bluuebunny/crossref_metadata_2025 huggingface dataset:
A 25-Year Follow-Up Study of Drug Addicts Hospitalised for Acute Hepatitis: Present and Past Morbidity
Authors: Gjeruldsen Susanne Rogne , Myrvang Bjørn , Opjordsmoen Stein
Published: April 2003

The aim of the study was to investigate present and past morbidity in drug addicts, 25 years after hospitalisation for acute hepatitis B or hepatitis nonA-nonB. The hospital records for 214 consecutively admitted patients were analysed, and a follow-up study on 66 of the 144 patients still alive was performed. At follow-up, 1 of 54 (1.8%) hepatitis B patients was still HBsAg positive. Twelve patients originally diagnosed as hepatitis nonA-nonB were all among 54 found to be anti-hepatitis C virus (anti-HCV) positive, and the total anti-HCV prevalence was 81.8%. Twelve (22.2%) of the HCV cases were unknown before the follow-up examination. Four (6.1%) participants were anti-human immunodeficiency virus positive, only 1 was on antiretroviral therapy, and none had developed AIDS. Other chronic somatic diseases were a minor problem, whereas drug users reported skin infections as a frequent complication. Forty-three patients (65%) had abandoned addictive drugs since the hospital stay. Serious mental disorders were reported by 19 patients (28.8%), and 17 (25.8%) regarded themselves as present (9) and former (8) compulsive alcohol drinkers. A large proportion of the participants were granted disability pension (39%), a majority because of psychiatric disorders, drug and alcohol abuse.
Thrombolytics for Cerebral Sinus Thrombosis
Authors: Canhão Patricia , Falcão Filipa , Ferro José M.
Published: April 2003

Background and Purpose: The use of thrombolytics is frequently mentioned in patients with cerebral venous or dural sinus thrombosis (CVDST) who deteriorate despite anticoagulant therapy. The aim of this review was to collect all the published information about their use in CVDST and to assess their efficacy and safety. Methods: To find cases of CVDST treated with thrombolytics, we performed a MEDLINE search from 1966 to July 2001, checked all reference lists of studies found and hand searched volumes of 11 journals. Data was extracted by means of a standardised data extraction form. Proportions and 95% confidence intervals (CI) were calculated for outcomes and complications of thrombolytics. Cases were stratified according to variables that may influence the outcome and subgroups were compared by odds ratios and 95% CI. Results: No randomised clinical trial (RCT) was found. Seventy-two studies (169 patients) were included. Urokinase was the thrombolytic most frequently administered (76%). In the majority of cases the thrombolytic was locally infused in the occluded sinus (88%). At discharge, 10 cases (7%; 95% CI 3–12%) were dependent and 9 cases (5%; 95% CI 2–9%) died. Intracranial haemorrhages occurred in 17% of cases. In 5% they were associated with clinical deterioration. Extracranial haemorrhages occurred in 21%, but only 2% required blood transfusion. Conclusions: Thrombolytics appeared to be reasonably safe in CVDST, but its efficacy cannot be assessed from the published data. Considering that CVDST is an uncommon disease, a randomised controlled trial to assess effectiveness and safety of local thrombolytics in cases of CVDST with poor prognosis is difficult but not impossible to undertake, on a multicentre international collaboration trial.
Retroperitoneal Bronchogenic Cyst as a Differential Diagnosis of Pancreatic Mucinous Cystic Tumor
Authors: Andersson Roland , Lindell Gert , Cwikiel Wojciech , Dawiskiba Sigmund
Published: April 2003

Cystic tumors of the pancreas where a pseudocyst has not been able to be excluded has been considered potentially proliferative and pre-malignant or malignant and thus aggressive surgical approach has been advocated. Retroperitoneal cystic tumors are rare and among these bronchogenic cysts are extremely infrequent. The present paper describes a case of bronchogenic cyst in association with the pancreas in which diagnostic work-up was not able to exclude a proliferative pancreatic cystic tumor.
Open and Laparoscopic Treatment of Nonparasitic Splenic Cysts
Authors: Gianom Duri , Wildisen Alessandro , Hotz Thomas , Goti Federico , Decurtins Marco
Published: April 2003

Background: Nonparasitic splenic cysts are rare. Therefore, there is no ‘evidence-based’ information regarding their optimal surgical management. In the last years the laparoscopic approach has gained increasing acceptance in splenic surgery. The aim of this study is to present our experience with the laparoscopic management of splenic cysts. Methods:The medical records of 7 patients with splenic cysts were reviewed retrospectively. Results: One patient had an open partial splenic resection. Five patients, 3 of them with a posttraumatic and 2 with an epidermoid splenic cyst, underwent laparoscopic unroofing of the cyst. In 4 of these cases the postoperative course was uneventful, whereas in 1 case the patient developed a cyst relapse soon postoperatively. Later on this patient successfully underwent an open partial splenic resection. The 7th patient had an explorative laparoscopy. The cyst was located intrasplenically, entirely covered with unaffected splenic parenchyma, and reached the splenic hilus. Therefore, a conversion to open partial splenectomy was performed. Conclusion: Open partial splenectomy and laparoscopic cyst wall unroofing are both effective tools in the management of splenic nonparasitic cysts. Surgeons must master both techniques as nowadays spleen-preserving techniques should be attempted in every case of splenic nonparasitic cyst.
Effects of PEEP on Residual Vascularization in Oesophageal Substitution Gastroplasty by Surface Oximetry-Capnometry and Photoplethysmography
Authors: Uribe Natalia , García-Granero Eduardo , Millan Monica , Belda Javier , Calvete Julio , García-Granero Mario
Published: April 2003

