bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk Stratification Using Heart Rate Turbulence and Ventricular Arrhythmia in MADIT II: Usefulness and Limitations of a 10‐Minute Holter Recording
Authors: Berkowitsch Alexander , Zareba Wojciech , Neumann Thomas , Erdogan Ali , Nitt Scott Mc , Moss Arthur J. , Pitschner Heinz F.
Published: July 2004

Background: We evaluated the usefulness of heart rate turbulence (HRT) parameters and frequency of ventricular premature beats (VPBs) for risk‐stratifying postinfarction patients with depressed left ventricular function enrolled in Multicenter Automatic Defibrillator Trial II (MADIT II).

Methods: In 884 MADIT II patients, 10‐minute Holter monitoring at enrollment was used to evaluate HRT parameters and frequency of VPBs. The primary endpoints were defined as all‐cause mortality in patients randomized to conventional treatment and as appropriate therapy for ventricular tachycardia or fibrillation in patients randomized to implantable cardioverter defibrillator (ICD) therapy.

Results: The median turbulence slope was lower in patients who died in comparison to survivors in the conventional arm (2.3 vs 4.5 ms/RR; P < 0.05); but it was not a significant predictor of mortality after adjustment for clinical covariates (age, ejection fraction, beta‐blocker use, and BUN levels). There was no association between HRT parameters and arrhythmic events in ICD patients. Conventionally treated patients who died and ICD patients who had appropriate ICD therapy had significantly more frequent VPBs than those without such adverse events. After adjustment for clinical covariates, frequent VPBs>3/10 min were associated with death in the conventional arm (HR = 1.63; P = 0.070) and were predictive for appropriate ICD therapy in the ICD arm (HR = 1.75; P = 0.003).

Conclusion: In postinfarction patients with severe left ventricular dysfunction, frequent VPBs are associated with increased risk of mortality and with appropriate ICD therapy. HRT obtained from 10‐min Holter ECG showed a trend toward the association with mortality in univariate analysis but HRT parameters were not predictive of the outcome in multivariate analyses.
Homicide and major mental disorders: a 25‐year study
Authors: Schanda H. , Knecht G. , Schreinzer D. , Stompe Th. , Ortwein‐Swoboda G. , Waldhoer Th.
Published: July 2004

Objective:  This study was designed to investigate the association between major mental disorders (MMDs) and homicide.

Method:  The rates of exculpations because of MMDs among 1087 Austrian homicide offenders during 1975 and 1999 were compared with the rates of the respective disorders in the general population.

Results:  MMDs were associated with an increased likelihood of homicide (two‐fold in men and six‐fold in women). This was exclusively because of schizophrenia (age‐adjusted ORs in men 5.85, CI 4.29–8.01; in women 18.38, CI 11.24–31.55) and delusional disorder in men (OR 5.98, CI 1.91–16.51). Comorbid alcohol abuse/dependence (additionally) increased the odds in schizophrenia, major depression and bipolar disorder.

Conclusion:  The increased likelihood of homicide in subjects with MMDs cannot be fully explained by comorbid alcoholism. The results point to the special importance of sufficient treatment for a subgroup of mentally ill individuals being at higher risk of violence.
Schizophrenia, neighbourhood, and crime
Authors: Lögdberg B. , Nilsson L.‐L. , Levander M. T. , Levander S.
Published: July 2004

Objective: To investigate the relationship between the prevalence of schizophrenia and measures of social deprivation in varying areas in the city of Malmö.

Method: A case‐finding study of schizophrenia was combined with a victimization survey. Data was factor‐analysed and visualized using geographical information system software.

Results: The schizophrenic patients lived predominantly in socially disorganized areas characterized by high levels of disorder, fear of crime and victimization. The local prevalence of schizophrenia covaried significantly with all indices of social disorganization. In addition, a significant but weak association was obtained between prevalence of schizophrenia and fear of specific persons in the neighbourhood.

