bluuebunny/crossref_metadata_2025 huggingface dataset:
Screening for Prolactin Isoforms in the Follicular Fluid of Patients Undergoing in vitro Fertilization
Authors: Romão Gustavo S. , Ferriani Rui A. , Moura Marcos D. , Martins Antonio R.
Published: April 2003

The purpose of this prospective and non-randomized study was to identify prolactin (PRL) isoforms in the follicular fluid (FF) of patients undergoing in vitro fertilization (IVF). The FF from 19 patients was obtained during oocyte retrieval at the University Hospital, Ribeirão Preto Medical School. The molecular weight of FF PRL was determined by column chromatography on Sephacryl S-200 HR combined with an immunometric assay. The only PRL isoform detected in FF exhibited a molecular weight of 20.5 kD. The molecular weights of FF PRL and small PRL are essentially identical. The 20.5-kD PRL accounted for 93.1 ± 9.1% (mean ± SD) of the recovered PRL after gel chromatography. Total PRL recovery was 74.2 ± 19%. Thus, the only PRL detected in the FF was the small PRL, the most potent one.
Functional Studies on Nine Different Haemoglobins with High Oxygen Affinity
Authors: David O. , Ivaldi G. , Rabino-Massa E. , Ricco G.
Published: April 2003

Nine carriers of β-abnormal haemoglobins with increased oxygen affinity (Hb X) were examined. Their oxygen dissociation curves from whole blood were more or less left-shifted, with six of nine also characterized by biphasism. This refers to an ‘inflection point’ usually positioned at about 50–60% of Hb O2 saturation, commonly believed to be a limit between oxygenation of the normal and abnormal components. In effect, the inflection does not always correspond to the Hb X level, which sometimes is much lower than 50% of the total Hb. Moreover, the upper half segment of the dissociation curve could not only be an expression of Hb A oxygenation, since it is always left-shifted. However, a high Hb A level is commonly believed to be the main compensatory factor of these subjects, but many indications suggest that often they have at least three, and not only two, main haemoglobin species: Hb A, Hb X plus hybrids of the type α2βAβX. These would oxygenate after Hb X, but before Hb A. Finally, the interaction of 2,3-diphosphoglycerate with Hb X and/or hybrid tetramers must be altered, and the releasing of oxygen from both is more or less reduced. Unfortunately, it is difficult to demonstrate the presence of hybrids directly, i.e. with amino acid analysis of the abnormal β-globin.
Molecular Characterization of Thalassemia intermedia Associated with HPFH-6/β-Thalassemia and HPFH-6/Hb E in Thai Patients
Authors: Fucharoen Supan , Fucharoen Goonnapa , Sanchaisuriya Kanokwan , Surapot Satja
Published: April 2003

We report the molecular and hematological characterizations of thalassemia caused by interactions of the hereditary persistence of fetal hemoglobin (HPFH)-6 with β-thalassemia in 2 Thai patients and the HPFH-6 with Hb E in another Thai patient. Marked hypochromic microcytosis, characteristics of thalassemia intermedia, were obvious in the former 2 cases but the latter had much milder clinical phenotype with normal Hb and a slightly reduced mean corpuscular volume (MCV) value. Hb analysis revealed no Hb A but Hb A2F patterns in the compound HPFH-6/β-thalassemia patients and the EF pattern in the HPFH-6/Hb E patient. The Gγ-globin chain predominated in all cases. Globin gene analyses demonstrated that all patients carried the 101-kb HPFH-6 deletion in trans to the β-thalassemia genes with the IVS1#5 G–C mutation and the G insertion between codons 8/9 and the βE-gene, respectively. Hematologic data of the patients were compared to those of the HPFH-6 heterozygotes found in their family members and different genotype-phenotype interactions of this HPFH determinant in these Thai patients are illustrated.
Follow-Up Examinations by Transcranial Doppler Ultrasound in Primary Angiitis of the Central Nervous System
Authors: Ritter Martin A. , Dziewas Rainer , Papke Karsten , Lüdemann Peter
Published: April 2003

Background: Primary angiitis of the central nervous system (PACNS) is a rare disease. The definite diagnosis is made upon proof of mononuclear inflammation of the vessel wall on brain biopsy. The diagnosis can also be established on clinical grounds, typical findings on intra-arterial angiography and other investigatory grounds excluding other diseases. Therapy comprises an aggressive immunosuppressive approach. Close monitoring of the patients is mandatory. Transcranial Doppler ultrasound (TCD) has not yet been used to follow up the vasculitic lesions in PACNS. Case: We report on a 32-year-old female with massive cerebral infarctions secondary to multiple large-vessel stenoses because of probable PACNS. The patient was followed closely by means of TCD. During therapy the cerebral blood flow velocities normalized as displayed by TCD. Clinical improvement followed several days after normalization of cerebral blood flow. Conclusions: TCD is a valuable noninvasive bedside tool to monitor cerebral blood flow velocities and therapy response in patients with cerebral vasculitis, if large arteries are involved.
The Venturi Effect and Cerebrovascular Ultrasound
Authors: Ritter Martin A. , Ringelstein E. Bernd
Published: April 2003