Objective: To evaluate the effects of positive end-expiratory pressure (PEEP) on residual vascularization in gastric tubes for oesophageal replacement. Design: Experimental open study. Materials: Eleven mongrel dogs. Methods: Intestinal parietal blood flow was evaluated by photoplethysmography (PPG) and measurement of surface oxygen (PsO2) and carbon dioxide (PsCO2) tensions under basal conditions. After Akiyama’s tubular gastroplasty, three levels of PEEP were administered. At each level, fluids were infused to counter the drop in cardiac output. PPG, surface gas tensions, arterial pressure, cardiac output and arterial blood gas tensions were monitored. Control sections of the bowel were also monitored by PPG. Results: Cardiac output dropped for each level of PEEP and returned to basal levels on volume restabilization and on removal of PEEP. Central venous pressure and pulmonary arterial and capillary pressures increased for each level of PEEP and only returned to basal levels on removal of PEEP. PsO2 values dropped for each level of PEEP and returned to basal levels on volume restabilization and on removal of PEEP. PsCO2 levels rose, and PPG wave amplitude dropped, for each level of PEEP; these two variables only returned to basal levels on removal of PEEP. PPG values for the control sections reflected those of the anastomotic area. Conclusions: PEEP affects surface oxygen values at the level of the gastroplasty by means of its effect on cardiac output. PEEP also creates a venous return compromise and PPG wave amplitude and surface carbon dioxide values are related to this compromise. All three variables could be significant in anastomotic wound healing.
T102C Polymorphisms at the 5-HT2A Receptor Gene in Turkish Schizophrenia Patients: A Possible Association with Prognosis
Authors: Herken Hasan , Erdal M. Emin , Erdal Nurten , Aynacioglu Sukru
Published: April 2003

Background: Serotonergic system abnormalities have been implicated in the pathogenesis of schizophrenia. The 5-HT2A receptor gene polymorphism has long been implicated to play a role in the pathogenesis of schizophrenia. Aim: In this study, we assessed the relationship of schizophrenia and its subgroups with 5-HT2A receptor gene polymorphism, and attempted to evaluate a possible correlation between the severity and prognosis of the illness and 5-HT2A receptor gene polymorphism. Method: Our study comprised 141 unrelated subjects who strictly met DSM-IV criteria for schizophrenia, and 79 healthy unrelated controls, all of Turkish origin. A clinical evaluation of all patients was accomplished applying the Brief Psychiatric Rating Scale (BPRS) test. The analysis of 5-HT2A receptor gene polymorphism was performed using the polymerase chain reaction technique. Results: Regarding 5-HT2A receptor gene polymorphisms, no statistically significant difference was found between schizophrenic patients and control subjects (p > 0.05). There was no significant difference between the average of BPRS points of the patients and 5-HT2A receptor gene polymorphisms (p > 0.05). Although there was no correlation between the duration of illness and polymorphism (p > 0.05), the frequency of hospitalization was found to be higher in the patients with T/C and T/T genotypes compared with the patients with C/C genotype (p < 0.05). Conclusion: Our findings indicate that the T102C polymorphisms of the 5-HT2A receptor gene does not play a substantial role in schizophrenia nor help evaluate susceptibility to schizophrenia. Since the 5-HT2A receptor gene polymorphism is associated with the frequency of hospitalization of the patients, it may be an indicator of prognosis in schizophrenia or help differentiate the patients who are somewhat refractory to antipsychotic treatment.
The Effects of Ginkgo biloba Extracts on the Memory and Motor Functions of Rats with Chronic Cerebral Insufficiency
Authors: Lin Chou-Ching K. , Cheng Wen-Ling , Hsu Shan-Hui , Chang Chieh-Ming J.
Published: April 2003

The main goal of the curren study was to investigate the effects of two Ginkgo leaf extracts, EGb 761 and an extract of local Ginkgo leaf (LGb), on the memory and motor functions of rats with chronic cerebral insufficiency (produced by bilateral common carotid artery ligation). After the operation, spatial memory and motor functions were tested for over 80 days. Tests included (1) radial-arm maze test for testing spatial memory and locomotor activity and (2) muscle force and hind limbs for escape. The results indicate that both EGb 761 and LGb improved spatial memory from the second week after operation, but only EGb 761 delayed deterioration of motor functions from the fifth week after operation.
Influence of Dietary Linoleic Acid Intake with Different Fat Intakes on Arachidonic Acid Concentrations in Plasma and Platelet Lipids and Eicosanoid Biosynthesis in Female Volunteers
Authors: Adam O. , Wolfram G. , Zöllner N.
Published: April 2003

Background/Aim: N-6 fatty acids are considered to promote diseases prevalent in industrialized countries and characterized by an increased eicosanoid biosynthesis from arachidonic acid (AA). We investigated the impact of the linoleic acid (LA) intake on AA levels in humans. Methods: Six healthy female volunteers (age range 23–34 years) were given liquid formula diets (LFD) devoid of AA for 6 weeks, providing a constant intake of zero energy% (LFD 0: protein 15%, carbohydrates 85%) or 20 energy% (LFD 20: protein 15%, carbohydrates 55%, fat 30%) LA, for 3 weeks each. Fatty acids of plasma cholesteryl esters and platelet lipids were determined each week, and the prostaglandin biosynthesis was measured in 24-hour urine samples. Results: LFD 0 increased (+31% of initial value) and LFD 20 lowered (–30% of initial value) the percentage of AA in plasma cholesteryl esters and platelet lipids. Moreover, absence of dietary AA lowered the percentages of AA in plasma (–31% week 0 vs. week 6) and platelet (–11%) lipids, indicating a low transformation of LA. LFD 0 reduced urinary metabolite levels of prostaglandins D, E, and F in 24-hour urine samples (–48%, p < 0.001) within 24 h, but did not significantly affect platelet aggregation (–10%) and thromboxane formation (–25%). LFD 20 significantly lowered platelet aggregation (–25%) and thromboxane formation (–43%). The prostaglandin metabolite levels increased during the first 10 days, declined thereafter, and were lower than the preexperimental values at the end of the 3-week period. Conclusions: The results show that dietary LA does not increase the AA levels in plasma or platelet lipids and does not persistently contribute to prostaglandin biosynthesis which is increased by AA intake with Western diets.
Relative Bioavailability and Antioxidant Potential of Two Coenzyme Q10 Preparations
Authors: Kurowska Elzbieta M. , Dresser George , Deutsch Luisa , Bassoo Errol , Freeman David J.
Published: April 2003