Conclusion: In spite of enormous changes in social conditions, psychiatric knowledge and organization of treatment, and political ambitions, schizophrenic patients still aggregate in socially deprived areas. This segregation may result in worsening of the illness as well as increasing the social disorganization in the local domicile.
Quality of life in persons with schizophrenia in out‐patient treatment with first‐ or second‐generation antipsychotics
Authors: Kilian R. , Dietrich S. , Toumi M. , Angermeyer M. C.
Published: July 2004

Objective: Effects of first in comparison with second‐generation antipsychotics on the subjective quality of life (QoL) of patients with schizophrenia under routine treatment conditions were examined.

Method: In a prospective naturalistic trial the QoL, social, clinical, and treatment‐related characteristics and type of antipsychotic medication of 307 patients with schizophrenia (ICD‐10 F 20) were assessed five times with 6‐month intervals over 2.5 years. Longitudinal and cross‐sectional effects of antipsychotic medication were assessed by hierarchical regression models. Selection bias was controlled by propensity scores.

Results: While positive effects of first‐generation antipsychotics on subjective QoL in comparison with no antipsychotic treatment were found, second‐generation antipsychotics caused no better QoL than first‐generation antipsychotics.

Conclusion: The hypothesis that second‐generation in comparison with first‐generation antipsychotics have a better effect on the improvement of subjective QoL of people with schizophrenia in routine out‐patient treatment was not supported.
The wider social environment and mental health service use
Authors: Drukker M. , Driessen G. , Krabbendam L. , Van Os J.
Published: July 2004

Objective:  Previous studies associating neighbourhood context with mental health service use typically included limited sets of confounders.

Method:  A data set including patients registered in a Case Register and population controls was subjected to multilevel analyses, including neighbourhood exposures and individual level confounders. In addition, days of care consumption of patients was addressed.

Results:  The association between socioeconomic deprivation and social capital on the one hand and mental health service use rates on the other could be attributed to individual level differences. However, number of days of service consumption was higher in neighbourhoods with more informal social control. In residentially stable neighbourhoods only, socioeconomic deprivation was associated with lower levels of service consumption.

Conclusion:  Higher levels of social control may induce patients to remain in contact with mental health services. Furthermore, higher levels of deprivation in neighbourhoods with little population mobility may result in reduced expectations of recovery and/or increased tolerance.
A large population cohort provides normative data for investigation of temperament
Authors: Miettunen J. , Kantojärvi L. , Ekelund J. , Veijola J. , Karvonen J. T. , Peltonen L. , Järvelin M. R. , Freimer N. , Lichtermann D. , Joukamaa M.
Published: July 2004

Objective:  We evaluated the psychometric properties of widely used scales for assessing temperament in a large birth cohort. We simultaneously compared the properties of the temperament dimensions of the Tridimensional Personality Questionnaire (TPQ) and of the Temperament and Character Inventory (TCI).

Method:  As part of the 31‐year follow‐up survey of the prospective Northern Finland 1966 Birth Cohort, the TPQ and TCI temperament questions were filled in by 4349 subjects (1974 males, 2375 males). Factor analysis and Cronbach's alpha were used to explore the psychometric properties of the scales.

Results:  Of the three higher‐order dimensions the reward dependence (RD) was the only one performing poorly in our study sample. Cronbach's alpha was higher in the TCI than in the TPQ.

Conclusion:  The results indicate good performance of the TCI and TPQ. Factor analysis support adoption of four temperament dimensions and suggest that developmental work is still needed in the RD dimension.
Spontaneous treatment discontinuation in panic disorder patients treated with antidepressants
Authors: Toni C. , Perugi G. , Frare F. , Mata B. , Akiskal H. S.
Published: July 2004

Objective:  We examined the relationships between long‐term treatment response, side‐effects and drug discontinuation in panic disorder (PD)–agoraphobia.

Method:  A total of 326 patients were naturalistically treated with antidepressants and followed for a period of 3 years. All patients were evaluated by means of the Panic Disorder/Agoraphobia Interview and the Longitudinal Interview Follow‐up Examination (LIFE‐UP).

Results:  A total of 179 patients interrupted pharmacological treatment. Among them, 26.8% were not traceable; 36.9% had deemed further contact with the psychiatrist unnecessary because of remission. Other reasons for interruption were: ineffectiveness (18.4%), side‐effects (10.6%) and personal reasons (7.3%). Patients who interrupted pharmacological treatment because of symptom remission remained in the study for a longer period than those patients who interrupted their treatment because of inefficacy.