Background: One of the most frequent diagnostic pitfalls in cerebrovascular ultrasound is the evaluation of the vertebrobasilar system in the case of vertebral artery (VA) hypoplasia because the diagnostic findings are sometimes suggestive of significant pathologies, but may be completely normal as well. The Venturi effect is a phenomenon of hydrodynamics which describes a drop in hydrostatic pressure along areas of high flow velocities. Method: We review the physical background of the Venturi effect and describe how it can explain both physiological and pathological flow phenomena encountered during cerebrovascular ultrasound investigations. We focused on flow phenomena at the vertebrobasilar junction by theoretically calculating conditions with different influx angles and flow velocities on two-dimensional digital subtraction angiography images. In the discussion, we also address other areas of cerebrovascular ultrasound, where the Venturi effect is of particular interest. Results and Conclusions: The blood flow velocity within the VAs and the angle between a hypoplastic VA and the basilar artery (BA) are important determinants of the intraluminal pressures of these arteries and thus their resistances. In the case of angles below 90° between the distal VA and the BA, abnormal extracranial flow profiles may suggest downstream VA stenosis or occlusion, whereas in the case of angles above 90°, a diagnosis of an AV fistula downstream to the V4 segment may be assumed. Furthermore, various hemodynamic effects at the site of a stenosis of the brain supplying arteries can also be explained by a transstenotic pressure drop created by the Venturi effect, particularly the generation of musical murmurs. The systolic dip (‘systolic deceleration’) at the origin of the VA due to subclavian artery stenosis is also a consequence of the Venturi effect.
Thrombocytosis Associated with Enzyme Replacement Therapy in Gaucher Disease
Authors: Dweck Altoon , Blickstein Dorit , Elstein Deborah , Zimran Ari
Published: April 2003

We describe a patient with an intact spleen and moderately severe symptoms of Gaucher disease in whom, after initiation of (low-dose) enzyme replacement therapy (ERT), thrombocytosis (720 × 109/l) was documented. Checking the International Gaucher Registry database revealed that this patient is the only nonsplenectomized patient of more than 1,000 treated patients to experience ERT-induced thrombocytosis. Platelet counts dropped immediately after the discontinuation of ERT.
Psychiatric and Psychosocial Outcome of Orthotopic Liver Transplantation
Authors: Rothenhäusler Hans-Bernd , Ehrentraut Sigrid , Kapfhammer Hans-Peter , Lang Christina , Zachoval Reinhart , Bilzer Manfred , Schelling Gustav , Gerbes Alexander L.
Published: April 2003

Background: The study aimed to explore the prevalence of psychiatric disorders among orthotopic liver transplantation (OLT) recipients, and to investigate how psychiatric morbidity was linked to health-related quality of life (HRQOL). Methods: We recruited 75 patients who had undergone OLT a median of 3.8 years previously (range = 5–129 months). Psychiatric morbidity was assessed using the Structural Clinical Interview for the DSM-III-R. Psychometric observer-rating and self-rating scales were administered to evaluate cognitive functioning (SKT), depressive symptomatology (HAMD17), posttraumatic stress symptoms (PTSS-10), social support (SSS), and HRQOL (SF-36 Health Status Questionnaire). Treatment characteristics were obtained from medical records. Results: 22.7% (n = 17) of our sample had a current or probable psychiatric diagnosis according to DSM-III-R: 2.7% full posttraumatic stress disorder (PTSD) (n = 2), 2.7% major depressive disorder (MDD) comorbid to full PTSD (n = 2), 1.3% MDD comorbid to partial PTSD (n = 1), and 16% partial PTSD (n = 12). Patients with PTSD symptoms demonstrated lower cognitive performance, higher severity of depressive symptoms and more unfavorable perception of social support. OLT-related PTSD symptomatology was associated with maximal decrements in HRQOL. The duration of intensive care treatment, the number of medical complications, and the occurrence of acute rejection were positively correlated with the risk of PTSD symptoms subsequent to OLT. Conclusion: OLT-related PTSD symptomatology impairing HRQOL is a complication for a subgroup of OLT recipients. Health-care providers should be aware of the possible presence of PTSD in OLT survivors.
Cytokines Accumulated in Acquired Renal Cysts in Long-Term Hemodialysis Patients
Authors: Ito Fumio , Nakazawa Hayakazu , Ryoji Osamu , Okuda Hisashi , Toma Hiroshi
Published: April 2003

Background: Cytokines play a pivotal role in growth, differentiation, and apoptosis. In this study, we measured cytokine content in the renal cyst fluid of patients with acquired cystic disease of the kidney (ACDK) in order to elucidate the possibility that cytokines are related to the development of ACDK. Patients and Methods: All or some of 15 cytokines, IL-1a, -1b, -2, -4, -5, -6, -8, -10, IFN-α, -γ, G-, M-, GM-CSF, TNF-α, and vascular endothelial growth factor (VEGF) were analyzed in cyst fluid and serum of 12 patients on hemodialysis (HD) including 8 with ACDK and 8 with normally functioning kidneys by sandwich enzyme-linked immunosorbent assay. Results: Out of these cytokines, only IL-6, -8, M-CSF, and VEGF were detected in the cyst fluid of patients with ACDK. Moreover, IL-6, -8, and VEGF showed significantly higher concentrations in the cyst fluid than in the blood (194.9 ± 90.9 vs. 0.0 ± 0.0 pg/ml, 2,377.5 ± 602.9 vs. 0.0 ± 0.0 pg/ml, 5,167.8 ± 1,316.9 vs. 41.1 ± 14.7 pg/ml, respectively), while M-CSF showed comparable concentrations in the cyst fluid with those in the blood (3,519.4 ± 730.0 vs. 3,250.3 ± 319.1 pg/ml, p = 0.69). Additionally, IL-6, -8, and VEGF accumulated more abundantly in the cyst fluid of patients with ACDK than in that of patients with other cystic nephropathies including ADPKD patients on HD (194.9 ± 90.0 vs. 4.6 ± 3.2 pg/ml, 2,377.5 ± 602.9 vs. 76.8 ± 46.5 pg/ml, 5,167.8 ± 1,316.9 vs. 131.1 ± 63.1 pg/ml, respectively). However, there was no significant correlation between the intracystic concentrations of these cytokines and the corresponding cyst diameters. Conclusion: These results showed that in ACDK patients a local environment exists in which production or accumulation of certain cytokines is selectively enhanced compared with patients with other cystic nephropathies. They imply that these cytokines are closely related to pathogenesis particular to ACDK.
Pathologic ‘Fused Gland’ as a Prognostic Factor for Prostate Cancer
Authors: Noguchi Sumio , Kubota Yoshinobu , Kondoh Iichirou , Harada Masaoki , Masuda Mitsunobu , Uemura Hiroji , Hosaka Masahiko
Published: April 2003

