bluuebunny/crossref_metadata_2025 huggingface dataset:
A Case of Acute Pneumonitis Induced by Injection of Silicone for Colpoplasty
Authors: Kim Cheol Hyeon , Chung Doo Hyun , Yoo Chul-Gyu , Lee Choon-Taek , Han Sung Koo , Shim Young-Soo , Kim Young Whan
Published: April 2003

Silicone fluid (polymethylsiloxane) is a liquid polymer that had been widely used in breast augmentation and other cosmetic procedures. However, many adverse reactions after silicone injections into human beings have been reported including adverse pulmonary sequelae. We report a case of a 46-year-old woman who suffered from acute pneumonitis that was induced by illicit injection of silicone into the vaginal wall for colpoplasty. The pulmonary involvement was documented by transbronchial lung biopsy and bronchoalveolar lavage where examination with the electron microscope disclosed the presence of large quantities of pleomorphic cytoplasmic inclusions in alveolar macrophages. Clinicians should be aware of this unusual complication of injection of silicone.
Bexarotene Is a New Treatment Option for Lymphomatoid Papulosis
Authors: Krathen Richard A. , Ward Staci , Duvic Madeleine
Published: April 2003

Background: Lymphomatoid papulosis (LyP) is a clonal T cell proliferation with large cell histology, a chronic course, and an increased risk of lymphoma. Bexarotene (Targretin®) is an RXR-selective retinoid (rexinoid) approved for the cutaneous manifestations of cutaneous T cell lymphoma. Objective: To determine whether bexarotene is effective in treating LyP. Methods: Ten patients with chronic and symptomatic LyP were prospectively treated with oral (n = 3) or topical gel (n = 7) formulations of bexarotene. Results: A favorable response to bexarotene treatment with decreased numbers or duration of lesions was seen in all with objective responses in 8 patients. Conclusions: Bexarotene may be an effective palliative treatment for LyP, warranting further controlled studies.
A Case of Unilateral, Systematized Linear Hair Follicle Nevi Associated with Epidermal Nevus-Like Lesions
Authors: Ikeda Shigaku , Kawada Juri , Yaguchi Hitoshi , Ogawa Hideoki
Published: April 2003

Multiple hair follicle nevi are an extremely rare condition. In 1998, a case of unilateral multiple hair follicle nevi, ipsilateral alopecia and ipsilateral leptomeningeal angiomatosis of the brain was first reported from Japan. Very recently, hair follicle nevus in a distribution following Blaschko’s lines has also been reported. In this paper, we observed a congenital case of unilateral, systematized linear hair follicle nevi associated with congenital, ipsilateral, multiple plaque lesions resembling epidermal nevi but lacking leptomeningeal angiomatosis of the brain. These cases implicate the possibility of a novel neurocutaneous syndrome. Additional cases should be sought in order to determine whether this condition is pathophysiologically distinct.
Homocysteine as a Risk Factor for Cognitive Impairment in Stroke Patients
Authors: Sachdev Perminder S. , Valenzuela Michael J. , Brodaty Henry , Wang Xing Li , Looi Jeffrey , Lorentz Lisa , Howard Lesley , Jones Megan , Zagami Alessandro S. , Gillies David , Wilcken David E.L.
Published: April 2003

Background: Elevated total homocysteine (tHcy) levels are associated with an increased risk of cerebrovascular disease. It is uncertain whether tHcy is also an independent risk factor for cognitive impairment. Methods: We examined 95 stroke subjects 3 months after their strokes, and 55 healthy comparison subjects, with a detailed neuropsychological assessment, and MRI brain scans in a proportion (n = 97). Baseline measurements of tHcy, serum folate and B12, creatinine and plasma fibrinogen levels were obtained. Results: tHcy levels were higher in the stroke subjects by a mean 34%. These levels were significantly correlated with the first factor of a principal component analysis of the neuropsychological data, after controlling for age, folate, B12 and creatinine levels. The correlation of Hcy levels was particularly significant with frontal-executive functioning and attention. tHcy levels were significantly correlated with number of infarcts and total stroke volume in the stroke group, but not with T2-weighted deep white matter hyperintensity scores, after correction for age. In the control group, tHcy levels were significantly correlated with ventricle-to-brain ratios as measures of brain atrophy. Conclusion: This study provides evidence that high tHcy levels are associated with cognitive impairment, in particular that of frontal-executive function. The major component of this association is accounted for by small and large strokes, but non-vascular neurotoxic effects of tHcy also appear to play a role. tHcy must receive greater attention as a risk factor for cognitive impairment.
Are MRI White Matter Lesions Clinically Significant in the ‘Old-Old’? Evidence from the Sydney Older Persons Study
Authors: Piguet Olivier , Ridley Lloyd , Grayson David A. , Bennett Hayley P. , Creasey Helen , Lye Tanya C. , Broe G. Anthony
Published: April 2003

