bluuebunny/crossref_metadata_2025 huggingface dataset:
A comparative study of fatty acid profiles of Passiflora seed oils from Uganda
Authors: Nyanzi Steven A. , Carstensen Bernd , Schwack Wolfgang
Published: November 2006

A comparative study is presented of the FA composition (FAC) of the seed oils from the yellow passion fruit Passiflora edulis Sims var. flavicarpa (I), the purple fruit Passiflora edulis Sims var. edulis (II), the purple Kawanda hybrid, which is a cross between I and II (III), and the light‐yellow apple passion fruit Passiflora maliformis L. (IV) grown in Uganda. Oil yields from the four varieties were between 18.5 and 28.3%. A GC analysis of the oils showed the most dominant FA to be linoleic (67.8–74.3%), oleic (13.6–16.9%), palmitic (8.8–11.0%), stearic (2.2–3.1%), and α‐linolenic (0.3–0.4%) acids. The unsaturated FA content in the oils was high (85.4–88.6%). Iodine values of the seed oils of I, II, III, and IV calculated from the FAC were 133, 141, 133, and 138, respectively. The FAC and the iodine value of the seed oil in III are distinctly closer to the rootstock (I) than the scion (II). This indicates that the rootstock influence on the FAC of passion fruit seeds is graft‐transmissible. The study further confirms that passion fruit seed oils represent a good source of essential unsaturated FA.
Olive oil microemulsions as a biomimetic medium for enzymatic studies: Oxidation of oleuropein
Authors: Papadimitriou V. , Sotiroudis T. G. , Xenakis A.
Published: November 2006

Microemulsions consisting of olive oil as the non‐polar solvent, lecithin as surfactant, 1‐propanol as cosurfactant, and water were prepared. The choice of the compositions of the microemulsions used was based on the pseudo‐ternary phase diagrams of the system determined at 30°C, for different weight ratios of lecithin/olive oil. Lecithin solubilization and water incorporation in these microemulsion systems was limited. Tyrosinase, an oxidizing enzyme present in olives, was successfully incorporated in the water core of these microemulsions. Enzymatic oxidation of oleuropein, the most abundant olive phenolic compound, in the restricted aqueous environment of olive oil microemulsions was studied. Formation of oleuropein oxidation products was followed spectrophotometrically at 30°C for several minutes. An absorption maximum was observed at 415 nm. When the enzymatic reaction was considered at different tyrosinase and oleuropein concentrations, a rapid inactivation of the enzyme was observed. Addition of l‐proline as a coupling reactor did not succeed in preventing enzyme inactivation in the microemulsions, probably owing to substrate localization and product accumulation around the entrapped enzyme molecules in the micellar interface.
Thermal properties and adhesiveness of soy protein modified with cationic detergent
Authors: Wang Y. , Wang D. , Sun X. S.
Published: November 2006

This research studied the effects of cationic detergents on the adhesiveness and thermal properties of soy protein isolate (SPI). Three cationic detergents, hexadecyltrimethyl ammonium bromide, ethylhexadecyldimethyl ammonium bromide (EDAB), and benzyldimethylhexadecyl ammonium chloride, each at concentrations of 1.3, 2.6, 5.2, and 7.8 mM, were used to modify SPI. The effect of pH at selected EDAB concentrations was also studied. Results showed that both detergent concentration and pH had significant effects on the adhesiveness of modified SPI. SPI modified with detergent at a concentration of 2.6 mM yielded the greatest dry tensile strength and water resistance, which indicated that a moderate protein denaturation might be favorable to the adhesion of SPI. Both modified and unmodified SPI showed greater adhesive strength at their optimal pH values. Modified SPI showed greatest adhesive strength at pH 7, whereas unmodified SPI showed greatest adhesive strength at pH 4.5; the tensile strength of modified SPI was greater than that of unmodified SPI. The protein‐denaturation temperature and the enthalpy of modified SPI adhesives were also analyzed by using DSC. Denaturation of the native structure of SPI increased as detergent concentration increased.
Crystal morphology, microstructure, and textural properties of model lipid systems
Authors: Shi Yuping , Liang Baomin , Hartel Richard W.
Published: November 2006

Mixtures of model lipid systems containing high‐melting and low‐melting lipid classes were crystallized and microscope images obtained for analysis of crystal morphology and microstructure. Rheological properties of these semisolid systems were tested by use of a texture analyzer. The nature of the highmelting component in a mixture dominated the crystal morphology and, combined with interactions between crystalline and liquid materials, resulted in different microstructures that influenced the rheological properties. In addition to size, shape, and amount (solid fat content) of crystalline material, the crystal packing density, representing how densely the crystalline particles in every level (individual, aggregate, or floc) were arranged, and the nature (or strength) of the link (or bridge) connecting the crystalline particles were important microstructural factors to determine rheological properties. Depending on different crystal packing densities and linking bridges, two different systems were identified in terms of microstructure type—mobile and immobile—in which the relative mobility of microstructural components had different levels. These mobility levels led to different rheological responses.
The use of 1H NMR for yield determination in the regioselective epoxidation of squalene
Authors: Aerts Hans A. J. , Sels Bert F. E. , Jacobs Pierre A.
Published: November 2006

1H NMR can be used to determine the epoxide yield rapidly in the oxidation of squalene. Moreover, unequivocal distinction can be made between internal and terminal epoxide bonds. To underline the power of this technique, different stoichiometric and catalytic epoxidation procedures were carried out using squalene as substrate. They were characterized in terms of substrate conversion and regioselectivity of the epoxide fraction.
The role of endogenous amphiphiles on the stability of virgin olive oil‐in‐water emulsions
Authors: Sotiroudis T. G. , Sotiroudis G. T. , Varkas N. , Xenakis A.
Published: November 2006

