GAS. These findings reflect an increased capacity for degradation of type IV collagen.

Conclusions: As a consequence of decreased synthesis/degradation ratio immobilization reduced the concentration of type IV collagen in all muscles. The regulation of type IV collagen through synthesis and/or degradation seems, however, to be muscle specific. Immobilization in lengthened position seems to delay and partly decrease the net degradation of type IV collagen.
Effects of sex, gonadectomy, and oestrogen substitution on ischaemic preconditioning and ischaemia–reperfusion injury in mice
Authors: Song X. , Li G. , Vaage J. , Valen G.
Published: December 2004

Aim:  Ischaemic preconditioning (IPC) has been demonstrated to protect heart function and viability, but has been predominantly studied in male animals.

Methods:  We studied a possible influence of sex and oestrogen for protection in IPC. Infarct size and heart function after 40 min global ischaemia and 60 min reperfusion with or without preceding classic IPC was investigated in Langendorff‐perfused hearts. Hearts were harvested from 10‐week‐old male and female C57BL6 mice with or without gonadectomy 6 weeks earlier, or gonadectomy and substitution with 17β‐oestradiol for 4 weeks (n = 104).

Results:  Classic IPC reduced depression of left ventricular developed pressure (P < 0.01), attenuated the increase of end‐diastolic pressure (P < 0.01), and reduced infarct size (P < 0.01) in hearts of untreated male mice, but failed to protect untreated females which had improved functional recovery and smaller infarctions than untreated males. After gonadectomy of female mice, developed pressure was reduced (P < 0.01) and infarct size increased (P < 0.01) compared with normal females, with no protection of preconditioning. The changes were not reversed by 17β‐oestradiol substitution. In hearts of gonadectomized males, the post‐ischaemic increase of end‐diastolic pressure was attenuated (P < 0.01), and enhanced after substitution with 17β‐oestradiol (P < 0.01). The preconditioning effect disappeared after gonadectomy and gonadectomy with substitution in male mice.

Conclusion:  There is a sex difference in evoking preconditioning in male and female mice which is only partially dependent on sex hormones.