We examined the significance of a pathologic ‘fused gland’ according to the WHO-Mostofi classification for predicting prognosis in hormonally treated prostate cancer. Of 284 newly diagnosed patients receiving hormone therapy, 60 patients had specimens with no ‘medullary’ or ‘column-cord’ elements. Twenty-five of these had a ‘fused gland’, while 35 did not. Survival of these patients was analyzed. Cause-specific survival of the patients with no medullary or column-cord elements showed a significantly better prognosis compared to others. Furthermore, the patients whose specimens contained a ‘fused gland’ component had significantly poorer survival than those without that component, suggesting that the ‘fused gland’ component is a poor prognostic factor for survival in patients with hormonally treated prostate cancer.
The ‘Wing’ versus the ‘Vapor Cut’ Electrodes in Transurethral Electrovaporization-Resection of the Prostate: Comparative Changes in Safety Parameters
Authors: Talic R.F. , Al Kudair W.K. , El Tiraifi A.E. , Al Bogami N.M. , Mansi M.K. , Altaf S. , Hargreaves T.B.
Published: April 2003

We compared the early safety features of two-band resection devices used in transurethral vaporization-resection of the prostate (TUVRP). Ninety patients with prostatic outflow obstruction were prospectively evaluated in two open studies for the treatment using the ‘Wing’ cutting electrode in group 1 (Richard Wolf, Germany) and the ‘Vapor Cut’ electrode in group 2 (Karl Storz, Germany). Patients in both groups were comparable in age, presentation, prostate size and blood parameters. Safety features evaluated included changes in serum hemoglobin, hematocrit, sodium concentration and incidence of side effects. The mean drop in hemoglobin, hematocrit and serum sodium 1 h postoperatively for the Wing group were 0.54 g/dl, 2.04 ml/dl and 0.084 mEq/l respectively compared to a mean drop of 1.1 g/dl, 3.07 ml/dl and 3.1 mEq/l in the Vapor Cut group. These differences were statistically significant (p = 0.004, 0.03 and <0.0001 respectively). The mean resection weight was 24.78 ± 10.4 and 24.46 ± 14.79 g in groups 1 and 2, respectively; however, the mean operation time was significantly longer in the Wing group (47.7 vs. 37.1 min, p = 0.003). We conclude that both loops were safe and efficacious in the treatment of patients with prostatic outflow obstruction. Safety features that are related to the vaporization effect are influenced by the speed of resection.
Sacral Nerve Stimulation for Pain Relief in Interstitial Cystitis
Authors: Zermann Dirk-Henrik , Weirich Torsten , Wunderlich Heiko , Reichelt Olaf , Schubert Jörg
Published: April 2003

A 60-year-old woman was treated for severe interstitial cystitis pain using sacral nerve stimulation. Pain and accompanying bladder dysfunction were improved by temporary and permanent sacral nerve stimulation. Six months after implantation of a sacral neuromodulator the patient is pain free and significantly improved on bladder dysfunction. Interstitial cystitis may be an indication for functional electrostimulation.
Assessment of Voiding Outcome, Sexual Function and Quality of Life Two Years following KTP/YAG Hybrid Laser Prostatectomy
Authors: Chahal R. , Sundaram S.K. , Gogoi N.K.
Published: April 2003

Objective: To assess the long-term outcome of patients undergoing KTP/YAG hybrid laser treatment for bladder outlet obstruction due to benign prostatic enlargement, in terms of symptomatic relief, complications, sexual function, patient satisfaction and acceptance of procedure. Patients and Methods: The study recruited 148 patients prospectively. The hybrid laser treatment involved performing an initial bladder neck incision using KTP laser at 34 W followed by 4/6 point coagulation using NdYAG laser at 60 W. Patients were followed up till 2 years and assessed using uroflowmetry, International Prostate Symptom Score (IPSS), Patient Satisfaction Score (PSS), BPH impact index (BII) and the Danish Prostate Symptom Score (DAN-PSS) sexual function questionnaire. Results: 137 patients were followed up for 2 years. There was a significant improvement in the maximum flow rate, IPSS and Quality of Life Scale (QLS). The mean BII (2.9) and the mean PSS (1.9) were low suggesting overall satisfaction with the procedure. The complications included urethral stricture (0.73%), bladder neck obstruction (2.15%) and retreatment (3.6%). 79.4% had a significant decrease in the ejaculate and 32.8% had a significant change in the strength of erections. On comparing the two groups (sexual function affected vs. not affected), the age, BII, IPSS and PSS were significantly higher (p < 0.05) in the group of patients that were affected. Conclusions: Following KTP/YAG hybrid laser prostatectomy the outcome for voiding is good and durable for up to 2 years. The patient satisfaction level following the procedure is high and the procedure well accepted. However, significant interference with sexual function occurs, which appears to be occurring in tandem with a poor voiding outcome.
General State of Health and Psychological Well-Being in Patients after Surgery for Urological Malignant Neoplasms
Authors: Ficarra V. , Righetti R. , D’Amico A. , Pilloni S. , Balzarro M. , Schiavone D. , Malossini G. , Mobilio G.
Published: April 2003