Stable virgin olive oil‐in‐water emulsions were prepared using total endogenous surface‐active components derived from oil as emulsifying agents, and the interfacial properties of the emulsion droplets were examined. The amount of oil extracted into the aqueous buffer increased with buffer pH, with the most stable emulsions being formed at pH 7.5. Light microscopy of the emulsions revealed the presence of spherical droplets with diameters ranging from 1.5 to 3 μm. Their surface was negatively charged at pH 7.5, as confirmed by the effect of ions and polycations. Potassium chloride, Ca2+, and spermine induced rapid aggregation (as monitored by the turbidity change and by light microscopy), showing their maximal effect at 1 M, 4 mM, and 60 μM, respectively. Papain treatment of the emulsion particles rapidly induced particle aggregation, suggesting the destruction of stabilizing structural olive oil proteins. Unlike papain, treatment with phospholipase C did not result in an appreciable turbidity change. Treatment with soybean lipoxygenase slightly increased the turbidity of the emulsion. The interaction of linoleate‐Tween 20 mixed micelles with emulsion droplets produced turbidity, which was maximal at a neutral pH, whereas interaction with proteolyzed and lipoxygenase‐treated droplets induced both a significant increase in turbidity and a red shift to a different absorption maximum of the system as compared with those of the untreated emulsion.
Enzymatic incorporation of stearic acid into a blend of palm olein and palm kernel oil: Optimization by response surface methodology
Authors: Lumor Stephen E. , Akoh Casimir C.
Published: November 2006

Response surface methodology was used to model the incorporation of stearic acid into a blend of palm olein and palm kernel oil in hexane using the sn‐1,3‐regiospecific lipase Lipozyme RM IM. The factors investigated were incubation time, temperature, and substrate molar ratio. A second‐order model with interaction was used to fit the experimental data. The coefficients of determination, R2 and Q2, were 0.96 and 0.90, respectively. The adjusted R2 was 0.95. The regression probability was less than 0.001, and the model showed no lack of fit. Also, a linear relationship was observed between the predicted and observed values. All parameters studied had positive effects on incorporation of stearic acid, with substrate molar ratio having the greatest effect. The interaction terms of substrate molar ratio with temperature and time also had positive effects on incorporation, whereas the effect of the squared term of substrate molar ratio was negative. The quadratic terms of temperature and time, as well as their interaction term, had no significant effect on incorporation at α0.05. Model verification was done by performing a chi‐square test, which showed that there was no significant difference between predicted values and a new set of observed responses.
Enrichment of CLA isomers by selective esterification with l‐menthol using Candida rugosa lipase
Authors: Kobayashi Takashi , Nagao Toshihiro , Watanabe Yomi , Yamauchi‐Sato Yoshie , Negishi Satoshi , Shimada Vuji
Published: November 2006

Commercially available preparations of CLA are composed of almost equal amounts of 9‐cis,11‐trans (9c,11t)‐CLA and 10‐trans,12‐cis (10t,12c)‐CLA. Each isomer was fractionated and enriched, for availability as a food supplement, by a process comprising selective esterification with l‐menthol by Candida rugosa lipase, distillation, and n‐hexane extraction. The first selective esterification of CLA isomers was conducted with an equimolar amount of l‐menthol of 30°C. The oil phase of the reaction mixture was fractionated into an l‐menthyl ester fraction (9c,11t‐CLA rich) and an FFA fraction (10t,12c‐CLA rich) by distillation. The FFA fraction was esterified again with an equimolar amount of l‐menthol to enrich 10t,12c‐CLA. The 10t,12c‐CLA preparation was obtained as the resulting FFA fraction by distillation. 10t,12c‐CLA was enriched to 91% with 40% recovery. To enrich 9c,11t‐CLA, the l‐menthyl ester fraction in the first esterification was chemically hydrolyzed, and the resulting FFA were esterified again with an equimolar amount of l‐menthol. The 9c, 11t‐CLA preparation was obtained by chemical hydrolysis of the resulting l‐methyl ester fraction, followed by n‐hexane extraction. 9c,11t‐CLA was enriched to 94% with 42% recovery. This effective process for purification of CLA isomers using l‐methol is applicable to the production of food supplements.
Ceramer coatings from castor oil or epoxidized castor oil and tetraethoxysilane
Authors: de Luca Maria Augusta , Martinelli Márcia , Jacobi Marly Maldaner , Becker Patrícia Luíza , Ferrão Marco Flores
Published: November 2006

New inorganic‐organic hybrids were synthesized through the reaction of castor oil (CO) or epoxidized castor oil (ECO) with tetraethoxysilane (TEOS). The mass proportions of ECO/TEOS varied from 90∶10 to 60∶40, and films of the material were thermally cured. An IR spectroscopy analysis was performed, and macro‐ and microscopic properties such as adhesion, hardness, swelling in toluene, microstructure (scanning electron microscopy), and Tg were investigated as a function of the proportion of their inorganic‐organic precursor. Morphologic studies showed that the hybrid films were homogeneous when lower proportions of the inorganic precursors were used. Hardness and tensile strength increased with TEOS concentration, whereas swelling in toluene decreased with TEOS concentration. Good adhesion was observed throughout the hybrid series.
Solvent extraction of ethanol from aqueous solutions using biobased oils, alcohols, and esters
Authors: Offeman Richard D. , Stephenson Serena K. , Robertson George H. , Orts William J.
Published: November 2006

Distribution coefficients and separation factors were determined for the partitioning of ethanol and water from aqueous mixtures into several vegetable oils and their fatty alcohol and fatty ester derivatives. Castor oil, ricinoleyl alcohol, and methyl ricinoleate all show higher ethanol distribution coefficients, and similar or reduced separation factors, relative to other oils and derivatives studied here or reported by others. Of particular interest, ricinoleyl alcohol has an ethanol distribution coefficient 50% higher than that of oleyl alcohol, a commonly studied solvent for ethanol extraction from fermentation broths.
A quantitative colorimetric method of measuring alkaline phosphatase activity in eukaryotic cell membranes
Authors: Akcakaya Handan , Aroymak Aysin , Gokce Sina
Published: November 2006