Background: The number of individuals aged over 80 years is the fastest increasing group in developed countries. White matter lesions (WML) observed on magnetic resonance imaging (MRI) have uncertain clinical significance, particularly in the old. Objectives: To determine the prevalence of periventricular and deep WML in survivors of an original cohort of randomly selected elderly community dwellers, and to examine their associations with clinical markers of vascular and extrapyramidal disorders of ageing, as well as quantitative cognitive measures. Methods: Brain MRI, lifestyle interview, cognitive testing and medical examination were administered to 122 participants from the Sydney Older Persons Study 6-year review (mean age: 85.5 years). Apolipoprotein E (ApoE) genotype was also established. Presence and severity of periventricular and deep WML were ascertained using semi-quantitative rating methods and their relations to the cognitive and clinical variables investigated. Results: Periventricular WML were present in all participants in similar severity for all three regions sampled. In contrast, a gradient of severity was observed for the deep WML: most severe in the parietal region, followed by the frontal and occipital regions, and least severe in the temporal region. Associations with gender or with the ApoE Ε4 allele were non-significant. WML were inconsistently associated with age and cognitive functioning or with the clinical markers of dementia. No frontal specificity emerged. Examination of individual lesion types did not change the general pattern of associations. Supporting evidence for a threshold effect was observed on some measures. Conclusions: WML are extremely common in elderly, non-demented individuals. Unlike in younger individuals, MRI abnormalities may not be evidence of a current pathological process and their importance may change with advancing age.
High Incidence of Hemochromatosis Gene Mutations in the Myelodysplastic Syndrome: The Budapest Study on 50 Patients
Authors: Várkonyi Judit , Tarkovács Gábor , Karádi István , Andrikovics Hajnalka , Varga Ferenc , Varga Fatime , Demeter Judit , Tordai Attila
Published: April 2003

Genotypic testing of nonselected patients with the myelodysplastic syndrome (MDS) for the C282Y and H63D mutations of the HFE gene responsible for hereditary hemochromatosis revealed a significantly increased frequency of these mutations when compared to healthy blood donors reflecting the average population. Among the 50 patients examined [26 refractory anemia (RA), 9 refractory anemia with ring sideroblasts (RARS), 2 refractory anemia with excess of blasts (RAEB) and 13 refractory anemia with excess of blasts in transformation (RAEB-t)] there were 24 heterozygotes (20 for H63D and 4 for C282Y), 1 homozygote for H63D and 1 compound heterozygote. The difference between the HFE-positive and HFE-negative MDS patients as regards initial serum iron and transferrin saturation was not significant. Inevitably the iron overload syndrome eventually develops in MDS patients due to intrinsic characteristics of the disease as well as an escalating need for blood transfusion therapy in the course of the disease. The high incidence rate of HFE gene mutations among MDS patients may also contribute to this vicious circle.
Tracking Down the Migration of Mouse Neural Crest Cells
Authors: Chan Wood Yee , Tam Wing Yip , Yung Kim Ming , Cheung Chui Shan , Sham Mai Har , Copp Andrew J.
Published: April 2003

During early embryonic development, cell migration is one of the most important morphogenetic processes. Neural crest cells arise from the dorsal part of the neural tube and migrate along different pathways to numerous locations where they differentiate into a variety of tissues. In the mouse, studies of neural crest cell migration have been difficult partly because of the absence of specific markers which can label neural crest cells throughout their migration from their origin to the site of differentiation. Nevertheless, the use of different experimental strategies involving extrinsic, intrinsic or genetic cell markers has already led to a good understanding of this migration. In our studies, extrinsic markers such as wheat germ agglutinin-gold conjugates and DiI and genetic markers including Hoxb2-lacZ and green fluorescent protein have been employed in tracing migrating neural crest cells. The labelling procedures and the strength and weaknesses of the tracing methods are reviewed herein.
Morphogenesis of Type II Lissencephaly: Neuropathology, Genetics and Pathomechanisms
Authors: Stoltenburg-Didinger Gisela , Steinbrecher Alice
Published: April 2003

Patients with type II lissencephaly show severe cortical disorganization with features of polymicrogyria. The condition is characterized by overmigration of neurons and glial tissue into the subarachnoid space through breaches of the glia limitans. Type II lissencephaly is found in Walker-Warburg syndrome (WWS), muscle-eye-brain disease (MEB) and Fukuyama congenital muscular dystrophy (FCMD), which also share features of congenital muscular dystrophy and ocular malformation. Type II lissencephaly was morphogenetically elucidated by a descriptive analysis of pathology focussing on the role of the glia limitans, vasculature, radial glia and Cajal-Retzius cells. The different developmental ages of the brains investigated enables study of the pathology in progress. The migration disorder could only be assessed by examining fetal brains. Malformations in type II lissencephaly affect neuronal migration, neuromesenchymal interaction and brain vascularization. Since muscular dystrophy is also present, proteins involved in the development and maintenance of skeletal muscles are targets of investigation in studies aimed at elucidating brain development and neuronal migration. Mutations in the gene for the protein O-mannosyltransferase (POMT1) have recently been found to cause the severe neuronal migration disorder WWS. This suggests that, like MEB and FCMD, WWS also results from abnormal protein glycosylation.
Relationship between the Number of Involved Cranial Nerves and the Percentage of Lesions Located in the Cavernous Sinus
Authors: Lin Chou-Ching K. , Tsai Jing-Jane
Published: April 2003

The main objective of this study is to investigate the relationship between the number of cranial nerves passing through the cavernous sinus affected by a lesion and the percentage of lesions located in the cavernous sinus itself. We collected cases retrospectively and classified them into groups according to the number of involved cranial nerves. The diagnoses were confirmed either with MRI, angiography or pathological examination. Sixty-eight cases in total were collected. In the increasing order of cranial nerve involvement (from 1 to 4 nerves), 17.7, 44.4, 56.3 and 77.8% of cases were found to have lesions in the cavernous sinus. A linear regression model with a least square estimator showed an approximately linear correlation. We concluded that there was an approximately linear correlation between the number of cranial nerves affected by a lesion and the percentage of lesions located in the cavernous sinus.
He Who Pays the Piper Calls the Tune: The Role of the Industry Sponsor in Acute Stroke Trials
Authors: Bozik Michael
Published: April 2003