Objective: To evaluate the general state of health and the psychological well-being in a group of 155 patients after surgery for urological malignant neoplasms. Materials and Methods: Surgery was performed in 55 patients for renal cell carcinoma, in 54 for invasive bladder carcinoma, in 30 for adenocarcinoma of the prostate, and in 16 for squamous penile carcinoma. All patients were invited to self-compile the General Health Questionnaire (GHQ) – 12 items according to Goldberg and the Hospital Anxiety and Depression Scale. Results were compared with those in a group of patients who underwent retropubic prostatectomy for benign prostatic hyperplasia. Results and Conclusion: The general state of health was significantly more impaired in neoplastic patients than in the control group. Levels of anxiety were significantly higher but depression levels were similar in both groups. As far as the type of tumor is concerned, patients who underwent radical cystectomy for bladder carcinoma and those treated with partial penectomy for squamous penile carcinoma showed a significant impairment of the general state of health compared with controls. Higher levels of anxiety were observed in patients who underwent ileal conduit after radical cystectomy, in those treated with radical prostatectomy for prostate cancer and in those who underwent partial penectomy. Significantly higher levels of depression than in the control group were observed only in patients with ileal conduit.
Expression of E-Cadherin and Catenins on Testis Tumor
Authors: Saito Toshihiro , Katagiri Akiyoshi , Watanabe Ryusuke , Tanikawa Toshiki , Kawasaki Takashi , Tomita Yoshihiko , Takahashi Kota
Published: April 2003

E-cadherin (ECD) is a homophilic Ca2+-dependent adhesion molecule associated with cell-to-cell interactions and normal growth. Recent reports have suggested that decrease or loss of ECD facilitates tumor progression and/or metastasis. ECD functions in a complex called an adherens junction, which includes several other proteins including α- and β-catenin. In the present study, fresh-frozen sections from 32 testis cancers, 16 seminomas and 16 non-seminomatous germ cell tumors (NSGCT), were examined immunohistochemically. E-cadherin was not expressed on normal germ cells, but expressed on 3 (18.8%) of 16 seminomas and 10 (62.5%) of 16 NSGCTs, mainly on the epithelial component of teratoma cells. α-Catenin was detected on 0 (0%) of 13 seminomas and 4 (25%) of 16 NSGCTs. β-Catenin was detected on 10 (71.4%) of 14 seminomas and 13 (81.2%) of 16 NSGCTs. ECD was detected significantly more frequently on NSGCTs than on seminomas. Immunoblot analysis confirmed the expression of ECD and β-catenin in NSGCTs. Expression of ECD and catenins may reflect the degree of differentiation and provide some information on the character of the tumor.
Evaluation of a Fibrin Sealant Free of Bovine-Derived Components in an Experimental Vas Anastomosis Study
Authors: Vankemmel Olivier , de la Taille Alexandre , Burnouf Thierry , Rigot Jean Marc , Duchene Frank , Mazeman Etienne
Published: April 2003

Objectives: The risk of transmission of bovine spongiform encephalopathy cannot be excluded from the use of bovine-derived products. The present study was undertaken to evaluate the performance of a new fibrin glue free of bovine-derived components in vas anastomosis and to compare this product to conventional vas anastomosis with fibrin glue. Methods: Bilateral delayed vas anastomosis was performed in 40 Sprague-Dawley rats. All animals underwent a fibrin glue-assisted vas anastomosis with three transmural sutures tied prior to fibrin glue application. The composition and preparation of fibrin glue was similar for all vas anastomoses except the fibrinolysis inhibitor component which was aprotinin (3,000 KUI/ml) in group 1 and tranexamic acid (10 mg/ml) in group 2. The animals (20 rats in both groups) were sacrificed 7 weeks postoperatively and evaluated for gross patency, presence of sperm granuloma and tensile strength measurements at the anastomosis site. Results: No difference was found between the 2 groups for all parameters evaluated whether a bovine-derived or a synthetic fibrinolysis inhibitor component was used. Conclusion: This study showed that tranexamic acid, a fibrinolysis inhibitor, can be substituted for conventional fibrin glue thereby avoiding the risks of bovine products.
Sertoli Cell Tumor in a Prepubertal Boy Mimicking Testicular Torsion
Authors: Tan M. Özgür , Uygur Cemil , Özer Elif , Erol Demokan
Published: April 2003

A 9-year-old boy presented with left, intermittent testicular pain that was present for 3 days. On physical examination, left testis was grossly enlarged and firm but mildly tender. Serum α-fetoprotein and β-human chorionic gonadotropin levels were within normal range. Color doppler ultrasonography which was performed to rule out testicular torsion revealed an intratesticular mass located at the upper pole of left testis and left radical orchiectomy was performed. The histopathological diagnosis was Sertoli cell tumor.
Moderne Mythen – Autopoiese und Intersubjektivität
Authors: Bahner Ernst
Published: April 2003

Archetypischer Code, genetischer Code und neuronaler Code repräsentieren unterschiedliche Ebenen für die Abbildung des Begriffspaares Bewusstsein und Unbewusstes. Die Symbolisierung in Form von Mythen gibt Auskunft über die Entwicklung des Verhältnisses der beiden Bereiche zueinander, Mythen repräsentieren als drittes einen Übergangsraum zwischen dem Individuellen und dem Kollektiven. Es werden die Ansätze von Jung, Neumann, Bischof, Jaynes, Singer und Reich umrissen. Die drastische Zunahme der Ersetzung von natürlichen durch künstliche Prozesse undder dem Menschen möglichen Eingriffsmengen lassen die Seite der Objekte und des Objektiven als vorgegebener Naturgesetzlichkeit immer mehr zurücktreten zugunsten des Herstellungscharakters des Objektiven: Es gibt nicht mehr das Ding an sich, sondern seine Abwesenheit oder Anwesenheit, seine Qualität und Quantität sind Ergebnis menschlicher Entscheidung. Zugleich differenziert sich die Seite des Subjektiven: Es wird selbst Objekt seiner Herstellungsbemühung und ist nicht mehr mit sich selbst identisch. Es findet seine Identität durch die Anerkennung des Andern als verschieden. Der Autor entwirft einen Mythos der «Zwitschermaschine» (Paul Klee, 1922) als heutiges Intersubjektivitätsparadigma, das die Begriffe Selbstautorisierung und Autopoiese als Problembestand zentriert: der Mensch wird ein Effekt jener Diskurse, die er über sich selbst führt.
Oral Bioavailability of Gatifloxacin in Healthy Volunteers under Fasting and Fed Conditions
Authors: Mignot Alain , Guillaume Michel , Göhler Karin , Stahlberg Hans-Jürgen
Published: April 2003