Alkaline phosphatase (ALP) is glycoprotein structured metalophosphatase with several defined functions. It is present in many tissues of all living beings from bacteria to mammals. The enzyme may catalyse the hydrolysis of various monophosphate esters at alkaline pH. The objective of this study was to quantify ALP functioning particularly in the membranes of eukaryotic cells. The membranes of seven different cells (myeloma cells; hybrid cells; erythroleukaemia cells; lymphocytes and erythrocytes) were tested for ALP activity using a cellular enzyme assay, which is based on the conversion of para‐nitrophenylphosphate (p‐NPP) to para‐nitrophenol and the colorimetric determination of the resulting coloured product. The test system was optimised with respect to substrate concentration, reaction time and the number of cells used as a source of enzyme. The obtained values were converted to quantitative results through a standard curve created using commercial ALP. In order to determine the effect of serum concentration on enzyme activity, 1G2 hybridoma, which is among the cells used in this study and which synthesizes monoclonal antibody against human serum albumin, was produced in different serum concentrations ranging from 0 to 15%.
In situ trapping of initiator caspases reveals intermediate surprises
Authors: Mohr Andrea , Zwacka Ralf M.
Published: November 2006

A novel method to identify initiator caspases is an in situ trapping approach using a cell‐permeable biotinylated caspase inhibitor valine‐alanine‐aspartate‐fluoromethyl ketone (bVAD) that binds covalently and irreversibly to the active cysteine site of caspases. This inhibits apoptosis and should allow precipitation of initiator caspases in their uncleaved forms. However, in our experiments TRAIL and FasL‐induced apoptosis and bVAD labelling did not result in streptavidin precipitation of the procaspase‐8 forms, but led to the pull‐down of the intermediate and to a lesser extent fully cleaved forms (p41/43 and p18). These findings are contrary to other reports and are of relevance to apoptosis research as they challenge the general concept of the bVAD approach that procaspases are being trapped. We show that (partially) processed forms of initiator caspases rather than procaspases might be precipitated with this method.
Relevance of apoptosis in influencing recovery of hibernating myocardium
Authors: Angelini Annalisa , Maiolino Giuseppe , La Canna Giovanni , Ceconi Claudio , Calabrese Fiorella , Pettenazzo Elena , Valente Marialuisa , Alfieri Ottavio , Thiene Gaetano , Ferrari Roberto
Published: November 2006

Background:

Hibernating myocardium (HM) is viable but dysfunctional myocardium which can recover following revascularization. Myocyte necrosis is virtually absent in HM; however, cellular loss may take place by apoptosis, although this is controversial.

Aim:

To assess the presence of apoptosis and its relevance in HM.

Methods:

During coronary artery by‐pass surgery (CABG), 21 patients underwent transmural biopsy in the dysfunctional left anterior descending artery tributary area of the left ventricle (LV), with kinetic recovery at follow‐up, thus fulfilling the HM criteria. All patients underwent echocardiographic follow‐up at 12 months. All biopsies were evaluated by light microscopy, electron microscopy (EM), and molecular analysis.

Results:

All biopsies were structurally altered, showing increased fibrosis and myocytes with variable size. Myocyte dedifferentiation was not detected by immunohistochemistry or EM. On stepwise linear regression, 1 year LVEF was predicted by the apoptotic index (β=−0.973, p=0.002), the normotrophic cell percentage (β=0.449, p=0.038), and mean fibrosis (β=−0.412, p=0.51).

Conclusions:

Our biopsy study detected a wide range of morphological substrate heterogeneity in HM with degenerative features. We have demonstrated for the first time in humans that myocyte apoptosis is an important phenomenon in HM, negatively influencing LV functional recovery after CABG.
Endogenous inhibitors of hypertrophy in concentric versus eccentric hypertrophy
Authors: Lemmens Katrien , Segers Vincent F.M. , Demolder Marc , Michiels Maria , Van Cauwelaert Philip , De Keulenaer Gilles W.
Published: November 2006

Left ventricular (LV) hypertrophy (LVH) is an adaptive response to hemodynamic overload, but also contributes to the pathogenesis of heart failure. LVH can be concentric (cLVH) but subsequent dilatation and progression to eccentric hypertrophy (eLVH) may lead to global pump failure. Recently, several endogenous molecular inhibitors of hypertrophy have been identified. Using real‐time PCR, we compared the myocardial mRNA expression of these inhibitors in pressure‐overload induced cLVH (severe aortic stenosis) and in volume overload‐induced eLVH (severe mitral regurgitation) in patients, and during the progression from cLVH to eLVH in pressure overload in rat. Each of these genes showed a unique temporal expression profile. Strikingly, except for SOCS‐3, changes in gene expression of these negative regulators in rat cLVH and eLVH vs sham were recapitulated in human cLVH and eLVH. In particular, VDUP‐1 and MCIP‐1 were high in cLVH but expression levels were normal in eLVH, both in rat and human. These data indicate that during the progression of LVH, both in pressure and volume overload, expression levels of endogenous inhibitors of hypertrophy are modified and that these changes may have pathophysiological significance. In particular, MCIP‐1 (the endogenous calcineurin inhibitor) and VDUP‐1 (the endogenous inhibitor of thioredoxin) are potential molecular switches in the progression of LV hypertrophy.
Shared executive dysfunctions in unaffected relatives of patients with autism and obsessive-compulsive disorder
Authors: Delorme Richard , Goussé Véronique , Roy Isabelle , Trandafir Anca , Mathieu Flavie , Mouren-Siméoni Marie-Christine , Betancur Catalina , Leboyer Marion
Published: November 2006

Background

Executive dysfunctions have been studied as a potential endophenotype associated with the genetic basis of autism. Given that recent findings from clinical and molecular genetic studies suggest that autism and obsessive-compulsive disorder (OCD) could share a common pattern of heritability, we assessed executive functions as a possible common cognitive endophenotype in unaffected family members of individuals with either autism or OCD.