Conclusion:  In the long‐term treatment of PD with antidepressants, a high percentage of patients who have achieved symptom remission tend to default from further treatment; adherence to long‐term treatment with antidepressants was predicted by severe and long‐lasting symptomatology.
No evidence for impaired ‘theory of mind’ in unaffected first‐degree relatives of schizophrenia patients
Authors: Kelemen O. , Kéri S. , Must A. , Benedek G. , Janka Z.
Published: July 2004

Objective:  The aim of this study was to investigate the possibility that ‘theory of mind’ (ToM) impairments are associated with schizophrenia liability.

Method:  Forty healthy control subjects and 79 first‐degree biological relatives of schizophrenia patients (32 siblings and 47 parents) received the Eyes Test, during which subjects are asked to choose the word best describes the mental state of a person whose eyes are depicted on a photograph.

Results:  The affected relatives (n = 14) performed worse on the Eyes Test compared with the controls (P = 0.0001), whereas the unaffected relatives (n = 65) showed intact performances (P = 0.4). The Eyes Test values did not correlate with age and IQ. There was no significant difference between male and female participants.

Conclusion:  ToM deficits, as measured by the Eyes Test, are not associated with schizophrenia liability.
Critical evaluation of cognitive dysfunctions as endophenotypes of schizophrenia
Authors: Kéri S. , Janka Z.
Published: July 2004

Objective:  Cognitive dysfunctions are potential endophenotypes of schizophrenia. The aim of this study was to investigate whether recent evidence indeed suggests that cognitive dysfunctions are potent indicators of specific genetic traits that represent susceptibility for schizophrenia.

Method:  Studies including large, well‐defined samples and controlled cognitive assessment have been reviewed.

Results:  Evidence suggests that schizophrenia patients and their unaffected biological relatives are impaired in several cognitive domains, including working memory, executive functions, sustained attention, verbal episodic memory, processing of visual and auditory stimuli, and smooth pursuit eye movements. However, these impairments are present only in a limited proportion of subjects, showing low specificity and sensitivity and high variability. Linkage with specific genes is weak.

Conclusion:  Although some results are promising, at present cognitive dysfunctions cannot be considered as highly sensitive and specific endophenotypes of schizophrenia.
Regulation of restitution after superficial injury in isolated guinea pig gastric mucosa
Authors: BHOWMIK ARUN , OKSALA NIKU , ROIVAINEN REINA , KOISTINAHO JARI , PAAVONEN TIMO , HALME TAPIO , MUSTONEN HARRI , PAIMELA HANNU
Published: July 2004

The immediate response of the gastrointestinal epithelium to superficial (i.e. microscopic) injury is primarily directed towards restoring the disturbed epithelial continuity. Both structural (i.e. cytoskeleton) and humoral (i.e. growth factors and cytokines) involvement in the process has recently been documented. Yet it is unclear whether humoral signaling regulating mucosal recovery after superficial injury is associated with tyrosine phosphorylation, and whether there are other signs of downstream activation of the signaling pathway. To evaluate the effects of exogenous genistein and phorbol‐myristate acetate in the assessment of the role of tyrosine receptor‐mediated signaling in the immediate repair of gastric mucosa after superficial injury. Guinea pig gastric mucosa was mounted in a Ussing chamber, injured with 1.25 M NaCl, and perfused for 4 h. Simultaneously, potential difference and tissue resistance were recorded. In some sets of experiments the tissue was exposed bilaterally either to genistein in order to inhibit tyrosine receptor‐mediated signaling or to 4‐phorbol‐myristate 13‐acetate (PMA) in order to enhance PKC signaling during the 4 h recovery. Phosphotyrosine (PTYR) and protein kinase C (PKC) immunoreactivity were assessed by immunoblotting and by immunohistochemistry. Proliferative activity was determined morphometrically after staining of the tissue for Ki‐67 nuclear antigen and expressed as proliferative index (PI). The inhibition of tyrosine kinases with exogenous genistein resulted in a significant decrease of the PTYR and the stimulation of PKC with PMA increased the PTYR. Nevertheless, no change in the PTYR was observed by immunoblotting after superficial injury alone. Several PKC isoenzymes were found in the guinea pig gastric mucosa, including PKC‐α, ‐ε, ‐ζ and ‐ι. They were unaffected either by the injury or the PMA treatment. The mean PI of tissues subjected to NaCl‐injury was higher than that of uninjured control tissues (p<0.05) (n=7). Exposure of tissue to genistein during recovery decreased the PI, while stimulation with PMA increased it (p<0.05 for both) (n=6). Both electrophysiologic and morphologic restitution were sensitive to genistein, but not to PMA. Superficial injury alone does not influence tyrosine phosphorylation to a degree which could be assessed by immunoblotting. Nevertheless, exogenous modulation of tyrosine receptor‐mediated signaling results in downstream signaling effects. The injury‐associated induction of proliferation is sensitive to modulation of tyrosine phosphorylation and PKC, suggesting that superficial epithelial injury results in endogenous activation of the epithelium, presumably after paracrine stimulation of the neighboring cells.
Colorectal tumors frequently express phosphorylated mitogen‐activated protein kinase
Authors: LEE SUG HYUNG , LEE JONG WOO , SOUNG YOUNG HWA , KIM SU YOUNG , NAM SUK WOO , PARK WON SANG , KIM SANG HO , YOO NAM JIN , LEE JUNG YOUNG
Published: July 2004