The effect of food on the pharmacokinetics of gatifloxacin given as a single oral dose of 400 mg under fasting and fed conditions was determined in 18 healthy male volunteers in an open, two-way, randomised cross-over study. Concomitant food intake did not significantly alter the peak plasma concentrations (Cmax) or the area under the plasma concentration-time curve (AUC) of gatifloxacin. The mean Cmax levels under fasting and fed conditions were 3.5 and 3.2 mg/l, respectively, after the 400-mg single dose of gatifloxacin. The corresponding mean AUC data were 32.8 mg × h/l (fasted) and 30.5 mg × h/l (fed). Moreover, the rate of absorption was not affected by food intake. The median Tmax value was 2 h in both treatment periods. No clinically relevant adverse effects or changes in clinical laboratory test results, ECGs or physical examinations were observed. The results of this study indicate that gatifloxacin given as a single 400-mg oral dose was well tolerated in the presence or absence of food. Concomitant administration of a continental breakfast with a caloric content of 1,050 kcal had no effect on the bioavailability of gatifloxacin. It is suggested that gatifloxacin can be given without regard to meals.
Processing Emotional Information in Alzheimer’s Disease: Effects on Memory Performance and Neurophysiological Correlates
Authors: Boller François , Dequeker Jan , El Massioui Farid , Degreef Hugo , Devouche Emmanuel , Busschots Anne-Marie , Traykov Latchezar , Mallia Carmel , Pomati Simone , Starkstein Sergio E.
Published: April 2003

Background: There is some impairment of the ability of patients with Alzheimer’s disease (AD) to perceive emotions, but this ability seems relatively preserved compared to the impairment of other cognitive domains. Few studies have focused on the link between emotional processing and other cognitive functions, such as memory or attention. Objective: This study was designed to investigate whether the emotional content of a text can influence memory in patients affected by AD and whether this effect is related to attentional processes as measured by event-related potentials (ERP). Methods: All subjects were administered neuropsychological tests and a logical memory test including emotional and nonemotional material. ERP were recorded during an attention task. Results: AD patients had better immediate recall of sad and, to a lesser extent, happy stories than of neutral stories. This difference also affected multiple choice recognition and identification (immediate and delayed) of emotional content. The amplitude of both P300 and mismatch negativity was significantly decreased in the group as a whole. There was no correlation between P300 parameters and performance on the memory tasks, whatever their emotional content. Conclusions: The results show relatively preserved emotional processing in patients with AD and suggest that the emotional content of a context can influence memory performance. We found no evidence that this effect is mediated by attention as measured by ERP.
Review on the Influence of Stress on Immune Mediators, Neuropeptides and Hormones with Relevance for Inflammatory Bowel Disease
Authors: Niess Jan H. , Mönnikes Hubert , Dignass Axel U. , Klapp Burghard F. , Arck Petra C.
Published: April 2003

Stress has long been postulated to influence the progression of inflammatory bowel disease (IBD). Our current understanding of the relationship between stress and IBD is still limited, and hence explanation for the occurrence of relapses has remained largely speculative. Stress affects the immune system, the neuroendocrine system and the intestinal epithelia. Stress induces the release of pro-inflammatory Th1 cytokines and neuropeptides, such as tachykinins. Thereby, stress may induce alterations of the intestinal epithelium via the interaction of the neuroendocrine and immune system and may induce relapses of IBD. The present review focuses on this network and highlights the role of distinct mediators and mechanisms, i.e. neurotransmitters, hormones and immune cells, which are involved in the response to stress on the one hand, and contribute to the onset, progression or relapses of IBD on the other.
Multiple Actions of Pituitary Adenylyl Cyclase Activating Peptide in Nervous System Development and Regeneration
Authors: Waschek James A.
Published: April 2003

Pituitary adenylyl cyclase activating peptide (PACAP) is widely expressed in the embryonic brain at the onset of neurogenesis, and is strongly upregulated in several models of nerve injury. Moreover, high-affinity PACAP receptors are expressed in proliferative zones in the embryonic and postnatal nervous system suggesting that PACAP regulates the development of both neuronal and glial precursors. Tissue culture studies indicate that PACAP exerts a variety of growth factor-like actions that depend on the origin of the cell population and developmental stage. These effects include regulation of proliferation, survival, maturation, neurite outgrowth, and expression of trophic factors, cytokines and trk receptors. The presence of other growth factors can also markedly affect these actions of PACAP, for example, reversing PACAP’s effect from proliferative to antiproliferative. In vivo models now provide additional evidence that PACAP acts in neural development and regeneration.
Transforming Growth Factor-Beta-1 Latency-Associated Peptide and Soluble Betaglycan Prevent a Glucose-Induced Increase in Fibronectin Production in Cultured Human Mesangial Cells
Authors: Nomura Kayoko , Tada Hisaya , Kuboki Koji , Inokuchi Toshiki
Published: April 2003