Methods

Five tests assessing executive functions (Tower of London, verbal fluency, design fluency, trail making and association fluency) were proposed to 58 unaffected first-degree relatives (parents and siblings) of probands with autism and 64 unaffected first-degree relatives of OCD patients. Results were compared with those of 47 healthy controls matched for age, sex, and level of education.

Results

In the Tower of London test, both groups of unaffected relatives showed significantly lower scores and longer response times compared with controls. No differences were observed between autism and OCD relatives and healthy controls in the four other tasks (verbal fluency, design fluency, trail making test and association fluency).

Conclusions

Our findings show the existence of executive dysfunction in the unaffected first-degree relatives of probands with OCD, similar to those observed in the relatives of patients with autism. These results support and extend previous cognitive studies on probands indicating executive dysfunctions in autism and OCD. Planning and working memory processes could thus represent a common cognitive endophenotype in autism and OCD that could help in the identification of genes conferring vulnerability to these disorders.
Sustained and selective attention deficits as vulnerability markers to psychosis
Authors: Mulet B. , Valero J. , Gutiérrez-Zotes A. , Montserrat C. , Cortés M.J. , Jariod M. , Martorell L. , Vilella E. , Labad A.
Published: November 2006

The first descriptions of schizophrenia emphasized attention problems patients with schizophrenia have but recent results evidence that other psychotic disorders share them.

We compared the performance in sustained and selective attention between psychotic patients (P), their healthy first degree relatives (R) and healthy volunteers (C) to prove whether these alterations could be an endophenotype of vulnerability to psychosis. We also compared the performance of schizophrenic patients (SZP) and that of patients with other functional psychoses (OP) in order to prove whether these alterations are specific of any psychotic disorder.

Seventy-six P, 70 R and 39 C were included in the study. A selective attention index, comprising TMT A and B and Stroop Test, and a sustained attention index comprising the Continuous Performance Test were calculated. We conducted an univariant general linear model to compare three group performances in these indexes, with age, sex and years of education as a covariables.

We found significant differences between the indexes when we compared P, R and C. No differences in performance were found between SZP and OP. Our data showed that sustained and selective attention alterations could be a vulnerability factor to psychotic disorders in general, but they were not specific of schizophrenia.
Enhanced Sensory Recovery after Median Nerve Epair Using Cortical Audio–Tactile Interaction. A Randomised Multicentre Study
Authors: ROSÉN B. , LUNDBORG G.
Published: November 2006

The “Sensor Glove System” offers an alternate afferent inflow from the hand early after nerve repair in the forearm, mediated through the hearing sense, implying that deprivation of one sense can be compensated by another sense. This sensory “by-pass” was used early after repair of the median nerve with the intention of improving recovery of functional sensibility by maintaining an active sensory map of the hand in the somatosensory cortex during the deafferentation period. In a prospective multicentre clinical study, one group ( n = 14) started early after surgery with sensory re-education using the Sensor Glove System and the control group ( n = 12) received conventional sensory re-education, starting 3 months postoperatively. The patients were checked regularly during a 1-year period, with focus on recovery of tactile gnosis. After 12, months, tactile gnosis was significantly better in the Sensor Glove System group. This highlights the timing for introduction of training after nerve repair, focusing on the importance of immediate sensory re-learning.
Immediate Mobilisation Following Corrective Osteotomy of Distal Radius Malunions with Cancellous Graft and Volar Fixed Angle Plates
Authors: HENRY M.
Published: November 2006

The purpose of the study was to examine the reliability with which a specific technique of corrective osteotomy of malunions of the distal radius combined with early mobilisation could both restore the normal anatomic parameters of the radius and achieve a functional range of motion with good strength. Corrective osteotomy of the distal radius was performed through a volar approach using a fixed angle volar plate and cancellous bone graft from the iliac crest in 19 patients of mean age 50 years with initial malunions with a mean dorsal tilt of 36° and 7 mm of ulnar variance. An immediate mobilisation programme was started. All healed at a mean of less than 12 weeks (including two heavy smoking patients who required repeat cancellous bone grafting to achieve final union) to achieve a total arc of wrist motion around 120°, forearm rotation of 158° and grip strength which was 80% of contralateral. This treatment strategy was judged to be straightforward and effective.
Der uninteressante Fall
Authors: Horn
Published: November 2006

Anhand eines so genannt «alltäglichen Fallbeispiels» wird die Problematik und Herausforderung des Managements multimorbider, chronisch kranker Menschen mit Polypharmazie in der Praxis diskutiert. Die kurze Arbeit soll Leserinnen und Lesern Gelegenheit vermitteln, ihre persönlichen Erfahrungen mit diagnostischen und therapeutischen Möglichkeiten, sowie der Zusammenarbeit mit Spitälern bei diesem immer wichtiger werdenden Patientensegment zu überdenken.
Eile mit Weile
Authors: Frei  , Moll  , Kurath  , Krause
Published: November 2006