Coenzyme Q10 (CoQ10) is synthesized by the human body and found in certain foods. Daily supplementation of CoQ10 could protect against heart disease but the bioavailability of CoQ10 supplements depends on the formulation taken. We compared the bioavailability and antioxidant properties of two commercial CoQ10 formulations, a commercial grade CoQ10 powder (commercial grade CoQ) and a new BT-CoQ10 BIO-TRANSFORMED® (BT-CoQ10) obtained by fermentation of a soy-based, CoQ10-rich media with baker’s yeast. Eleven healthy individuals participated in a randomized two-way crossover trial, with a 3-week washout period. Capsules containing 300 mg of either BT-CoQ10 or commercial grade CoQ10 were given daily for 1 week and multiple blood samples were taken for CoQ10, glutathione and glutathione peroxidase (GPx) determination. In 3 subjects, baseline plasma CoQ10 levels were lower prior to BT than prior to commercial grade CoQ treatment. In the remaining participants, ingestion of BT vs. commercial grade CoQ significantly increased maximum plasma CoQ10 concentration (+126%, p = 0.04) and tended to increase CoQ10 area under the curve from 0 to 24 h (+160%, p = 0.07). One week of treatment with each formulation increased plasma CoQ10 but did not alter plasma glutathione or GPx activity. The enhanced bioavailability of the BT product might be due to its predominantly reduced, hydrophilic membrane-complex form.
Intercellular Electrical Coupling in Vascular Cells Present in Rat Intact Cerebral Arterioles
Authors: Yamazaki Jun , Kitamura Kenji
Published: April 2003

Using arterioles dissected from rat cerebral pial membrane, we investigated cell-to-cell communication by means of the amphotericin-B-perforated whole-cell patch clamp technique. During a brief voltage step or ramp in voltage clamp mode, the leak current through the membrane of a smooth muscle cell in situ in an arteriole was attenuated by different types of gap junction inhibitors. Macroscopic current recording via two electrodes attached to adjacent smooth muscle cells or to a smooth muscle cell and a nearby endothelial cell revealed transjunctional current flow between cells of the same or different types. The pseudo-junctional conductance-voltage relationship obtained from adjacent smooth muscle cells differed from that obtained from a smooth muscle cell and an endothelial cell (symmetrical for the former and asymmetrical for the latter). Single- or multiple-channel events could be recorded from weakly coupled cells of the two types: simultaneous, equal-sized events in opposite directions were recorded via two electrodes, demonstrating electrical coupling directly between cell pairs. The single-channel conductance observed most frequently varied: 200–230 pS for pairs of two smooth muscle cells and 240–260 pS for mixed pairs. These data suggest the existence of differential patterns of electrical communication in vascular cells present in rat intact cerebral arterioles.
Lack of Nitric Oxide Mediation of Flow-Dependent Arteriolar Dilation in Type I Diabetes Is Restored by Sepiapterin
Authors: Bagi Zsolt , Koller Akos
Published: April 2003

The mechanisms leading to microangiopathy in diabetes mellitus have still not been clearly elucidated. We hypothesized that type I diabetes mellitus affects the endothelium and alters flow-dependent dilation of arterioles, an important mechanism involved in local regulation of blood flow. Isolated, pressurized gracilis muscle arterioles (inside diameter approximately 150 µm at 80 mm Hg) from rats with streptozotocin (STZ)-induced diabetes mellitus exhibited reduced dilations induced by increases in perfusate flow compared to those of normal rats (plasma glucose: 25.7 ± 0.7 vs. 6.4 ± 0.5 mmol/l; maximum increase in diameter: 15 ± 4 vs. 31± 3 µm, p < 0.05). In control arterioles, both nitric oxide (NO) and prostaglandins mediated the flow-dependent dilation, whereas flow-induced dilations of diabetic arterioles were unaffected by Nω-nitro-L-arginine methyl ester (L-NAME) and were abolished by indomethacin. Sepiapterin – precursor of the endothelial NO synthase (eNOS) cofactor tetrahydrobiopterin (BH4) – restored the L-NAME-sensitive portion of flow-dependent dilations of diabetic arterioles. Furthermore, depletion of BH4 by 2,4-diamino-6-hydroxypyrimidine (DAHP) in control arterioles also resulted in reduced flow-dependent dilations, which were restored by intraluminal sepiapterin [but not with superoxide dismutase (SOD) plus catalase (CAT) (SOD+CAT)] and then could be inhibited by L-NAME. Dilations induced by the NO donor sodium nitroprusside (SNP) were unaffected by L-NAME in diabetes mellitus arterioles or when eNOS was activated by intraluminal flow in DAHP-treated arterioles (with or without SOD+CAT). In contrast, pyrogallol (known to produce reactive oxygen species) substantially reduced acetylcholine- and SNP-induced dilation in a SOD+CAT-reversible manner. Collectively, these findings suggest that in diabetic arterioles, due to the reduced bioavailability of BH4, the synthesis of NO by eNOS is limited, resulting in a reduced flow-induced dilation, a mechanism that may also be responsible for the development of diabetic microangiopathy and exacerbation of other vascular diseases.
Inhibitors of Actin Filament Polymerisation Attenuate Force but Not Global Intracellular Calcium in Isolated Pressurised Resistance Arteries
Authors: Shaw Linda , Ahmed Shabbir , Austin Clare , Taggart Michael J.
Published: April 2003