This study was performed to investigate the effects of transforming growth factor-β1 (TGF-β1) latency-associated peptide (LAP) and betaglycan on TGF-β1 activity, and on the glucose-induced overproduction of fibronectin in cultured human mesangial cells (MCs). We found that recombinant LAP and recombinant soluble betaglycan decrease the active form of TGF-β1, measured by ELISA, in a dose-dependent manner in a cell-free system. The effective dosages of LAP and soluble betaglycan for a 50% reduction were approximately 20- and 75-fold of the TGF-β1 concentration, respectively. The active form of TGF-β1 in the media secreted from MCs was significantly (p < 0.01) reduced by the addition of 10 nmol/l LAP and 10 nmol/l soluble betaglycan with no significant change in total (active + latent) TGF-β1. Recombinant LAP and soluble betaglycan also inhibited a recombinant TGF-β1-stimulated increase in fibronectin production in MCs. Furthermore, the glucose-induced increase in fibronectin secreted from MCs was significantly (p < 0.01) suppressed by concomitant incubation with LAP or soluble betaglycan, while these agents had no effect on fibronectin production under physiological glucose concentrations. These results indicate that recombinant LAP and soluble betaglycan suppress the glucose-induced overproduction of fibronectin presumably via inhibition of TGF-β1 activity in MCs. Further in vivo studies are needed to define the possible beneficial effects of these agents in diabetic nephropathy.
Monocyte Activation in Peripheral Blood and Dialyser Eluates: Phenotypic Profile and Cytokine Release
Authors: Schouten W.E.M. , Grooteman M.P.C. , Schoorl M. , van Houte A.J. , Nubé M.J.
Published: April 2003

Background/Aims: Monocyte activation and subsequent cytokine generation is presumed to be involved in haemodialysis (HD)-related morbidity. The present study was designed to investigate HD-induced changes in monocytes, with respect to their phenotypic profile and cytokine release, both in peripheral blood (PB) and dialyser eluates (DE). In addition, the effect of the type of dialyser on monocyte activation was assessed. Methods: Dialyser elution was performed in 8 patients after 3 h of HD, using cuprammonium (CU) and polysulfon (PS) dialysers in a randomised cross-over design. PB samples and DE were analysed for both the expression of a variety of monocyte cell surface markers (CD62L, CD11b, CD25, HLA-DR, CD64 and CD14) by flow cytometry and IL-1β levels. Monocytes were identified by dual labelling with antibodies against CD14. Results: In PB, the expression of CD11b increased during HD with both devices, but was more pronounced with CU (CU versus PS: p < 0.05). CD62L decreased during HD, but only significantly for PS (p < 0.02). HLA-DR was downregulated during HD with CU (p = 0.056). The expression of CD64 was higher during HD with CU (p = 0.02). Finally, CD14 increased during HD with both dialysers (p < 0.03). DE yielded a mean cell count of 51 × 106 cells. The proportion of monocytes in DE was 3% for CU and 4% for PS. In eluted monocytes, a significant upregulation of CD11b, CD25, and HLA-DR was observed. CD62L was downregulated when compared to PB at t180 (p < 0.001). In DE, no correlation was found between the type of dialyser and the phenotypic changes. In 10 of 16 DE supernatants, 6 CU and 4 PS, IL-1β release could be demonstrated, CU yielding significantly more of this cytokine than PS (p = 0.03). Conclusions: According to both their phenotypic profile and cytokine release, monocytes sticking to the dialyser membrane after HD are considerably more activated than circulating monocytes. Activation of eluted monocytes appeared independent of the type of dialyser, suggesting an effect of mechanical stress rather than bioincompatibility. In contrast, phenotypic activation of peripheral blood monocytes and cytokine release in the DE supernatant were mainly dialyser-dependent.
Effect of Ticlopidine Hydrochloride on Erythropoietin-Induced Rise in Blood Pressure in Patients on Maintenance Hemodialysis
Authors: Kusano E. , Inoue M. , Akai Y. , Furuya H. , Ando Y. , Tabei K. , Asano Y.
Published: April 2003

Background/Aims: A recent observation that antiplatelet-aggregation drugs, including ticlopidine hydrochloride, may prevent erythropoietin (EPO)-induced rise in blood pressure in hemodialysis (HD) patients remains a subject of particular interest. The aim of the present study was to determine the effect of ticlopidine hydrochloride on EPO-induced rise in blood pressure of HD patients with special reference to blood levels of vasoactive substances. Methods: HD patients who showed hypertension or aggravation of preceding hypertension with EPO treatment were selected for this study. Ticlopidine hydrochloride was administered at a dose of 200 mg daily for 4 weeks. Blood pressure and serum levels of nitric oxide (NO), atrial natriuretic peptide (ANP) and endothelin (ET) were determined before and after drug administration. Patients were divided into two groups, one of which showed a drop in mean blood pressure (MBP) of >10 mm Hg (group I) and one which did not (group II), and a comparison was made between them with respect to the blood parameters. Results: Five of 15 patients showed a drop of MBP of >10 mm Hg (group I), and 10 patients did not show any change in MBP (group II). In group I, there was a significant increase in blood NO levels compared to the concentrations before ticlopidine administration, while there was no change in group II. With respect to ANP and ET, there was no significant change in either of the groups. Conclusion: The findings suggest that the preventive effect of ticlopidine hydrochloride on EPO-induced rise in blood pressure may partly be related to the enhancement of NO production in patients on maintenance HD.
Familial Aggregation of End-Stage Kidney Disease in Brazil
Authors: Queiroz Madeira Eugênio Pacelle , da Rosa Santos Omar , Ferreira Santos Sérgio Fernando , Alonso da Silva Lara , MacIntyre Innocenzi Adriana , Santoro-Lopes Guilherme
Published: April 2003