Ein 36-jähriger Portugiese wurde wegen eines diffusen Krankheitsgefühls, eines Gewichtsverlusts von 25 kg im letzten halben Jahr sowie wegen Nachtschweißes auf Zuweisung eines Hausarztes bei uns im Spital abgeklärt. Im CT des Thorax und Abdomens fand sich nebst einer bis nach retrosternal reichenden Struma eine Raumforderung im vorderen oberen Mediastinum. Gleichzeitig wurde die Diagnose einer Hyperthyreose vom Typ eines Morbus Basedow gestellt. Diese wurde mittels Carbimazol thyreostatisch behandelt. Aufgrund der unklaren Dignität wurde die Raumforderung im vorderen oberen Mediastinum thorakoskopisch entfernt. Histologisch handelte es sich um eine Thymushyperplasie mit Begleitthymitis ohne Zeichen der Malignität. Die Assoziation von Morbus Basedow und Thymushyperplasie ist in der Literatur beschrieben, bei Internisten und auch Endokrinologen jedoch wenig bekannt. Die Thymushyperplasie ist unter thyreostatischer Therapie regredient. Rückblickend hätten wir bei unserem Patienten auf die Thymektomie verzichten sollen.
Vom Verhungern zur lebensbedrohlichen Ernährung – Kranken-Geschichte einer chronischen intestinalen Pseudoobstruktion
Authors: Reinhart
Published: November 2006

Es ist die Kranken-Geschichte einer heute 70-jährigen Frau mit einer chronischen intestinalen Pseudoobstruktion. 1994 musste wegen zunehmender Kachexie eine parenterale Dauerernährung über ein Port-à-Cath-System begonnen werden. Diese funktionierte in den ersten Jahren recht gut, dann traten wiederholt verschiedene Komplikationen auf: Thrombotische Verschlüsse, mehrfach Katheterinfektionen mit verschiedenen Keimen, welche jeweils den Ausbau des Port-à-Cath-Systems zur Folge hatten, eine Aortenklappenendokarditis, welche einen Klappenersatz nötig machte und später eine lebensbedrohliche abszedierende Bioprothesen-Endokarditis mit schwerer Insuffizienz, was herzchirurgisch ein weiteres Mal saniert werden konnte. Die Patientin steht zur Zeit wieder unter parenteralen Ernährung und blickt einer höchst unsicheren Zukunft entgegen.
Individualisierung der Evidenz – Single Case Randomized Trial
Authors: Haefeli
Published: November 2006

Ein 64-jähriger Patient mit gut eingestellter essentieller Hypertonie berichtet überzeugend vom Therapieerfolg mit Yohimbin in der Akutbehandlung seiner erektilen Dysfunktion. Er wünscht die Verschreibung dieser Substanz, wovon wiederum sein Arzt nicht begeistert ist, da Akuteffekte dieser Behandlung ungewöhnlich sind und die Blockade von α2-adrenergen Rezeptoren den Blutdruck erhöhen kann. Sie einigen sich auf die Objektivierung von Wirksamkeit oder Versagen von Yohimbin in einer experimentellen Untersuchung nach einem Single Case Randomized Trial Design, also einer kontrollierten Versuchsanordnung in einem Einzelpatienten mit doppelblinder Durchführung. Der zehnmalige Vergleich von Placebo und oralem Yohimbin ließ keinen Unterschied erkennen und verhinderte, dass der Patient mit einer potenziell schädlichen Arzneimittel-Kombination exponiert wurde.
In den Gärten der Medea
Authors: Huynh-Do
Published: November 2006

Es werden zwei Fälle beschrieben, wo Colchicin als Entzündungshemmer eingesetzt wurde. Im ersten Fall wurde ein unklares, rezidivierendes Fieber erfolgreich behandelt, der dankbare Patient wurde geheilt nach Hause entlassen. Im zweiten Fall kam es zu einer fatalen Colchicinvergiftung. Der Wirkmechanismus und Abbauweg des Colchicin werden erläutert, mit besonderem Hinweis auf die Interaktion zwischen Colchicin und Makroliden. Die Symptome und Behandlungsmöglichkeiten bei Colchicinvergiftung werden zusammengefasst.
Die Pest im Grindelwaldtal 1669 – was lehrt uns die Geschichte einer Krankheit?
Authors: Horn
Published: November 2006

«Am Mittag war das Fieber auf seinem Höhepunkt. Ein, wie aus den Eingeweiden kommender Husten schüttelte den Körper des Kranken, der erst jetzt Blut zu spucken begann. Die Lymphknoten waren nicht mehr weiter angeschwollen. Sie waren immer noch da, hart wie in die Gelenkhöhlen geschraubte Muttern (A. Camus: Die Pest).
Schmerzprävalenz und Patientenpräferenzen bezüglich Schmerzbehandlung in Notfallstationen
Authors: Martin Jacqueline S. , Spirig Rebecca
Published: November 2006

Schmerzen gehören zu den häufigsten Symptomen, weshalb Patienten eine Notfallstation aufsuchen. Entsprechend ist ein rasches und wirksames Schmerzmanagement von zentraler Bedeutung. Die vorliegende Literaturübersicht wurde erstellt, um die Häufigkeit von Schmerzen in Notfallstationen zu erfassen und gute Kenntnisse über Patientenpräferenzen zur Schmerzbehandlung erhalten zu können. Sie basiert auf einer systematischen Suche in den Datenbanken Medline, CINAHL und Cochrane. Übereinstimmend zeigen die 14 analysierten Studien eine hohe Prävalenz und eine ungenügende Behandlung von Schmerzen in Notfallstationen. Gängige Vorgehensweisen, gemäß denen Schmerzmittel erst nach der ärztlichen Erstuntersuchung oder nach gesicherter Diagnose verordnet und verabreicht werden, stehen in krassem Gegensatz zu den Bedürfnissen der Patienten, die eine Schmerzbehandlung kurz nach Eintritt erwarten. Der Wunsch nach einer Behandlung steigt mit der Schmerzstärke. Als Gründe für die Ablehnung wurden u.a. die Angst vor Abhängigkeit von Schmerzmitteln und mögliche Nebenwirkungen genannt. Die meisten Patienten erwarten bei Austritt keine vollständige Schmerzfreiheit, aber eine stärkere Schmerzlinderung. Der Zusammenhang soziodemographischer Faktoren und Patientenpräferenzen ist aufgrund der wenigen Korrelationsstudien bisher nur ungenügend geklärt. Die Forschung in diesem Gebiet ist noch sehr jung. Alle integrierten Studien sind deskriptiv und wurden in den letzten fünf Jahren – v.a. in den USA – durchgeführt. Um die Forschung in diesem Gebiet weiter zu entwickeln, wird es zukünftig auch wichtig sein, die Behandlungspräferenzen von Menschen mit Schmerzen in europäischen Notfallstationen zu untersuchen.
Schmerzerfassung bei sedierten und maschinell beatmeten Patienten: Eine systematische Literaturanalyse
Authors: Jeitziner Marie-Madlen , Schwendimann René
Published: November 2006