Ischemic stroke remains a complex neurobiological and clinical disease, and stroke drug development remains time consuming and costly. In addressing these challenges, the pharmaceutical industry has a principal responsibility to ensure that the acute stroke trials it sponsors are ethically conducted, scientifically sound and satisfy global regulatory requirements. The industry must also be a leader in promoting the innovative and effective partnerships between the public, private and academic sectors that are necessary if new therapies for patients with acute stroke are to be developed.
One-Year Growth Hormone Therapy Improves Granulocyte Function without Major Effects on Nutritional and Anthropometric Parameters in Malnourished Hemodialysis Patients
Authors: Kotzmann Harald , Schmidt Alice , Lercher Piero , Schuster Ernst , Geyer Georg , Frisch Herwig , Hörl Walter H. , Mayer Gert , Luger Anton
Published: April 2003

Background/Aims: Growth hormone (GH) resistance leads to enhanced protein catabolism and contributes to the malnutrition of patients with chronic renal failure (CRF). In short-term trials anabolic effects of rhGH therapy have been demonstrated in patients on chronic hemodialysis. Methods: This study was initiated to determine the effects of 12 months of rhGH therapy on polymorphonuclear leukocyte (PMNL) function as well as on nutritional and anthropometric parameters. 0.125 IU/kg rhGH was given 3 times a week during the first 4 weeks and 0.25 IU/kg thereafter to 19 malnourished hemodialysis patients with a mean age of 59.3 ± 13.4 years. Results: Insulin-like growth factor I (IGF-I) concentrations rose significantly from 169.2 ± 95.6 to 262.9 ± 144.4 ng/ml (p < 0.01) in the first 3 months, but declined thereafter. Phagocytic activity of PMNLs also increased significantly in response to rhGH therapy and this activation remained stable over the whole 12-month period. Other parameters of PMNL function were not influenced by rhGH therapy. In addition, nutritional parameters such as albumin, prealbumin, transferrin, cholesterol, HDL-cholesterol, cholinesterase, predialytic creatinine and blood urea nitrogen were not affected by rhGH therapy. A decline of total body fat (TBF) was observed after 3 and 9 months of rhGH therapy (17.5 ± 10 vs. 16.7 ± 10% after 3 months, p < 0.017 and 16.8 ± 8.7% after 9 months, p < 0.049), whereas lean body mass remained stable. Conclusions: Twelve months of rhGH therapy caused a significant increase in IGF-I levels, stimulated phagocytic activity of PMNLs and induced a decline of TBF. Other anthropometric and nutritional parameters were not affected, which might be related to the persistence of GH resistance.
Dynamics of 5S rDNA in the tilapia (Oreochromis niloticus) genome: repeat units, inverted sequences, pseudogenes and chromosome loci
Authors: Martins C. , Wasko A.P. , Oliveira C. , Porto-Foresti F. , Parise-Maltempi P.P. , Wright J.M. , Foresti F.
Published: April 2003

In higher eukaryotes, the 5S ribosomal DNA (5S rDNA) is organized in tandem arrays with repeat units composed of a coding region and a non-transcribed spacer sequence (NTS). These tandem arrays can be found on either one or more chromosome pairs. 5S rDNA copies from the tilapia fish, Oreochromis niloticus, were cloned and the nucleotide sequences of the coding region and of the non-transcribed spacer were determined. Moreover, the genomic organization of the 5S rDNA tandem repeats was investigated by fluorescence in situ hybridization (FISH) and Southern blot hybridization. Two 5S rDNA classes, one consisting of 1.4-kb repeats and another one with 0.5-kb repeats were identified and designated 5S rDNA type I and type II, respectively. An inverted 5S rRNA gene and a 5S rRNA putative pseudogene were also identified inside the tandem repeats of 5S rDNA type I. FISH permitted the visualization of the 5S rRNA genes at three chromosome loci, one of them consisting of arrays of the 5S rDNA type I, and the two others corresponding to arrays of the 5S rDNA type II. The two classes of the 5S rDNA, the presence of pseudogenes, and the inverted genes observed in the O. niloticus genome might be a consequence of the intense dynamics of the evolution of these tandem repeat elements.
Prolonged culture of normal chorionic villus cells yields ICF syndrome-like chromatin decondensation and rearrangements
Authors: Tsien F. , Fiala E.S. , Youn B. , Long T.I. , Laird P.W. , Weissbecker K. , Ehrlich M.
Published: April 2003