Background/Aims: Familial aggregation of end-stage kidney disease (ESKD) has been reported in several studies, most of them carried out in USA. It is uncertain to what extent these findings can be generalized to other populations. The objective of this study was to assess whether familial aggregation of ESKD occurs in Brazil and whether it is influenced by race. Methods: Case-control study including 555 ESKD patients and 595 controls without renal disease. Multivariate logistic regression models were used to assess the association between a history of ESKD in a first-degree relative (Fam-ESKD) and the risk of ESKD. Additionally, the association between Fam-ESKD and race among ESKD cases was analyzed. Results: Twenty-seven cases (4.9%) and 5 controls (0.8%) reported Fam-ESKD (p < 0.001). Fam-ESKD was significantly more frequent among cases in a regression model adjusted for all studied covariates (OR = 5.71, 95% CI = 2.13–15.4; p < 0.001). The frequency of Fam-ESKD among dialysis patients belonging to the white, black and ‘mixed’ racial subgroups was 6.0, 4.3 and 4.0%, respectively (p = 0.62). There was no association between race and Fam-ESKD (p = 0.54) in adjusted regression analyses. Conclusion: Fam-ESKD occurs in Brazil but, as opposed to what has been suggested by American studies, it does not appear to be influenced by race.
Prepubertal Treatment with Angiotensin Receptor Blocker Causes Partial Attenuation of Hypertension and Renal Damage in Adult Dahl Salt-Sensitive Rats
Authors: Nakaya Hideaki , Sasamura Hiroyuki , Mifune Mizuo , Shimizu-Hirota Ryoko , Kuroda Mari , Hayashi Matsuhiko , Saruta Takao
Published: April 2003

Recently, we have shown that treatment of stroke-prone spontaneously hypertensive rats with angiotensin inhibitors for a limited time-window before puberty results in an attenuation of hypertensive nephrosclerosis in later life. The aim of this study was to examine the applicability of this therapeutic paradigm to a low-renin model. Dahl salt-sensitive (Dahl-S) rats were fed a high-salt diet from age 6 weeks. Some rats were treated with the angiotensin receptor blocker (ARB) candesartan cilexetil (2 mg/kg/d) from weaning to puberty (age 3–10 weeks), whereas other rats were treated continuously until overt renal damage was seen (age 3–16 weeks). Dahl-S rats on a high salt diet had increased blood pressure (207 ± 3 vs. 125 ± 2 mm Hg), proteinuria, and glomerular/vascular histological changes. The prepubertal treatment with ARB resulted in a continued suppression of blood pressure (153 ± 2 mm Hg) at 16 weeks. Both proteinuria and renal histological changes were significantly (p < 0.05) attenuated, but not completely prevented by the treatment. No significant differences in plasma renin activity, renin mRNA, or AT1/AT2 mRNA were seen between groups. These results suggest that prepubertal treatment affords sustained renoprotection, even in an animal model with a suppressed renin-angiotensin system, and support the notion that appropriate prepubertal intervention may lead to a partial attenuation in the susceptibility to inherited renal diseases.
Prognostic Value of Multidrug Resistance 1, Glutathione-S-Transferase-π and p53 in Advanced Nasopharyngeal Carcinoma Treated with Systemic Chemotherapy
Authors: Hsu Chih-Hung , Chen Chi-Long , Hong Ruey-Long , Chen Kai-Lii , Lin Jing-Fan , Cheng Ann-Lii
Published: April 2003

Objective: Nasopharyngeal carcinoma (NPC) is one of the dominant cancers in South China and Taiwan. Although NPC is highly chemosensitive, the use of chemotherapy for treating patients with recurrent or metastatic NPC has not been very successful. The emergence of drug resistance may be one of the major reasons. However, the mechanisms of drug resistance of NPC have never been addressed before. In this study, we sought to clarify the role of classical drug resistance markers in predicting the chemosensitivity and the prognosis of patients with advanced NPC. Methods: In a cohort of 202 consecutive patients diagnosed at the Department of Pathology of the National Taiwan University Hospital, 44 patients with adequately preserved pretreatment tumor tissues and complete clinical information regarding the details of chemotherapy and tumor response were identified. The expression of multidrug resistance (MDR1), glutathione-S-transferase-π (GSTπ), and p53 were determined by immunohistochemistry. Tumor response to chemotherapy and survival of the patients were the endpoints of this analysis. Results: Thirty-four patients received cisplatin-based regimens, and 28 of them were enrolled in a prospective trial using a doxorubicin-containing regimen. The overall response rate was 70%. Expression of MDR1 was seen in only 5 cases (11%) and was associated with a significantly worse overall survival, yet did not appear to predict chemoresistance to the doxorubicin-containing regimen. Overexpression of p53 was seen in 22 patients, and surprisingly, was correlated with chemoresponse and a trend towards better survival. GSTπ expression was demonstrated in 13 cases (30%) and was not correlated with chemoresistance to cisplatin-containing regimens and overall survival. Conclusion: In this relatively small cohort, positive MDR1 immunostaining predicted a poor overall survival for recurrent or metastatic NPC patients receiving chemotherapy. Overexpression of p53 by immunohistochemical staining, however, was associated with a better response rate to systemic chemotherapy and a trend towards better survival.
RCAS1 Expression: A Potential Prognostic Marker for Adenocarcinomas of the Lung
Authors: Oizumi Satoshi , Yamazaki Koichi , Nakashima Manabu , Watanabe Takeshi , Hommura Fumihiro , Ogura Shigeaki , Nishimura Masaharu , Dosaka-Akita Hirotoshi
Published: April 2003