Sedierte und maschinell beatmete Patienten sind aufgrund der Schwere ihrer Erkrankung, der eingeschränkten Kommunikationsmöglichkeiten, der endotrachealen Intubation sowie der Sedation und der Analgesie eine besonders vulnerable Patientengruppe. Sie sind gefährdet, mit ihren Schmerzen unerkannt zu bleiben. Unkontrollierte Schmerzzustände können bei diesen Patienten zu vermehrten Beatmungstagen und verlängerten Spitalaufenthalten führen sowie die Morbidität erhöhen. Die Schmerzen dieser Patienten werden durch die Fachpersonen häufig anhand individueller Kriterien subjektiv eingeschätzt und beurteilt. Ziel dieser Untersuchung war deshalb, verschiedene Schmerzeinschätzungsinstrumente für sedierte und maschinell beatmete Patienten hinsichtlich ihrer Validität, Reliabilität und praktischen Anwendung zu beschreiben. Mittels einer systematischen Suchstrategie wurden in den Datenbanken PUB-MED (National Library of Medicine) und CINAHL (Cumulative Index to Nursing and Allied Health Literatur) sowie weiteren bibliographischen Quellen 61 Artikel identifiziert. Als einzuschätzende Schmerzparameter werden bei sedierten und maschinell beatmeten Patienten physiologische und verhaltensbezogene Reaktionen beschrieben, wobei biochemische Parameter nicht berücksichtigt werden. Die Validität der meisten Instrumente wurde nur ansatzweise überprüft, ebenso fehlten Angaben zur Praktikabilität im klinischen Alltag. Wesentliche Bestandteile der untersuchten Instrumente sind Algorithmen, anhand derer schrittweise entschieden werden kann, ob, wann und welche Interventionen einzuleiten sind. Die Resultate weisen darauf hin, dass mögliche Schmerzparameter bei sedierten und maschinell beatmeten Patienten weiter zu erforschen respektive entsprechende Instrumente weiter zu entwickeln und im klinischen Alltag zu validieren sind.
«Auf die Zähne beißen»: Ein schwieriger Begriff in der Pflege
Authors: Käppeli Silvia
Published: November 2006

Die vorliegende Analyse der Forschungsliteratur zum Begriff enduring in der Pflege erfolgte auf dem Hintergrund der Forderung nach evidence based nursing. Das Ziel war, an einem konkreten Beispiel zu überprüfen, inwiefern diese Forderung in Bezug auf Begriffe, welche subjektive Erfahrungen von Patientinnen und Patienten beschreiben, erfüllt werden kann und sinnvoll ist. Der aktuelle Stand der ausschließlich qualitativen Forschung beinhaltet verschiedene problematische Aspekte konzeptueller, wissenschaftstheoretischer, linguistischer und Pflegetradition bezogener Art. Diese haben wichtige Implikationen für die Handhabung des Begriffes enduring in der Pflegepraxis.
Akutes Leberversagen – Internistische Sicht
Authors: Schattenberg  , Galle  , Schuchmann
Published: November 2006

Das akute Leberversagen ist eine seltene und unbehandelt häufig letal verlaufende Erkrankung. Der plötzliche Verlust der Leberfunktion ohne vorbestehende Lebererkrankung ist von den Formen des akuten Leberversagens auf dem Boden einer vorbestehenden Schädigung (akut auf chronisch) zu unterscheiden. Ätiologisch sind die häufigsten Auslöser akute virale Hepatitiden, Medikamente und Toxine. Das Krankheitsbild ist geprägt von dem Verlust der Exkretions- und Synthesefunktion der Leber und manifestiert sich mit Ikterus, Koagulopathie und Enzephalopathie. Neben diesen Kardinalsymptomen treten häufig Nierenfunktionseinschränkungen und Sepsis auf und verursachen die hohe Mortalität. Pathomechanistisch kommt es durch Aktivierung von Zelltodmechanismen zur Apoptose und Reduktion des funktionellen Leberparenchyms. Als definitive Therapie steht seit dem Jahr 1969 in Deutschland die Lebertransplantation zur Verfügung. Im Jahr 2004 wurden 91 Lebertransplantationen in Deutschland auf Grund eines akuten Leberversagens (10.3% aller Lebertransplantationen) durchgeführt.
Akutes Leberversagen – Chirurgische Sicht
Authors: Jonas
Published: November 2006

Die Notfall-Lebertransplantation ist die einzige Intervention mit nachgewiesenem Überlebensvorteil bei akutem Leberversagen. Die Indikationsstellung zur Lebertransplantation erfordert klinische Erfahrung. Der positive prädiktive Wert von Prognose-Scores ist relativ verlässlich, während der negative prädiktive Wert nur etwa 60% beträgt. Aufgrund einer hohen perioperativen Letalität von 20–30% sind die Ergebnisse insgesamt ungünstiger als bei Lebertransplantationen wegen chronischer Lebererkrankungen. Die wesentlichen Prognosefaktoren sind dabei die Schwere eines Multiorganversagens und der Grad der Enzephalopathie vor der Transplantation. Demgegenüber steht ein im Langzeitverlauf sehr gutes Patientenüberleben.
Fulminante Pankreatitis – Internistische Sicht
Authors: Adler
Published: November 2006