Receptor-coupled contractile activation of arterial smooth muscle involves increases in intracellular calcium ([Ca2+]i) and subsequent alteration of myosin light chain phosphorylation. An additional mechanism whereby agonists could regulate vascular contractility may be alteration of actin filament dynamics. Therefore, in this study, we have investigated the influence of two inhibitors of actin filament polymerisation, cytochalasin D and latrunculin B, on the [Ca2+]i and force responsiveness of pressurised rat mesenteric arteries to α-adrenergic stimulation. Following cytochalasin D or latrunculin B treatment, phenylephrine-induced constrictions were significantly reduced to 11 ± 3.2% (n = 6) and 10 ± 4.4% (n = 6) of control, respectively, whereas [Ca2+]i remained at 98 ± 21% and 104 ± 7.0% of control, respectively. Such effects of cytochalasin D were not restricted to mesenteric small arteries. Cytochalasin D also significantly reduced the force, but not [Ca2+]i responses to agonist stimulation in other vascular (portal vein) and non-vascular (uterine) tissues. These data indicate that inhibitors of net actin polymerisation attenuate maximum agonist-induced force responsiveness without similar reductions in [Ca2+]i in pressurised resistance vessels and other smooth muscle tissues. This suggests that modulation of the dynamic equilibrium between filamentous F-actin and monomeric globular actin (G-actin) may be an important mechanism, acting independently of global [Ca2+]i homeostasis, to regulate the smooth muscle contractile state.
Safety and Risk of Microelectrode Recording in Surgery for Movement Disorders
Authors: Hariz Marwan I.
Published: April 2003

There is an ongoing controversy about whether it is necessary to use microelectrode recording (MER) techniques in stereotactic surgery for Parkinson’s disease and other movement disorders. This paper consists of a critical review of the published literature in order to analyze the value of MER in providing safe, efficient and accurate functional stereotactic surgery. Review of the literature revealed that MER techniques do not necessarily improve targeting accuracy or clinical results, compared to techniques using impedance monitoring and macrostimulation. In terms of safety for the patients, however, MER techniques are relatively safe, but non-Mer techniques, based on macrostimulation-guided surgery, are at least five times safer.
Diagnostic Outcome of Methods Frequently Used for Caries Validation
Authors: Hintze Hanne , Wenzel Ann
Published: April 2003

The aim of this study was to compare the caries diagnostic outcome of four methods frequently used as validation for dental caries. The diagnostic outcome of clinical examination (CL), radiography (RA), and histology after serial tooth sectioning (HI-serial) on 373 approximal and 158 occlusal surfaces was compared, and furthermore histology after hemi- (HI-hemi) and serial sectioning on another 113 approximal and 53 occlusal surfaces was compared. Two thresholds for each method (CL: (1) sound vs. all caries scores, and (2) non-cavitated vs. cavitated lesions; RA and HI: (1) sound vs. all caries scores, and (2) no dentine vs. dentine lesions) were evaluated. In general, large differences in diagnostic outcomes were observed with the various methods. At threshold 1, CL resulted in significantly more lesions than both RA and HI-serial on approximal surfaces, and than RA on occlusal surfaces. At threshold 2, no significant differences between CL, RA and HI-serial were found on approximal surfaces, but on occlusal surfaces significantly more lesions were diagnosed with RA and HI-serial than with CL. Significantly more occlusal lesions were found by HI-serial than by RA at both thresholds 1 and 2. On approximal surfaces, a similar result was found only at threshold 1. On approximal surfaces, significantly more lesions were diagnosed with HI-serial than with HI-hemi at both thresholds 1 and 2. On occlusal surfaces the same was found only at threshold 1. The intra-observer reproducibility was higher using HI-serial than using RA and CL.
Clinical and Photographic Scoring of Skin Aging
Authors: Kappes U.P. , Elsner P.
Published: April 2003

Chronic exposure to sunlight induces clinical, histological and physiological changes that are described as photoaging. To assess the resulting skin changes different clinical and photographic scores have been evaluated. Regarding different scoring systems a standardized grading system would be useful in a variety of indications, in particular to improve the quality of epidemiologic and clinical studies of photodamage. Photonumeric grading is considered superior to descriptive scales; however, the combination of both may suggest an advanced assessment of photodamage.
The Topical Treatment of Psoriasis
Authors: van de Kerkhof P.C.M. , Vissers W.H.P.M.
Published: April 2003

According to the patients, improvement of efficacy, long-term safety and improvement of compliance are needed. The topical treatment has been innovated during the last decade. Most important are the introduction of two new classes of treatments: topical vitamin D3 analogues and the retinoid tazarotene. To what extent, however, have we achieved developments which are in line with the needs as expressed by the patients? Improved efficacy has been realized by successful combinations of topical treatments. In particular, the combinations of dithranol, vitamin D3 and tazarotene with a topical corticosteroid proved to be very effective with a reduced profile of side-effects. The efficacy of vitamin D3 analogues and tazarotene is such that the efficacy of a potent corticosteroid (betamethasone-17-valerate) is approached; calcipotriol even showed an efficacy which is at least as good as this corticosteroid. The long-term safety of new compounds has been evaluated for at least 12 months in large studies. Remarkably for corticosteroids such information is available for only 12 weeks. However, intermittent applications of a topical corticosteroid in combination with another topical treatment provide an effective and safe long-term control of psoriasis. Compliance is a conditio sine qua non for an effective topical treatment. Important progress has been made to increase compliance. Short-contact dithranol has been popularized as an ambulatory treatment which is a highly effective approach as a care instruction programme. Formulations which are better from a cosmetical point of view have been developed for various topical treatments. Reduction of the frequency of applications proved to be possible for most treatments. Once daily applications for corticosteroids, vitamin D3 analogues and retinoids have been developed, and intermittent applications, a few times per week, are possible for corticosteroids, which proved to be very effective with a reduced profile of side-effects, and are also developed for dithranol.
Under What Circumstances Can Seizures Produce Hippocampal Injury: Evidence for Age-Specific Effects
Authors: Galanopoulou Aristea S. , Vidaurre Jorge , Moshé Solomon L.
Published: April 2003