Objective: RCAS1 (receptor-binding cancer antigen expressed on SiSo cells) is a new tumor-associated antigen recognized by 22-1-1 monoclonal antibody. RCAS1 expressed on human cancer cells acts as a ligand for a putative receptor present on peripheral lymphocytes. RCAS1 has been shown to inhibit the in vitro growth of receptor-expressing cells and to induce apoptosis, which may contribute to the ability of tumor cells to evade host immune surveillance. In this study, we evaluated the prognostic significance of RCAS1 expression in primary lung adenocarcinomas. Methods: Immunohistochemical analysis was performed on tissue specimens surgically obtained from 102 patients with primary lung adenocarcinomas. Then, the association of RCAS1 expression with clinicopathological variables and prognosis of patients were analyzed. Results: Of 102 lung adenocarcinomas, positive RCAS1 expression was observed in 82 cases (80%). There was no correlation between RCAS1 expression and clinicopathological variables. In 70 potentially curatively resected lung adenocarcinomas, patients with RCAS1-positive tumors had a significantly shorter survival than those with RCAS1-negative tumors (p = 0.02), and RCAS1 expression was a significant and independent prognostic factor by multivariate analysis (p = 0.03). Conclusions: These results indicate that RCAS1 expression predicts prognosis in patients with lung adenocarcinomas, and this new antigen could be a novel tumor marker which reflects the clinical outcome of lung cancers.
Long-Term Outcome after Resection of Benign Cerebellar Astrocytomas in Children and Young Adults (0–19 Years): Report of 110 Consecutive Cases
Authors: Due-Tønnessen Bernt Johan , Helseth Eirik , Scheie David , Skullerud Kari , Aamodt Geir , Lundar Tryggve
Published: April 2003

The objective of this retrospective study was to present long-term follow-up data for 110 consecutive children and young adults treated for a benign cerebellar astrocytoma at our institution between 1960 and 2001. Mean age at presentation was 8.9 years. The total surgical mortality was 9%, but declined from 16% in 1960–1977 to 0% in 1988–2001. At the close of the study 97/110 patients were still alive. Nine deaths were surgery related, 2 patients died of shunt-related causes and 2 patients died due to tumor recurrence. Five-, 10- and 25-year survival were 90, 89 and 85%, respectively. Multiple Cox regression analysis showed that tumor infiltration of the brain stem and the time period of surgery were the only explanatory variables significantly associated with survival. Five-year survival improved from 79% in the time period of 1960–1977 to 100% in the time period of 1988–2001. Tumor recurrence after total tumor resection was observed in 5 of 76 (7%) evaluable patients. Growth of residual tumor after subtotal tumor resection was observed in 7 of 26 (27%) evaluable patients. Recent follow- up MR revealed regression of residual tumor in 14 of 16 patients. Only 5 of these patients had received radiotherapy. Thus, spontaneous regression of residual tumor is a more frequent event than growth of residual tumor. The functional outcome was favorable in 82% of the patients [Karnofsky performance index (KPI) ≧90]. Eighteen percent of the patients had moderate to severe disabilities (KPI 50–80). Conclusions: Benign cerebellar astrocytoma is a surgical disease where the prognosis with respect to both survival and functional outcome is favorable. Spontaneous regression of residual tumor is frequently encountered, allowing for observation of residual tumors instead of performing a second resection in cases where a second resection carries a high risk of neurological sequelae.
Intramedullary Neurenteric Cyst Presenting as Infantile Paraplegia: A Case and Review
Authors: Agrawal Deepak , Suri Ashish , Mahapatra A.K. , Sharma M.C.
Published: April 2003

The authors report a case of a 3-month-old male child with paraplegia in whom magnetic resonance imaging (MRI) revealed a nonenhancing intramedullary cystic lesion extending from the level of D1 to D7 without any other associated anomaly. Intraoperatively, these findings were confirmed and the spinal cord was found to have splayed circumferentially into a papery thin rim. The patient underwent marsupialization of the cyst with subtotal excision of the cyst wall. Histopathological examination revealed ciliated pseudostratified columnar epithelium consistent with the diagnosis of a neurenteric cyst. Intramedullary neurenteric cysts are rare developmental malformations, and out of the 13 previously reported cases, only 3 were evaluated by MRI. This is the first case report in the literature of an intramedullary neurenteric cyst presenting as infantile paraplegia. In the present report, the embryology, etiopathogenesis, radiological imaging and management of this rare clinical entity are discussed and a detailed literature review is presented.
The DSM Series and Experience with DSM-IV
Authors: First Michael B.
Published: April 2003

DSM-IV is the standard language for psychiatric diagnosis in the United States. An unanticipated consequence of DSM-III is international interest in this American document; for example, DSM-III was translated into 13 languages. This was due to its adopting a descriptive classification that eschewed etiologic theory and contained operational definitions, following Stengel’s recommendations in his WHO report in 1959. These principles were eventually implemented in ICD-10, with the result of being two somewhat different classification systems. Although WHO-APA collaborations have minimized differences, a significant number remains, with only a few reflecting true ideological differences. The challenge for the future will be to integrate the two systems to produce, as much as possible, a unified system for international diagnostic communication.
International Surveys on the Use of ICD-10 and Related Diagnostic Systems
Authors: Mezzich Juan E.
Published: April 2003

Several interesting surveys on the use of diagnostic systems have been conducted over the past two decades, initially focused on ICD-9 and DSM-III and then on more recent editions of these systems. They have reported on the extent and perceived value of their use as well as offered recommendations for future systems. The widest survey to date is that on ICD-10 and related systems recently conducted by the WHO Committee on Evaluating and Updating the ICD-10 Mental Health Component and the WPA Section on Classification and Diagnostic Assessment. It involved the participation of 205 psychiatrists from 66 different countries across all continents. Comparing the two most visible diagnostic systems, it found that ICD-10 was more frequently used and more valued for clinical diagnosis and training and that DSM-IV was more valued for research. Accessibility to diagnostic manuals and training appeared limited, particularly concerning the research criteria, primary care, and multiaxial versions of ICD-10. It also elicited structural and strategic recommendations for the elaboration of new diagnostic systems. It is suggested that it may be useful to widen the scope of future surveys, to additionally include policy makers, patients and families, and to conduct naturalistic studies of clinical care.