Mounting evidence suggests that activation of the mitogen‐activated protein (MAP) kinase pathway plays an important role in tumorigenesis. MAP kinase/ERK kinase (MEK), a crucial constituent of this pathway, is activated by phosphorylation, and the phosphorylated MEK (pMEK) in turn activates ERK kinase. The expression of pMEK has been described in some human malignancies, but not in primary human colon tumors. In this study, we analyzed the expression of pMEK in 123 colorectal tumors by immunohistochemistry. pMEK was detected either in the cytoplasm (63 cases) or nucleus (40 cases) in 93 of the 123 tumors (76%). Tubular adenomas and villous adenomas also expressed pMEK in 30% and 40% of the tumors, respectively. By contrast, the epithelial cells in the normal colonic mucosa showed no or only weak expression of pMEK in the cytoplasm. Taken together, these results indicate that MEK is frequently phosphorylated in colorectal tumors, and suggest that phosphorylation of MEK may play a role in the development of colorectal tumors.
Macroscopic oropharyngeal signs indicating impaired defensive function of palatine tonsils in adults suffering from recurrent tonsillitis
Authors: KASENÕMM PRIIT , MESILA INGRID , PIIRSOO ANDRES , KULL MART , MIKELSAAR MARIKA , MIKELSAAR RAIK‐HIIO
Published: July 2004

The present study explored in adults suffering from recurrent tonsillitis the association between macroscopic oropharyngeal signs of recurrent inflammation, immunomorphology of palatine tonsils (counts of neutrophils by CD4 and macrophages by CD68 monoclonal antibodies in tonsillar microcompartments) and the occurrence of post‐tonsillectomy bacteremia. The study involved 50 adults (31 females and 19 males) with recurrent tonsillitis. According to predominance of either inflammatory changes or evidence of sclerotic process in palatine tonsils and surrounding tissue macroscopic at oropharyngeal examination, the patients were divided into groups with ‘inflammatory‐type’ and ‘sclerotic‐type’ tonsils. Biochemically detected mean collagen content was significantly higher in ‘sclerotic‐type’ tonsils than in ‘inflammatory‐type’ tonsils (p=0.001). Post‐tonsillectomy bacteremia was found in 22 patients (44%). A noteworthy finding was the higher recovery of anaerobes from blood cultures than in previous studies. A logistic regression analysis revealed that the post‐tonsillectomy bacteremia was strongly associated with ‘sclerotic‐type’ tonsils (p=0.0015) and with low counts of neutrophils in tonsillar tissue (p=0.047). We conclude that macroscopic oropharyngeal signs of sclerotic process in palatine tonsils indicate impaired tonsillar defense, in terms of lowered counts of neutrophils, increasing the risk of post‐tonsillectomy bacteremia.
Vascular endothelial growth factor (VEGF) receptor neuropilin‐1's distribution in astrocytic tumors
Authors: BROHOLM H. , LAURSEN H.
Published: July 2004