Mesial temporal sclerosis (MTS) is the characteristic hippocampal pathology of temporal lobe epilepsy in adults. Both clinical and experimental studies indicate that although the immature brain is highly susceptible to seizures, it is more resistant to the development of the seizure-induced hippocampal pathology akin to MTS, compared with the adult brain. However, seizures in the immature brain may produce age-specific effects on hippocampal morphology or function. The spectrum of these effects is still unknown. Factors such as the presence of prior neurological abnormalities, age, etiology of the seizures, repetitive seizures and genetic predisposition may affect the range and severity of hippocampal changes. The key point is to identify the significance of these changes and design age-appropriate preventative treatments.
Effect of Natriuretic Peptides on in vitro Stimulated Adrenocorticotropic Hormone Release and Pro-Opiomelanocortin mRNA Expression by the Fetal Rat Pituitary Gland in Late Gestation
Authors: Chatelain D. , Lesage J. , Montel V. , Chatelain A. , Deloof S.
Published: April 2003

Objective and Methods: We investigated the effects of individual natriuretic peptides (atrial natriuretic peptide, ANP; brain natriuretic peptide, BNP, and C-type natriuretic peptide, CNP) on rat corticotropin-releasing factor stimulated adrenocorticotropic hormone (ACTH) secretion by the pituitary gland of 21-day-old rat fetuses in vitro and on pro-opiomelanocortin gene expression using in situ hybridization. Results: Graded concentrations of ANP, BNP, or CNP (10–10, 10–9, and 10–8 mol/l) induced a log dose dependent inhibition of ACTH secretion induced by rat corticotropin-releasing factor (10–10 mol/l). These natriuretic peptides showed equipotent effects on a molar basis. Moreover, ANP, BNP, or CNP at 10–10 mol/l reduced significantly the pituitary pro-opiomelanocortin mRNA expression. In addition, the immunoreactive ANP, BNP, and CNP cells were localized in the anterior lobe, but not in the intermediate lobe of the fetal pituitary gland. Conclusions: These data suggest that the fetal pituitary gland may be both a source and a target for natriuretic peptides that might control ACTH synthesis and release via an endocrine and/or paracrine mechanism. The natriuretic peptides could participate, as well as glucocorticoids, in the control of the corticotropin-stimulating activity of the fetal rat in late gestation.
Early Antitoxin Treatment in Wound Botulism Results in Better Outcome
Authors: Chang Gregory Youngnam , Ganguly Gautam
Published: April 2003

Wound botulism in 7 heroin ‘skin poppers’ produced ophthalmoplegia and descending paralysis. Rapid recovery occurred in 2 who received the antitoxin within the fourth day of symptom onset. A poor outcome was seen in 4 who received the antitoxin after the eighth day of symptoms and 1 who did not receive the antitoxin. Early antitoxin administration is important in achieving a favorable outcome.
Interleukin-2 Production by Peripheral Blood Mononuclear Cells from Patients with Myasthenia gravis
Authors: Utsugisawa Kimiaki , Nagane Yuriko , Obara Daiji , Kondoh Ryushi , Yonezawa Hisashi , Tohgi Hideo
Published: April 2003

We examined interleukin-2 (IL-2) production by phytohemagglutinin (PHA)-stimulated peripheral blood mononuclear cells (PBMs) from 75 untreated myasthenia gravis (MG) patients and 48 control patients. Patients with MG consisted of those with elevated PBM IL-2 production (>1,250 pg/ml; mean + 2SD of the controls) (n = 29, 39%) and those with normal PBM IL-2 production (<1,250 pg/ml) (n = 46, 61%). Significant characteristics of patients with elevated PBM IL-2 production included elevated serum levels of anti-acetylcholine receptor antibodies, severe generalized symptoms, thymic hyperplasia, and marked effects of thymectomy (p < 0.05). These findings suggest that elevated PBM IL-2 production can reflect functional abnormalities of T cells in some patients with MG, and that PBM IL-2 production should be considered as a candidate target of therapy.
Comparative Evaluation of Anoxomat and Conventional Anaerobic GasPak Jar Systems for the Isolation of Anaerobic Bacteria
Authors: Shahin May , Jamal Wafaa , Verghese Tina , Rotimi V.O.
Published: April 2003