Untreated cultures from normal chorionic villus (CV) or amniotic fluid-derived (AF) samples displayed dramatic cell passage-dependent increases in aberrations in the juxtacentromeric heterochromatin of chromosomes 1 or 16 (1qh or 16qh). They showed negligible levels of chromosomal aberrations in primary culture and no other consistent chromosomal abnormality at any passage. By passage 8 or 9, 82 ± 7% of the CV metaphases from all eight studied samples exhibited 1qh or 16qh decondensation and 25 ± 16% had rearrangements in these regions. All six analyzed late-passage AF cultures displayed this regional decondensation and recombination in 54 ± 16 and 3 ± 3% of the metaphases, respectively. Late-passage skin fibroblasts did not show these aberrations. The chromosomal anomalies resembled those diagnostic for the ICF syndrome (immunodeficiency, centromeric region instability, and facial anomalies). ICF patients have constitutive hypomethylation at satellite 2 DNA (Sat2) in 1qh and 16qh, generally as the result of mutations in the DNA methyltransferase gene DNMT3B. At early and late passages, CV DNA was hypomethylated and AF DNA was hypermethylated both globally and at Sat2. DNMT1, DNMT3A, or DNMT3B RNA levels did not differ significantly between CV and AF cultures or late and early passages. The high degree of methylation of Sat2 in late-passage AF cells indicates that hypomethylation of this repeat is not necessary for 1qh decondensation. Sat2 hypomethylation may nonetheless favor 1qh and 16qh anomalies because CV cultures, with their Sat2 hypomethylation, displayed 1qh and 16qh decondensation and rearrangements at significantly lower passage numbers than did AF cultures. Also, CV cultures had much higher ratios of ICF-like rearrangements to heterochromatin decondensation in chromosomes 1 and 16. These cultures may serve as models to help elucidate the biological consequences of cancer-associated satellite DNA hypomethylation.
Role of Nitric Oxide in the Early Renal Changes Induced by High Fructose Diet in Rats
Authors: Cosenzi Alessandro , Bernobich Elena , Bonavita Michela , Gris Furio , Odoni Giulio , Bellini Giuseppe
Published: April 2003

Background: Early glomerular hypertrophy and late glomerulosclerosis have been observed in rats fed high fructose diet (HFD), comparable with those of diabetic rats. Several studies suggest a role for nitric oxide (NO) in the pathogenesis of renal damage in diabetes. This study investigated the possible role of NO in the pathogenesis of HFD-induced glomerular changes. Methods: Three study protocols were adopted. In the first, 20 rats were divided into two groups to evaluate the effect of HFD on glomerular size and on the urinary excretion of NO. In the second, the glomerular size was evaluated in 40 rats divided into four groups receiving: (1) standard diet (SD); (2) HFD; (3) HFD + L-NAME, and (4) SD + L-NAME for 1 month. In the third, the renal expression of inducible enzyme (iNOS) was compared in 10 rats on HFD and in 10 controls after a 1-month diet. Results: The results showed: (1) increased urinary excretion of NO and glomerular size, both induced by HFD; (2) prevention by L-NAME of the HFD-increased glomerular size, and (3) increased iNOS expression in the kidneys of rats fed HFD. Conclusion: These results suggest a role for NO in the pathogenesis of the early renal changes induced by HFD.
Acid Shock Accumulation of Sigma S in Salmonella enterica Involves Increased Translation, Not Regulated Degradation
Authors: Audia Jonathon P. , Foster John W.
Published: April 2003

Enteric pathogens such as Salmonella enterica and Escherichia coli face the daunting task of surviving passage through the extremely acid pH of the stomach in order to establish an infection in the host intestinal tract. These organisms have evolved elaborate stress response systems that aid in survival. The alternative sigma factor σS is a key regulator of many stress responses in S. enterica and is regulated at the levels of transcription, translation, and protein stability. Of these control mechanisms, proteolysis has been considered paramount in determining σS levels in the cell. Until the current report, acid shock was thought to increase σS levels by directly regulating degradation. However, mutant strains unable to degrade σS still exhibited acid shock induction of σS. We demonstrate here that rpoS translation is a major focus of acid stress control and is responsible for the observed increase in σS levels. A series of deletions of the 566-nucleotide untranslated region of the rpoS mRNA were constructed to examine the importance of this regulatory region in acid shock induction of rpoS. Progressive deletions starting from the 5′ end of the rpoS message produced alternating loss and recovery of acid shock control. The results suggest that competing stem-loop structures work in concert to control the acid shock induction of rpoS. Further, the half-life of σS was unchanged in response to acid shock and over-expression of the MviA recognition protein resulted in constitutive σS degradation under acid stress conditions. The data indicate that in log phase, nonstressed cells increasing σS production is sufficient to increase protein half-life. In toto, these results suggest that acid shock stabilization of σS is the result of increased synthesis via translational control and does not involve changes in the activity of the MviA (RssB/SprE) ClpXP degradation complex. Therefore, constitutive degradation may enable the cell to reset the level of σS once acid stress is alleviated.
Metachronous Renal Oncocytomatosis
Authors: Ac’h Stéphane , Chapuis Héliette , Mottet Nicolas
Published: April 2003

A renal oncocytoma is a benign and usually solitary lesion. We present a new case of diffuse oncocytomatosis in one kidney after previous contralateral surgery for an isolated oncocytoma. This very unusual situation must be kept in mind in cases of multifocal oncocytomas, as a recurrence will generally occur after partial surgery.
A Right-Sided Renal Carcinoma Uniquely Presenting as a Mass in the Spermatic Cord
Authors: Hicks J.A. , Britton J.P. , Carter P.G. , Conroy B.
Published: April 2003

Renal cell carcinoma presenting as a mass in the left testis or spermatic cord has previously been described with retrograde venous spread along the gonadal artery as the suggested mechanism. However a right-sided presenting lesion has not been described and suggests an alternative method of spread.
Synergism of Fas-Mediated Apoptosis and Tumor Necrosis Factor on Adriamycin Cytotoxicity to Transitional Cell Carcinoma
Authors: Yu Dah-Shyong , Hsieh Dar-Shih , Chen Hong-I , Chang Sun-Yran
Published: April 2003