Das Ausmass der Pankreasnekrosen und die Beteiligung verschiedener Organsysteme an dem entzündlichen Prozess bestimmen den klinischen Verlauf und Schweregrad einer akuten Pankreatitis. Mit keiner Methode kann zu Beginn der Erkrankung eine sichere Aussage über Schweregrad und Verlauf gemacht werden. Deshalb sind der zeitgerechte Einsatz aussagefähiger laborchemischer und morphologischer Verfahren und insbesondere die wiederholte klinische Untersuchung und intensive Betreuung des Patienten von entscheidender prognostischer Bedeutung. Die rechtzeitige Erkennung, Vermeidung und Behandlung des Multiorganversagens hat entscheidenden Einfluss auf den Verlauf der Erkrankung. Während spezifische Medikamente weiterhin nicht zur Verfügung stehen, hat die konservative, intensivmedizinische Behandlung die Prognose der schweren Form der akuten Pankreatitis entscheidend verbessert.
Fulminante Pankreatitis – Chirurgische Sicht
Authors: Werner
Published: November 2006

Die chirurgische Therapie der akuten Pankreatitis ist heute zunehmend seltener indiziert. Die Infektion der Pankreasnekrose stellt heute den Hauptrisikofaktor im Krankheitsverlauf der akuten Pankreatitis dar. Eine prophylaktische Antibiotikatherapie bei der nekrotisierenden Pankreatitis kann die Infektion und die Mortalität senken und sollte durchgeführt werden. Bei Verdacht auf eine infizierte Pankreasnekrose sollte diese durch eine Feinnadelaspiration gesichert werden. Die infizierte Pankreasnekrose ist weiterhin eine absolute Indikation für eine Operation. Ziel der Nekrosektomie ist die Entfernung des septischen Fokus. Der optimale Zeitpunkt der Operation ist nach der 3. Krankheitswoche, da zu diesem Zeitpunkt die Nekrosen demarkiert sind und so Blutungen und die Entfernung von vitalem Gewebe vermieden werden können. Operative Verfahren der Wahl sind heute die Kombination von Nekrosektomie und der postoperativen Entfernung von Nekrosen durch Drainagen oder Lavage (postoperative kontinuierliche Lavage oder «Closed Packing»). Im Gegensatz hierzu sind sterile Pankreasnekrosen nur in Ausnahmefällen operativ zu therapieren. Die fulminante Pankreatitis ist eine seltene Form der akuten Pankreatitis mit rapidem progressivem Multiorganversagen. Die Therapie ist intensivmedizinisch. Obwohl als ultima ratio häufig chirurgische Massnahmen durchgeführt werden, lässt sich der fatale Verlauf in der Regel nicht verhindern.
The effects induced by the sulphonylurea glibenclamide on the neonatal rat spinal cord indicate a novel mechanism to control neuronal excitability and inhibitory neurotransmission
Authors: Ostroumov K , Grandolfo M , Nistri A
Published: November 2006

Background and purpose:

Using the neonatal rat spinal cord in vitro, we investigated the action of glibenclamide, a drug possessing dual pharmacological effects, namely block of KATP channels and of the cystic fibrosis transmembrane conductance regulator (CFTR).

Experimental approach:

Intra‐ and extracellular recordings were performed on motoneurons and interneurons. RT‐PCR and western immunoblotting were used to determine gene and protein expression.

Key results:

Glibenclamide (50 μM) facilitated mono‐ and polysynaptic reflexes, hyperpolarized motoneuron resting potential, increased action potential amplitude, decreased Renshaw cell‐mediated recurrent inhibition, and increased network excitability by depressing GABA‐ and glycine‐mediated transmission. The action of glibenclamide was mimicked by tolbutamide (500 μM) or the CFTR blocker diphenylamine‐2,2‐dicarboxylic acid (500 μM). The action of glibenclamide was independent from pharmacological inhibition of the Na+–K+ pump with strophanthidin (4 μM) and was associated with a negative shift in the extrapolated reversal potential for CI‐ dependent synaptic inhibition. On interneurons, intracellularly‐applied 8‐bromo‐cAMP elicited an inward current and resistance decrease; effects antagonized by the selective CFTR antagonist, CFTRinh‐172 (5 μM). RT‐PCR and western immunoblotting indicated strong expression of the CFTR in neonatal rat spinal cord.

Conclusions and implications:

These data suggest the CFTR expressed in motoneurons and interneurons of the neonatal spinal cord is involved in the control of Cl‐ homeostasis and neuronal excitability. CFTR appeared to contribute to the relatively depolarized equilibrium potential for synaptic inhibition, an important process to control hyperexcitability and seizure‐predisposition in neonates.