Objectives: To evaluate the performance of the Anoxomat, in comparison with the conventional anaerobic GasPak jar system, for the isolation of obligate anaerobes. Method: Anoxomat, model WS800, and anaerobic GasPak jar system (Oxoid) were evaluated. Anoxomat system utilized a gas mixture of 80% N2, 10% CO2 and 10% H2, while the GasPak used a gas mixture of 90% H2 and 10% CO2. An anaerobic indicator within the jars monitored anaerobiosis. A total of 227 obligate anaerobic bacteria comprising 116 stock strains, 5 ATCC reference strains and 106 fresh strains, representing different genera, were investigated for growth on anaerobic agar plates and scored for density, colony sizes, susceptibility zones of antibiotic inhibition and the speed of anaerobiosis (reducing the indicator). Results: The results demonstrate that the growth of anaerobic bacteria is faster inside the Anoxomat jar than in the anaerobic GasPak jar system. Of the 227 strains tested, the colonies of 152 (67%) were larger (by size range of 0.2–2.4 mm) in the Anoxomat at 48 h than in the GasPak jar compared with only 21% (range 0.1–0.3 mm) that were larger in the GasPak than in the Anoxomat. The remaining 12% were equal in their sizes. There was no measurable difference in the colony sizes of the reference strains. The Porphyromonas asaccharolytica strains failed to grow within the GasPak system but grew inside the Anoxomat. With the Anoxomat, anaerobiosis was achieved about 35 min faster than in the GasPak system. The density of growth recorded for 177 (78%) strains was heavier in the Anoxomat than in the GasPak jar. The zones of inhibition of the antibiotics tested were not different in the two systems. Conclusion: The Anoxomat system provided superior growth, in terms of density and colony size, and achieved anaerobiosis more rapidly. Evidently, the Anoxomat method is more reliable and appears to support the growth of strict anaerobes better.
Penetration of Levofloxacin into Human Aqueous Humor
Authors: Kobayakawa Shinichiro , Tochikubo Tetsuo , Tsuji Akiyoshi
Published: April 2003

This study was designed to measure the concentration of levofloxacin in aqueous humor after topical and oral administration in patients undergoing cataract extraction. Patients were randomly divided into four groups. Levofloxacin concentration in the aqueous humor was the highest in the group in which 600 mg was given orally plus five topical instillations before surgery. The aqueous humor levels of levofloxacin after topical and oral administration exceeded the minimum inhibitory concentrations for certain bacterial species that frequently cause intraocular infection.
Isoflavone Consumption Does Not Increase the Bone Mass in Osteopenic Obese Female Zucker Rats
Authors: Picherit Christel , Horcajada Marie-Noëlle , Mathey Jacinthe , Chanteranne Brigitte , Puel Caroline , Lebecque Patrice , Davicco Marie-Jeanne , Coxam Véronique , Barlet Jean-Pierre
Published: April 2003

Some controversy exists in the literature concerning the effects of leptin on bone metabolism. Thus we have compared femoral bone density and biochemical markers of bone metabolism in male and female fatty (leptin-resistant) Zucker rats and their lean homozygous controls at 3 and 6 months of age. At 3 months, no differences concerning total, diaphyseal (cortical bone), and distal metaphyseal (trabecular bone) femoral bone densities, plasma osteocalcin concentrations, and urinary deoxypyridinoline excretion were observed between fatty and lean rats. On the opposite, at 6 months of age, in both males and females, total, diaphyseal, and distal metaphyseal femoral bone densities and plasma osteocalcin concentrations were lower in Zucker than in lean rats. Soybean isoflavone consumption (40 µg/g body weight/day for 90 days, a dose which prevents osteopenia following ovariectomy both in lean Zucker homozygous controls and in Wistar rats) by obese female Zucker rats had no significant effect upon their bone mass.
Increased Abdominal Obesity, Insulin and Glucose Levels in Nondiabetic Subjects with a T29C Polymorphism of the Transforming Growth Factor-β1 Gene
Authors: Rosmond Roland , Chagnon Monique , Bouchard Claude , Björntorp Per
Published: April 2003

Background: In humans, a T→C transition at nucleotide 29 in the region encoding the signal peptide sequence of the transforming growth factor (TGF)-β1, which results in a Leu→Pro substitution at codon 10, has been associated with myocardial infarction. Aims/Methods: In the present study, we genotyped 284 unrelated, nondiabetic Swedish men born in 1944 to assess the impact of the Leu10Pro variant on obesity, including abdominal obesity, and estimates of insulin, glucose and lipid metabolism as well as blood pressure. Results: The frequency of the Pro10 variant was 38.9% (95% CI 32.2–46.0%), and the distribution of genotypes was in Hardy-Weinberg equilibrium. Data analysis showed that heterozygotes had significantly higher body mass index compared to homozygous carriers to the Leu10 variant. In addition, homozygous carriers of the Leu10 variant had significantly lower abdominal sagittal diameter than both Leu10Pro and Pro10Pro carriers. We also found that heterozygotes had significantly higher fasting insulin values as well as higher HOMA insulin-resistance index in comparison to homozygous carriers of the Leu10. Fasting glucose levels were significantly higher in subjects with the Pro10Pro variant compared to subjects with either the Leu10Leu or Leu10Pro variant. Conclusion: These findings suggest that the Pro10 allele in the TGF-β1 gene pathway might contribute to prevalent diseases such as obesity and type 2 diabetes mellitus.
11β-Hydroxysteroid Dehydrogenase Type 1 Deficiency (‘Apparent Cortisone Reductase Deficiency’) in a 6-Year-Old Boy
Authors: Małunowicz Ewa M. , Romer Tomasz E. , Urban Maria , Bossowski Artur
Published: April 2003