Objective: To explore the accurate Fas antigenic expression in transitional cell carcinoma (TCC) cells and and compare its synergistic modulation on adriamycin cytotoxicity with α-tumor necrosis factor (TNF-α). Methods: The expression of Fas antigen in normal urothelium and TCC cell lines was measured by flow cytometry. The Fas/Fas ligand reaction-induced cytotoxic changes in tumor cells were evaluated by microculture MTT technique. The synergism efficacy of Fas-mediated apoptosis and TNF-α on adriamycin cytotoxicity of TCC cells was analyzed. The Fas/Fas ligand-induced apoptosis in tumor cells was studied by annexin-V apoptotic cell expression and DNA ladder fragmentation analysis. Results: 75% of TCC cell lines showed Fas antigen expression. The Fas expression was not influenced by in vitro growth density of tumor cells. Apoptosis of TCC cells was observed during 48 h of treatment after activation of the Fas/Fas ligand pathway. TNF-α had a higher cytotoxicity activity on TCC cells than Fas ligand (17 vs. 0.7%) while combination of both reagents had 30% increased synergistic cytotoxicity. The increasing rate of apoptotic body after 3 days of treatment was 74% in adriamycin, 32% in Fas ligand, 60% in TNF-α, 69% in Fas and adriamycin combination and Fas and TNF-α combination, 103% in combination of TNF-α and adriamycin, and 136% in combination of these three reagents individually. In the DNA ladder analysis, Fas ligand had a 1.5-fold increase of DNA fragmentation when compared with adriamycin while TNF-α had a 4.4-fold increase and triple combination had a 5.5-fold increase after 3 days of treatment. Conclusions: Although the Fas antigen expression is common in TCC cells and apoptosis can be activated by the Fas/Fas ligand pathway activation, the synergistic cytotoxicity of adriamycin by the Fas/Fas ligand pathway is lower than that of TNF-α.
Correlation between Intrathecal Sulfatide and TNF-α Levels in Patients with Vascular Dementia
Authors: Tarkowski E. , Tullberg M. , Fredman P. , Wikkelsö C.
Published: April 2003

Objectives: Subcortical vascular dementia (SVD) is associated with white matter lesions and demyelination. The aim of the present study was to examine the cerebrospinal fluid (CSF) levels of TNF-α, a proinflammatory cytokine mediating myelin damage, in SVD patients. The intrathecal TNF-α levels were related to the clinical symptoms of dementia, as well as to intrathecal levels of sulfatide, a marker of white matter degradation, and of neurofilament, a marker of neuronal degeneration. Methods: CSF levels of TNF-a, sulfatide and neurofilament were all analyzed by immunoenzymatic procedures in 17 patients with SVD and in 26 healthy controls. Results: The intrathecal concentration of TNF-α was significantly increased in SVD patients compared to healthy controls (p = 0.0001). The intrathecal levels of TNF-α were significantly correlated (r = 0.6, p = 0.02) to the levels of sulfatide, but not to the levels of neurofilament, (r = 0.08, NS). Conclusions: We have demonstrated intrathecal production of TNF-α in SVD patients. The correlation between TNF-a and sulfatide levels in the CSF suggests that this apoptosis-inducing cytokine leads to the death of oligodendrocytes, thereby contributing to white matter degeneration, a hallmark of SVD.
Subjective Memory Impairment, Cognitive Function and Depression – A Community Study in Older Koreans
Authors: Kim Jae-Min , Stewart Robert , Shin Il-Seon , Choi Sung-Ku , Yoon Jin-Sang
Published: April 2003

Correlates of subjective memory impairment (SMI) were investigated using data from a community study of 1,204 individuals aged 65 or over in an urban and rural area of South Korea. SMI and depression were ascertained from the Geriatric Mental State Schedule and cognitive function from the Korean version of the Mini-Mental State Examination (MMSE-K). 686 participants had also completed the MMSE-K two years earlier. SMI was present in 22% of the sample and was associated with depression and lower MMSE-K scores. Depression and SMI were most strongly associated in the presence of cognitive impairment. SMI was weakly associated with previous cognitive decline and was not associated with APOE e4. SMI and cognitive impairment were most strongly associated in urban residents, particularly rural-to-urban migrants.
Skin Paints (Pseudo-Tattoos) with ‘Black Henna’: Hazards and Long-Term Risks
Authors: Le Coz Christophe J. , Tromp Guy
Published: April 2003

Background: Skin paints, traditionally performed with henna, are sometimes realized with hair-dyeing preparations like ‘black henna’ containing aromatic amines. Observations: Nine patients, 7 women and 2 men aged 9–41 years, had had skin painting with ‘black henna’. Six experienced acute manifestations: flare-up (1), eczema (1) or both (1), eczema after hair dyeing (1) or chemical burn (2). Two were symptom free. In 1, a positive p-phenylenediamine (PPD) patch test was explained by previous pseudo-tattooing. Patients positive for PPD (4/4 tested) reacted to toluene-2,5-diamine (2/2), aminophenols (1/2), Disperse Orange 3 (3/3) and several azoic textile dyes (1/3). Conclusions: Some skin paint preparations contain irritant and sensitizing aromatic amines. The peculiar conditions of applications and their repetition enhance the sensitization risk. Long-term consequences of sensitivity to PPD or derivatives are allergic contact dermatitis following hair dyeing or after contact with some azoic textile dyes. Occupational consequences may be of importance.
Enterolith Ileus as a Complication of Jejunal Diverticulosis
Authors: Steenvoorde P. , Schaardenburgh P. , Viersma J.H.
Published: April 2003