Neuropilin‐1 is a VEGF165‐ and semaphorin receptor expressed by endothelial cells and tumor cells. The specific function of neuropilin‐1 is not fully known, but in the developing nervous system neuropilin, as a semaphorin receptor, has been shown to influence neuronal guidance. The expression of neuropilin‐1 was studied in low‐grade and high‐grade astrocytic tumors, the latter characterized by extensive angiogenesis. We examined 20 low‐grade astrocytomas (WHO grade II) and 46 glioblastomas (WHO grade IV) immunohistochemically for neuropilin‐1, p53 and EGFR. The glioblastomas were according to the p53 and EGFR expression classified as 35 primary –de novo– glioblastomas, 9 secondary glioblastomas, and 2 uncertain cases. Furthermore, the presence of mast cells was evaluated to search for any potential function in angiogenesis. The glioblastomas expressed neuropilin‐1 in the endothelial cells of the proliferating vessels and the majority of the glioblastomas had immunoreactive neoplastic astrocytes, with no difference between the glioblastoma subgroups. Six out of twenty of the low‐grade astrocytomas were negative in the endothelial cells and 8 out of 20 in the tumor cells for neuropilin‐1. Mast cells were observed in the collagen matrix around larger vessels in the leptomeninges, but not adjacent to malignant tumor vessels or as part of the tumor process itself. Increased expression of neuropilin‐1 is shown in endothelial cells and in neoplastic astrocytes of glioblastomas. Less neuropilin‐1 expression is found in about half of the low‐grade astrocytomas in both neoplastic astrocytes and endothelial cells. The results suggest a correlation between neuropilin‐1 and vascularity in human astrocytic tumors and a possible role for neuropilin‐1 as a receptor for VEGF‐induced angiogenesis.
Accuracy of axillary staging using sentinel node biopsy or diagnostic axillary lymph node dissection – a case‐control study
Authors: LEIDENIUS MARJUT , KROGERUS LEENA , TUKIAINEN EIJA , VON SMITTEN KARL
Published: July 2004

We aimed to compare the accuracy of axillary staging in breast cancer between sentinel node biopsy (SNB) and axillary lymph node dissection (ALND). The prevalence of axillary metastases was studied in 166 breast cancer patients with SNB and pair‐matched control patients with ALND. The matching factors included age of the patient and grade, histological type and histological size of the tumour. There were 37% of patients with axillary metastases in the SNB group and 31% in the ALND group. Altogether, 57 pairs were discordant in relation to axillary metastases. In 34 discordant pairs the SNB patient and in 23 the ALND patient had axillary metastases, p=ns. Among the 36 discordant pairs with invasive ductal carcinoma (IDC), axillary metastases were detected as often in the SNB and the ALND patients. In the 21 discordant pairs with other histological types, the SNB patient had axillary metastases in 16 pairs and the ALND patient in 5 pairs, p<0.03. SNB seems to be as accurate a method for axillary staging as ALND. However, SNB generated no upstaging effect in IDC, only in other histological tumour types.
Monocytes of distinct clinical types of leprosy are differentially activated by cross‐linking class II HLA molecules to secrete IL‐12
Authors: OHYAMA HIDEKI , KATO NAHOKO , TAKEUCHI KAZU , SOGA YOSHIHIKO , UEMURA YASUSHI , NISHIMURA FUSANORI , MATSUSHITA SHO
Published: July 2004