Objective: We present the 1st case of prepubertal hyperandrogenism because of a defect in the conversion of cortisone (E) to cortisol (F) by hepatic11β-hydroxysteroid dehydrogenase type 1. Methods and Results: Clinical and anthropometric data were obtained. Serum androgens and gonadotropins with luteinizing hormone releasing hormone stimulation test, dexamethasone suppression test, and corticotropin-releasing hormone stimulation test were evaluated. Adrenal imaging and urinary steroid profiling by gas chromatography/mass spectrometry were employed. A 6.9-year-old boy presented with precocious pubarche, height (+2.6 SD), accelerated bone age (11.5 years), and Tanner stage 2 pubic hair and genitalia. Serum androgen levels were elevated and dexamethasone suppressible. Serum F was normal, but the E concentration was increased. Central precocious puberty and congenital adrenal hyperplasia were excluded. The excretion of androgen metabolites was moderately increased, but a highly increased tetrahydrocortisone (THE) and a diminished tetrahydrocortisol (THF + allo-THF) excretion was found with a [THF + allo-THF/ THE] ratio of 0.032 (normal controls 1.05 ± 0.17). The corticotropin-releasing hormone stimulation test showed an exaggerated adrenocorticotropic hormone response, suggesting a relative deficiency of F. Two months of hydrocortisone treatment (17.5 mg daily) failed to suppress androgens adequately. Treatment with dexamethasone (0.375 mg/daily) resulted in androgen suppression. Conclusions: In the case of precocious pubarche and accelerated growth, the diagnosis of 11β-hydroxysteroid dehydrogenase type 1 deficiency (‘apparent cortisone reductase deficiency’) should be considered. The diagnosis is based on determinations of urinary steroid metabolites.
Pericardial Cystic Mass with Fetal Tachycardia
Authors: Simsek T. , Kardelen F. , Simsek M. , Trak B.
Published: April 2003

A pericardial cystic mass is a rare congenital anomaly and may be mistaken for other pericardial and pleural masses. A 31-year-old pregnant woman at 38 weeks of gestation presented with fetal pericardial cyst and fetal tachycardia, which were confirmed by transthoracal echocardiography after delivery. Tachycardia did not persist after delivery. The case is being followed up without any clinical problems at the pediatric cardiology clinic.
Isolated, Persistent Functional Tricuspid Valve Regurgitation in a Fetus with Normal Heart Anatomy (and No Extracardiac Malformation)
Authors: Respondek-Liberska M. , Krasoń A.
Published: April 2003

Functional fetal tricuspid valve regurgitation was diagnosed by echocardiography at 27 weeks of gestation as an isolated anomaly with a maximum velocity of the regurgitation jet of 3 m/s. This was also observed at 30, 32 and 35 weeks of gestation and at term. Just after delivery pneumonia was diagnosed in the newborn baby based on clinical symptoms, chest X-ray and laboratory findings. To date persistent fetal tricuspid valve regurgitation has not been described in the literature on normal fetal heart anatomy. Various etiologies and possible pathomechanisms are discussed.
Successful Fetal Surgery for the Repair of a ‘Myelomeningocele-Like’ Defect Created in the Fetal Rabbit
Authors: Pedreira Denise A.L. , Valente Paulo R. , Abou-Jamra Rogério C. , Pelarigo Cláudio L. , Silva Lilian M. , Goldenberg Saul
Published: April 2003

Objective: To study the correction of a ‘myelomeningocele-like’ defect in fetal rabbits. Methods: Twelve pregnant rabbits had a spinal defect surgically created in 40 of their fetuses at 23 days of gestation. Immediate repair was performed in 30 fetuses (group I), and 10 remained uncorrected (group II). After 30 days, the fetuses were harvested and the anatomopathological aspects where compared using Fisher’s exact test. Results: Three different techniques to apply a cellulose graft were used for correction in 8 (technique A), 7 (technique B), and 15 animals (technique C), but only one (technique C) was successful. The survival rate at 30 days was 66.7% (10/15) in group I and 80% (8/10) in group II. A ‘myelomeningocele-like’ defect was present in all fetuses in group II, while in group I the defect was successfully repaired in 80% of the surviving fetuses (p < 0.01). Conclusion: The surgically created spinal defect was successfully repaired, and also the fetal rabbit could be established as a model for the study of intrauterine correction of a myelomeningocele-like defect.
White Matter Changes in Stroke Patients
Authors: Leys Didier , Englund Elisabet , Del Ser Theodoro , Inzitari Domenico , Fazekas Franz , Bornstein Natan , Erkinjuntti Timo , Bowler John V. , Pantoni Leonardo , Parnetti Lucilla , De Reuck Jacques , Ferro José , Bogousslavsky Julien
Published: April 2003

White matter changes (WMC), detected by imaging techniques, are frequent in stroke patients. The aim of the study was to determine how WMC relate to stroke subtypes and to stroke outcome. We made a systematic Medline search for articles appearing with two of the following key words: either ‘WMC or white matter lesions or leukoencephalopathy or leukoaraiosis’ and ‘stroke or cerebral infarct or cerebral hemorrhage or cerebrovascular disease or transient ischemic attack (TIA)’. WMC, as defined radiologically, are present in up to 44% of patients with stroke or TIA and in 50% of patients with vascular dementia. WMC are more frequent in patients with lacunar infarcts, deep intracerebral hemorrhages, cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy and cerebral amyloid angiopathy. After an acute ischemic stroke, WMC are associated with a higher risk of death or dependency, recurrent stroke of any type, cerebral bleeding under anticoagulation, myocardial infarction, and poststroke dementia. WMC in stroke patients are often associated with small-vessel disease and lead to a higher risk of death, and poor cardiac and neurological outcome. However, several questions remain open and need further investigations.
Decrease of Activated Lymphocytes Four and Nine Hours after a Subcutaneous Injection of a Viscum album L. Extract in Healthy Volunteers
Authors: Stoss Matthias , Peter Ellen , Gorter Robert W.
Published: April 2003