Background: In a period of 5 years, 2 patients with enterolith ileus, caused by jejunal diverticulosis, were treated in our hospital. In order to learn more about treatment options, the literature was reviewed. Methods: The case history of the 2 patients is described. Relevant articles were identified using Medline® and PubMed®. Data regarding patient gender, age, operative findings, therapeutic measures and outcome were collected. Results: Including patients reported in the literature, 34 cases of intestinal obstruction due to enteroliths expelled from jejunal diverticula were identified. A distinction is made between complicated and uncomplicated enterolith ileus. If there are signs of bowel ischemia, other (unborn) enteroliths, inflammation of the bowel or if there are signs of a (sealed) perforation, the case is considered a complicated enterolith ileus. If none of these signs are present, uncomplicated enterolith ileus is present. In uncomplicated enterolith ileus (21 patients), more often milking and crushing or enterotomy was performed. In complicated enterolith ileus (13 patients), more often a segmental resection of the involved jejunum was performed (p < 0.01). Conclusion: Small bowel obstruction due to enteroliths expelled from jejunal diverticula is a rare condition. Relevant literature is only available in the form of case reports. On the basis of the presented patients and patients reported in the literature, a justifiable therapeutic strategy is presented. The least invasive step in the therapeutic approach is to crush and milk the obstructing enterolith down to the colon. Laparoscopic crushing and milking of the enterolith is described. If this fails an enterotomy could be tried, if possible proximal or distal from the obstruction site, in order to make an incision in a less edematous area. If the first two strategies fail, or if complicated enterolith ileus is present, resection of the involved jejunal segment could be considered.
No Evidence for an Association between the T102C and 1438 G/A Polymorphisms of the Serotonin 2A Receptor Gene in Attention Deficit/Hyperactivity Disorder in a Turkish Population
Authors: Zoroglu Suleyman Salih , Erdal Mehmet Emin , Erdal Nurten , Ozen Sakır , Alasehirli Belgin , Sivasli Ercan
Published: April 2003

Disturbances in the serotonergic neurotransmission system have been implicated in the etiology of attenion deficit/hyperactivity disorder (ADHD). As the importance of genetic factors is well established, genes encoding for proteins of the serotonergic pathway are important candidates to unravel the underlying genetic contribution. We previously demonstrated that the polymorphisms of the serotonin transporter gene promoter and regions of variable number of tandem repeats were involved in the pathogenesis of ADHD. The purpose of this study was to examine the relationship between ADHD and two polymorphisms (T102C and 1438 G/A) in the 5-HT2A gene in a sample of Turkish children. Using the PCR technique, these polymorphisms were assessed in 70 patients with ADHD and in 100 healthy controls. There was no significant difference between the frequencies of the T, C, G and A alleles of both groups. No association was found between the studied polymorphisms of the 5-HT2A gene and ADHD in this sample consisting of Turkish children. Overall, our results suggest that the investigated 5-HT2A polymorphisms are not major susceptibility factors in the etiology of ADHD.
Influence of Mirtazapine on Salivary Cortisol in Depressed Patients
Authors: Laakmann G. , Hennig J. , Baghai T. , Schüle C.
Published: April 2003

Unlike other antidepressants, mirtazapine does not inhibit the reuptake of norepinephrine or serotonin but acts as an antagonist at presynaptic α2-receptors, at postsynaptic 5-HT2 and 5-HT3 receptors, and at histaminergic H1 receptors. Furthermore, mirtazapine has been shown to acutely inhibit cortisol secretion in healthy subjects. In the present study, the impact of mirtazapine treatment on salivary cortisol secretion was investigated in 12 patients (4 men, 8 women) suffering from major depression according to DSM-IV criteria. Patients were treated with mirtazapine for 3 weeks, receiving 15 mg mirtazapine on day 0, 30 mg on day 1 and 45 mg per day from day 2 up to the end of the study (day 21). Response to mirtazapine treatment was defined by a reduction of at least 50% in the Hamilton Rating Scale for Depression after 3 weeks of therapy. Salivary cortisol concentrations were measured before treatment (day –1), at the beginning of treatment (day 0), after 1 week (day 7) and after 3 weeks (day 21) of treatment with mirtazapine. Saliva samples were collected hourly from 08.00 until 20.00 h. The area under the curve values served as parameter for the salivary cortisol secretion. Following analysis of variance with a repeated measures design, tests with contrasts revealed a significant reduction of cortisol concentrations already after 1 day of mirtazapine treatment that was comparable in responders and nonresponders. In addition to new pharmacological approaches such as CRH1 receptor antagonists, mirtazapine therefore appears to be an effective strategy to decrease hypercortisolism and restore HPA system dysregulation in depression. However, the importance of the acute inhibitory effects of mirtazapine on cortisol secretion for its antidepressant efficacy has to be further clarified.
Evolution of Specialized Pyramidal Neurons in Primate Visual and Motor Cortex
Authors: Sherwood Chet C. , Lee Paula W.H. , Rivara Claire-Bénédicte , Holloway Ralph L. , Gilissen Emmanuel P.E. , Simmons Robert M.T. , Hakeem Atiya , Allman John M. , Erwin Joseph M. , Hof Patrick R.
Published: April 2003