British Journal of Pharmacology (2007) 150, 47–57. doi:10.1038/sj.bjp.0706943
Activin is a Neuronal Survival Factor that is Rapidly Increased after Transient Cerebral Ischemia and Hypoxia in Mice
Authors: Mukerji Shibani S , Katsman Ekaterina A , Wilber Charles , Haner Noah A , Selman Warren R , Hall Alison K
Published: November 2006

One approach for developing targeted stroke therapies is to identify the neuronal protective and destructive signaling pathways and gene expression that follow ischemic insult. In some neural injury models, the transforming growth factor-beta family member activin can provide neuroprotective effects in vivo and promote neuronal survival. This study tests if activin supports cortical neurons after ischemic challenge in vitro and if signals after cerebral ischemia involve activin in vivo. In a defined cell culture model that uses hydrogen peroxide (H2O2)-free radical stress, activin addition maintained neuronal survival. H2O2 treatment increased activin mRNA twofold in surviving cortical neurons, and inhibition of activin with neutralizing antibodies caused neuronal death. These data identify activin gene changes as a rapid response to oxidative stress, and indicate that endogenous activin acts as a protective factor for cortical neurons in vitro. Similarly, after transient focal cerebral ischemia in adult mice, activin mRNA increased at 1 and 4 h ipsilateral to the infarct but returned to control values at 24 h after reperfusion. Intracellular activated smad signals were detected in neurons adjacent to the infarct. Activin was also increased after 2 h of 11% hypoxia. Activin mRNA increased at 1 h but not 4 or 24 h after hypoxia, similar to the time course of erythropoietin and vascular endothelial growth factor induction. These findings identify activin as an early-regulated gene response to transient ischemia and hypoxia, and its function in cortical neuron survival during oxidative challenge provides a basis to test activin as a potential therapeutic in stroke injury.
High Glycogen Levels in the Hippocampus of Patients with Epilepsy
Authors: Dalsgaard Mads K , Madsen Flemming F , Secher Niels H , Laursen Henning , Quistorff Bjørn
Published: November 2006

During intense cerebral activation approximately half of the glucose plus lactate taken up by the human brain is not oxidized and could replenish glycogen deposits, but the human brain glycogen concentration is unknown. In patients with temporal lobe epilepsy, undergoing curative surgery, brain biopsies were obtained from pathologic hippocampus ( n = 19) and from apparently ʻnormal' cortical grey and white matter. We determined the in vivo brain glycogen level and the activity of glycogen phosphorylase and synthase. Regional differences in glycogen concentration were examined similarly in healthy pigs ( n = 5). In the patients, the glycogen concentration in ʻnormal' grey and white matter was 5 to 6 mmol/L, but much higher in the hippocampus, 13.1 ± 4.3 mmol/L (mean ± s.d.; P < 0.001); the activities of glycogen phosphorylase and synthase displayed the same pattern. In normal hippocampus from pigs, glycogen was similarly higher than in grey and white matter. Consequently, in human grey and white matter and, particularly, in the hippocampus of patients with temporal lope epilepsy, glycogen constitutes a large, active energy reserve, which may be of importance for energy provision during sustained synaptic activity as epileptic seizures.
From Business Process Management to Business Process Ecosystem
Authors: Vidgen Richard , Wang Xiaofeng
Published: November 2006

New technologies, notably service-oriented architectures and Web services, are enabling a third wave of business process management (BPM). Supporters claim that BPM is informed by complexity theory and that business processes can evolve and adapt to changing business circumstances. It is suggested by BPM adherents that the business/IT divide will be obliterated through a process-centric approach to systems development. The evolution of BPM and its associated technologies are explored and then coevolutionary theory is used to understand the business/IT relationship. Specifically, Kauffman's NKC model is applied to a business process ecosystem to bring out the implications of coevolution for the theory and practice of BPM and for the relationship between business and IT. The paper argues that a wider view of the business process ecosystem is needed to take account of the social perspective as well as the human/non-human dimension.
Emergent States in Virtual Teams: A Complex Adaptive Systems Perspective
Authors: Curşeu Petru Lucian
Published: November 2006

Research on virtual teams (VTs) has proliferated in the last decades. However, few clear and consistent theoretical attempts to integrate the literature on VTs in a systemic way have emerged. This paper uses the complex adaptive systems (CAS) perspective to integrate the literature on emergent states in VTs. According to this general framework, VT effectiveness depends on the interaction between three levels of dynamics: local, global and contextual. Team cognition, trust, cohesion and conflict are described as states that emerge from the interactions among the VT members and as parts of global dynamics, they impact on VT effectiveness, and in the same time they are influenced by the outcomes of the VT. The insights on this bidirectional causality as well as other benefits of using the CAS framework to improve our understanding of VTs are discussed in the paper. It also provides an overview of artificial simulation models as well as simulation results concerning the emergence of the four states described in the CAS framework and discusses several ways to improve the accuracy of the simulation models using empirical data collected in real VTs.
Moving to the Edge of Chaos: Bureaucracy, IT and the Challenge of Complexity
Authors: Boisot Max
Published: November 2006

Bureaucracies in the Weberian mould, whether of the state or corporate type, are rational-legal structures organized to deliver order, stability and predictability. Early developments in information and communication technologies (ICTs) appeared set to deliver such an outcome. Yet the new economy turns out to be more ‘distributed’ than had originally been expected. What is the nature of the challenge that this poses for bureaucracies? To address this question, the paper first presents a conceptual framework, the Information-Space or l-Space, which allows us to explore the relationship between how knowledge is structured and how it flows within and between populations of agents. The paper then examines what cultural and institutional challenges the new ICTs pose for both state and corporate bureaucracies, confronted as they are with the complexities of an increasingly distributed social order.
Using Coevolutionary and Complexity Theories to Improve IS Alignment: A multi–Level Approach
Authors: Benbya Hind , McKelvey Bill
Published: November 2006

The misalignment of information systems (IS) components with the rest of an organization remains a critical and chronic unsolved problem in today's complex and turbulent world. This paper argues that the coevolutionary and emergent nature of alignment has rarely been taken into consideration in IS research and that this is the reason behind why IS alignment is so difficult. A view of IS alignment is presented about organizations that draws and builds on complexity theory and especially its focus on coevolution-based self-organized emergent behaviour and structure, which provides important insights for dealing with the emergent nature of IS alignment. This view considers Business/IS alignment as a series of adjustments at three levels of analysis: individual, operational, and strategic, and suggests several enabling conditions – principles of adaptation and scale-free dynamics – aimed at speeding up the adaptive coevolutionary dynamics among the three levels.