The immunomodulatory substance, VaQuFrF (an aqueous extract of Viscum album L. of the oak tree) is used as an adjuvant and as monotherapy in the treatment of cancer and AIDS. After subcutaneous injection, there is a local inflammatory reaction at the injection site and systemic elevation of activated lymphocytes. The immunomodulatory effect of VaQuFrF in the first 24 h after subcutaneous injection on blood leukocyte and lymphocyte subpopulation was investigated. Because a significant natural circadian variation of these cellular parameters exist, the influence was studied in regard to this. In two groups of healthy volunteers, one group receiving VaQuFrF, the following parameters were measured every 2–3 h over a period of 24 h: leukocytes, band form, segmented and eosinophilic granulocytes, monocytes, total lymphocytes and CD4-, CD8-, CD3/25- and CD8/38-positive lymphocytes in count and percentage. In regard to the natural circadian variation 24 h after injection of VaQuFrF, a statistically significant fall in the absolute numbers and percentage of CD3/25- and CD8/38-positive lymphocytes was observed. Also, monocytes in percent and absolute numbers show a transient fall 6–9 h, lymphocytes only in absolute and CD4-positive lymphocytes only in percentage 2 h after injection. The results demonstrate that there is increased extravasation of (activated) lymphocytes and monocytes after subcutaneous injection of 1 mg VaQuFrF.
Subacute Stereotactic Aspiration of Haematomas within the Basal Ganglia Reduces Occurrence of Complications in the Course of Haemorrhagic Stroke in Non-Comatose Patients
Authors: Marquardt Gerhard , Wolff Robert , Sager Anke , Janzen Rudolf W.C. , Seifert Volker
Published: April 2003

Background and Purpose: Medical complications occurring after stroke of both ischaemic and haemorrhagic origin are frequent and constitute an important problem. The strongest factor predicting the occurrence of complications is known to be the initial neurological impairment level. The aim of this study was to examine whether subacute stereotactic aspiration of haematomas within the basal ganglia is suitable to reduce the occurrence of complications in the course of haemorrhagic stroke in non-comatose patients. Methods: Following rigorous selection criteria, 56 consecutive non-comatose patients were treated by subacute stereotactic evacuation of the haematomas. Glasgow Coma Scale (GCS) scores after initiation of treatment, medical complications, mortality and length of in-patient stay before discharge for further rehabilitative treatment were recorded for each patient and were compared with the results obtained in a comparable group of 39 patients treated purely medically in another hospital. Results: The level of consciousness improved markedly after stereotactic surgery, and GCS scores were significantly higher than those after pure medical treatment (p < 0.0001). In comparison with medical patients, complications were considerably fewer in the surgical group, and thus peri-ictal morbidity and mortality were significantly lower. Length of necessary treatment in the intensive care unit as well as total in-patient stay in the acute care facility were significantly reduced. Conclusions: Improving alertness, subacute stereotactic aspiration of deep-seated haematomas decreases occurrence of medical complications in the course of haemorrhagic stroke. Recovery can be accelerated, and patients are earlier suitable for further rehabilitative treatment.
Brachytherapy for Intracranial Meningioma Using a Permanently Implanted Iodine-125 Seed
Authors: Obasi Patrick C. , Barnett Gene H. , Suh John H.
Published: April 2003

Purpose: To investigate the response and complications of iodine-125 brachytherapy for the treatment of recurrent and newly diagnosed meningiomas. Clinical cases of 2 patients treated with this method are presented. Materials and Methods: Thirteen patients with primary and recurrent intracranial meningioma were treated by frameless stereotactic implantation of iodine-125 seeds from January 1996 to June 1998. The total dose to decay ranged from 7,000 to 17,000 cGy, with a dose rate of 5–10 cGy/h. Results: All 11 evaluable patients had a decrease or stabilization in the size of their lesions as detected by MRI during follow-up. There were no acute complications. All patients who received a total dose greater than 10,000 cGy had postoperative radiation necrosis and/or vasogenic edema while only 20% of the patients who received doses of 10,000 cGy or less had radiation changes (p = 0.002). Conclusions: MRI-guided stereotactically assisted permanent implantation of iodine-125 seeds seems to be a safe, effective and noncomplicated method for the treatment of primary and recurrent meningiomas for selected patients, when doses are limited to 10,000 cGy.
Electrical Membrane Activity and Intracellular Calcium Buffering Control Exocytosis Efficiency in Xenopus Melanotrope Cells
Authors: Scheenen Wim J.J.M. , Dernison Marc M. , Lieste Jacco R. , Jenks Bruce G. , Roubos Eric W.
Published: April 2003

In neural and neuroendocrine cells, Ca2+ influx is essential for exocytosis. Ca2+ influx takes place through electrical membrane activity, which often occurs in bursts of action potentials that lead to intracellular Ca2+ oscillations. Cytoplasmic Ca2+ buffers and intracellular Ca2+ stores are involved in the propagation of the oscillations through the cell. Studies focused on action potential bursts with a high frequency up to 20 Hz indicate that, depending on the cell type under investigation, bursts either enhance or reduce exocytosis efficiency. In many cell types, the bursting frequency can be as low as 1 Hz, although no information is present on whether this influences exocytosis efficiency. The present study addresses the role of low-frequency bursts around 1 Hz and cytoplasmic Ca2+ buffering in the regulation of exocytosis efficiency, using neuroendocrine melanotrope cells of the amphibian Xenopus laevis. Exocytosis efficiency was determined by membrane capacitance measurements. Mimicking the bursting activity of 1 Hz (typical for this cell type) by repetitive depolarizing pulses enhanced exocytosis efficiency by 58% compared to application of only one single depolarizing pulse. This increase appears to be particularly due to a small number of distinct depolarizing pulses within a burst. Including the fast Ca2+ buffer BAPTA in the intracellular solution reduced exocytosis efficiency by 60% in the first part of a burst, whereas during the later part of the burst, stimulation (+50%) took place. We conclude that low-frequency bursting in the Xenopus melanotrope cell strongly promotes exocytosis efficiency and that this efficiency also depends on the capacity of the cytoplasm to buffer the intracellular Ca2+ signal; strong Ca2+ buffering during a short burst will decrease exocytosis efficiency, whereas with prolonged bursts, buffering capacity will be overcome, leading to Ca2+ accumulation and thus enhanced exocytosis efficiency.