The neocortex of primates contains several distinct neuron subtypes. Among these, Betz cells of primary motor cortex and Meynert cells of primary visual cortex are of particular interest for their potential role in specialized sensorimotor adaptations of primates. Betz cells are involved in setting muscle tone prior to fine motor output and Meynert cells participate in the processing of visual motion. We measured the soma volumes of Betz cells, Meynert cells, and adjacent infragranular pyramidal neurons in 23 species of primate and two species of non-primate mammal (Tupaia glis and Pteropus poliocephalus) using unbiased stereological techniques to examine their allometric scaling relationships and socioecological correlations. Results show that Betz somata become proportionally larger with increases in body weight, brain weight, and encephalization whereas Meynert somata remain a constant proportion larger than other visual pyramidal cells. Phylogenetic variance in the volumetric scaling of these neuronal subtypes might be related to species-specific adaptations. Enlargement of Meynert cells in terrestrial anthropoids living in open habitats, for example, might serve as an anatomical substrate for predator detection. Modification of the connectional and physiological properties of these neurons could constitute an important evolutionary mode for species-specific adaptation.
The Scaling of White Matter to Gray Matter in Cerebellum and Neocortex
Authors: Bush Eliot C. , Allman John M.
Published: April 2003

It is known that the white matter of neocortex increases disproportionately with brain size. However, relatively few measurements have been made of white matter/gray matter scaling in the cerebellum. We present data on the volumes of white and gray matter in both structures, taken from 45 species of mammals. We find a scaling exponent of 1.13 for cerebellum and 1.28 for neocortex. The 95% confidence intervals for our estimates of these two exponents do not overlap. This difference likely reflects differences in the connectivity and/or micro-structure of white matter in the two regions.
Adult-Onset Atopic Dermatitis in a Patch Test Population
Authors: Ingordo Vito , D’Andria Giuliano , D’Andria Corrado
Published: April 2003

Background: Epidemiological studies about atopic dermatitis (AD) almost exclusively relate to childhood disease with little mention of adult-onset disease. In clinical practice, however, patients who have AD and in whom the onset of disease occurs in adult life are sometimes seen. Objective: Because the subjects with a chronic and recalcitrant eczema are frequently patch tested, the aim of this study was to evaluate the prevalence of adult-onset AD in a patch test population and the differences existing between the early- and adult-onset subsets. Methods: This retrospective analysis was performed on 502 adults (458 males, 44 females) affected by eczematous dermatitis, consecutively examined in the Department of Dermatology of the Italian Navy Hospital in Taranto. In this department, all the eczematous subjects are routinely submitted to the following tests: standard series (GIRDCA or SIDAPA with integrative haptens), prick test with environmental aeroallergens and common food allergens and dosage of total serum IgE. If it is required, additional series of patch tests are also applied. Many patients are also submitted to the atopy patch test (APT) with whole bodies of house dust mites at a concentration of 20%. In the AD patients, diagnosed according to the criteria of Hanifin and Rajka, the ages of onset were subdivided into the following categories: infancy (0–3 years); childhood (4–11 years); adolescence (≧12 years). We arbitrarily also used the age of 18 years as the cut-off mark to allocate the patients to the adult-onset group (AOG) and defined as early-onset group (EOG) the cases encompassed in the aforesaid categories (i.e. onset ≤17 years). Results: 8.8% of all eczemas were adult-onset ADs. 28 (5.6% of all eczemas) adult-onset ADs were ‘sole’ ADs, while 22 cases (3.2% of all eczemas) were adult-onset ADs in which a contact sensitization was detected. The mean SCORAD indexes, according to the age-of-onset groups, decreased when the age of onset increased. No statistical difference was detected between the EOG and AOG with regard to true contact sensitization, clinically relevant or non-relevant contact sensitization, prevalence of ‘pure’ AD and ‘mixed’ AD, and outcome of the APT. The hands were the most frequently affected site in the AOG. Conclusion: A small but significant number of patch-test-negative eczematous cases could be adult-onset ADs and, in this instance, the other two allergological tests (i.e. prick tests and dosage of total serum IgE) and an accurate evaluation according to stated clinical criteria should be performed. However, other studies on large series of patients are required to confirm our observation.
Association between Smoking and Hair Loss: Another Opportunity for Health Education against Smoking?
Authors: Trüeb Ralph M.
Published: April 2003

Besides being the single most preventable cause of significant morbidity and an important cause of death in the general population, tobacco smoking has been associated with adverse effects on the skin. Smoke-induced premature skin ageing has attracted the attention of the medical community, while only recently an observational study has indicated a significant relationship between smoking and baldness. The mechanisms by which smoking causes hair loss are multifactorial and are probably related to effects of cigarette smoke on the microvasculature of the dermal hair papilla, smoke genotoxicants causing damage to DNA of the hair follicle, smoke-induced imbalance in the follicular protease/antiprotease systems controlling tissue remodeling during the hair growth cycle, pro-oxidant effects of smoking leading to the release of pro-inflammatory cytokines resulting in follicular micro-inflammation and fibrosis and finally increased hydroxylation of oestradiol as well as inhibition of the enzyme aromatase creating a relative hypo-oestrogenic state. In view of the psychological impact of androgenetic alopecia on affected men and women, increasing public awareness of the association between smoking and hair loss offers an opportunity for health education against smoking that may be more effective than the link between smoking and facial wrinkles or grey hair, since the latter can be effectively counteracted by current aesthetic dermatologic procedures, while treatment options for androgenetic alopecia are limited.
Orofacial Granulomatosis as the Initial Presentation of Crohn’s Disease in an Adolescent
Authors: Bogenrieder Thomas , Rogler Gerhard , Vogt Thomas , Landthaler Michael , Stolz Wilhelm
Published: April 2003

Orofacial granulomatosis (OFG) is a rare and heterogeneous clinical condition that presents with chronic swelling of the oral or facial tissues due to granulomatous inflammation. It is histologically characterized by noncaseating giant cell granulomata and epithelioid histiocytes. OFG includes the previously recognized clinical entities of Melkersson-Rosenthal syndrome and cheilitis granulomatosa (Miescher’s cheilitis). A consistently effective medical treatment is not currently available. We describe an adolescent patient with a history of recurrent orofacial swelling preceding gastrointestinal symptoms by several years. He exhibited clinical and histological changes consistent with the diagnosis of OFG. It was resistant to standard therapies such as topical corticosteroids. Thorough history taking and clinical examination suggested Crohn’s disease (CD), and further tests confirmed the diagnosis. The patient improved promptly after initiating oral treatment for CD with mesalazine and prednisolone. We conclude that OFG may be under- or misdiagnosed since the clinical manifestation may be misleading and its course is independent of or even preceding CD. Thus, patients with OFG should be asked about gastrointestinal symptoms consistent with CD. Those with suspicious symptoms should undergo a careful gastrointestinal evaluation, possibly including enteroclysis and complete gastrointestinal endoscopic examination, especially when the patient’s history is conspicuous.
Randomized, Open-Labeled, Non-Inferiority Study between Ciclopiroxolamine 1% Cream and Ketoconazole 2% Foaming Gel in Mild to Moderate Facial Seborrheic Dermatitis
Authors: Chosidow O. , Maurette C. , Dupuy P.
Published: April 2003

Background: Topical ketoconazole (KC) is considered a standard treatment for seborrheic dermatitis. In a placebo-controlled, double-blind clinical study, we demonstrated that antifungal ciclopiroxolamine (CIC) 1% cream was effective in mild to moderate facial seborrheic dermatitis. Objectives: We report here the results of a randomized, open-labeled clinical study comparing CIC 1% cream and KC 2% foaming gel in patients with mild to moderate facial seborrheic dermatitis, using a non-inferiority trial design. Methods: Three hundred and three patients were enrolled, 154 patients in the CIC group and 149 patients in the KC group, and comprised the study population for intent-to-treat (ITT) analysis. The per protocol (PP) population comprised a total of 282 patients, 147 in the CIC group and 135 in the KC group. Patients were randomly allocated to apply either the CIC 1% cream twice a day for 28 days maximum (initial phase), followed by once a day for another 28 days (maintenance phase); or the KC 2% foaming gel twice a week at the initial phase, followed by once a week during the maintenance phase. Test lesions were defined as lesions localized to the nasolabial folds, alae nasi, and/or the eyebrows. The main efficacy parameter (endpoint) was the proportion of patients who presented a complete disappearance of both erythema and scaling on test lesions and pruritus on all lesions at the end of the initial phase (28 days or less). Results: At baseline, both treatment groups were comparable in terms of demographic data and lesional status. At the end of the initial phase, responders were found to be non-inferior with CIC treatment compared with KC treatment in both study populations (ITT population: 37% CIC responders and 34% KC responders; in the PP population: 39 and 36% responders, respectively). The 95% confidence interval limit for differences were –7.99–13.56 in the ITT population, and –8.06–14.5 in the PP population. At the end of the maintenance phase, treatment response to CIC was greater than to KC in both ITT and PP populations (57 and 44% in both populations, respectively, p = 0.03). Local tolerance as well as global acceptability was better with CIC than with KC (p = 0.001, intergroup analysis). Conclusion: CIC 1% administered as a cream demonstrated to be non-inferior to KC 2% foaming gel in mild to moderate facial seborrheic dermatitis.
Tubular and Interstitial Expression of ICAM-1 as a Marker of Renal Injury in IgA Nephropathy
Authors: Arrizabalaga Pilar , Solé Manel , Abellana Rosa , de las Cuevas Xavier , Soler Josep , Pascual Jordi , Ascaso Carlos
Published: April 2003

Background: The upregulated renal expression of intercellular adhesion molecule 1 (ICAM-1) is associated with glomerular and interstitial infiltration of leukocytes. Aim: To test the hypothesis that renal expression of ICAM-1 may be predictive in the highly variable IgA nephropathy (IgAN). Methods: ICAM-1 (CD54) in tubular epithelium and interstitial leukocytes, macrophages (CD14), and T cells (CD3) were assessed using avidin-biotin-peroxidase in renal biopsy specimens from 45 patients with IgAN and from 29 patients with no glomerulonephritis. Results: In IgAN, tubular ICAM-1+ was seen in 25 of 45 (55%) biopsy specimens, associated with glomerular hypercellularity, glomerulosclerosis involving less than 50% of the glomerular area, interstitial cellular infiltration, tubular atrophy, and proteinuria (U = 44, p = 0.005). Interstitial ICAM-1+ leukocytes were correlated with glomerulosclerosis involving less and more than 50% of the glomerular area, tubular atrophy, interstitial fibrosis, and serum creatinine concentration (r = 0.6343, p < 0.001). In patients with an increase of 50% in the serum creatinine concentration, interstitial ICAM-1+ leukocytes and CD14+ and CD3+ cells were significantly more numerous than in patients with a stable creatinine concentration. In patients with no glomerulonephritis, tubular ICAM-1+ was seen in 7 of 29 (24%) biopsy specimens, inversely correlated with the number of normal glomeruli and associated with glomerulosclerosis covering more than 50% of the glomerular area, tubular atrophy, and creatinine. Conclusions: Tubular and interstitial expression of ICAM-1 can be a marker of tubulointerstitial disturbance in IgAN. Interstitial ICAM-1 may be an adverse predictor of disease progression.