Leprosy is characterized by a wide spectrum of clinical features depending on the individual differences in Th1‐type immunity. The objective of this study was to evaluate whether monocyte activation by stimulus via class II HLA molecules would be correlated with the differences in cellular immune responses among diverse clinical forms of leprosy. IL‐1β and IL‐12 productivity in monocyte preparations obtained from PBMCs was estimated in patients with lepromatous‐ and tuberculoid‐type leprosy. We found that monocytes from lepromatous patients produced significantly higher (about 4‐fold higher) amounts of IL‐12 as compared to in patients with tuberculoid type of leprosy when class II HLA molecules were cross‐linked with anti‐HLA class II antibodies, whereas almost equal amounts of IL‐1β were produced from each monocyte preparation by stimulus via class II HLA molecules regardless of the clinical form of leprosy. These results suggest that monocyte activation differs between lepromatous and tuberculoid patients in terms of IL‐12 secretion, which might be related to individual differences in the cellular immune responses according to the clinical type of leprosy.
Morules in cribriform‐morular variant of papillary thyroid carcinoma: Immunohistochemical characteristics and distinction from squamous metaplasia
Authors: HIROKAWA MITSUYOSHI , KUMA SEIJI , MIYAUCHI AKIRA , QIAN ZHI RING , NAKASONO MASAHIKO , SANO TOSHIAKI , KAKUDO KENNICHI
Published: July 2004

Morules are a diagnostic clue to the cribriform‐morular variant (C‐MV) of papillary thyroid carcinoma, and are superficially similar to squamous metaplasia. In order to clarify the histogenesis of morules and differentiate them from squamous metaplasia, we immunohistochemically compared the morules in five cases of C‐MV with squamous metaplasia in six cases of diffuse sclerosing variant (DSV) of papillary thyroid carcinoma. The squamous metaplastic cells were immunopositive for low‐ and high‐molecular‐weight cytokeratin, whereas the morular cells were negative or focally positive. Vimentin‐positive cells were observed focally in the morules and squamous metaplasia, except for one case of CMV that showed intense positivity. The morular cells showed weak cytoplasmic positivity for beta‐catenin, and the cell membrane was not highlighted. Some nuclei of the morular cells were also positive for this antibody. Beta‐catenin was intensively positive along the cell membrane of the metaplastic cells, and did not react against the nuclei or cytoplasm. Bcl‐2 was positive in the morular cells, but negative in the metaplastic cells. S‐100 protein‐positive dendritic cells were observed in the metaplastic nests, but not in the morules. We argue that morules appear in connection with nuclear and cytoplasmic aberrant localization of beta‐catenin, and are not an early form of squamous metaplasia.
Reverse transcriptase polymerase chain reaction (RT‐PCR) detection of HLP gene expression in Candida glabrata and its possible role in in vitro haemolysin production
Authors: LUO G. , SAMARANAYAKE L. P. , CHEUNG B. P. K. , TANG G.
Published: July 2004

Although haemolysins are known to be putative virulence factors contributing to pathogenicity in Candida species, the haemolytic activity of Candida glabrata and its genetic expression is ill understood at present. Thus, we studied a total of 34 Candida glabrata isolates for their in vitro haemolytic activity using a previously described plate assay system. The mRNA expression of HLP, a putative haemolysin gene, of these isolates was also evaluated using a semi‐quantitative, non‐competitive RT‐PCR assay. All 34 C. glabrata isolates exhibited both partial (α) and complete (β) haemolytic activity to varying degrees. In parallel with the haemolytic activity, all isolates were also positive for HLP mRNA expression. The expression levels of HLP mRNA (as relative units) ranged from 1.01 to 1.82, with a mean value of 1.32. On regression analysis of latter values and the haemolytic activity (in terms of the dimension of the haemolytic zone in the plate assay) of the C. glabrata isolates a highly significant positive correlation was noted (r=0.759, p<0.0001). Taken together, our data illustrate not only the phenotypic characteristics of haemolysin(s) and HLP expression of a battery of C. glabrata clinical isolates, but also, for the first time, evidence for a role of HLP in haemolysis.
Role of penicillin‐binding protein 5 C‐terminal amino acid substitutions in conferring ampicillin resistance in Norwegian clinical strains of Enterococcus faecium
Authors: JUREEN R. , MOHN S. C. , HARTHUG S. , HAARR L. , LANGELAND N.
Published: July 2004

The importance of amino acid sequence differences in the C‐terminal part and levels of mRNA expression of penicillin‐binding protein 5 (PBP5) for ampicillin resistance in Enterococcus faecium was investigated. Seventeen isolates from Norwegian hospitalized patients (ampicillin MIC 0.064‐>256 mg/L) with different C‐terminal pbp5 DNA sequences encoding 11 different amino acid sequences were analyzed with a 14C‐radiolabeled penicillin‐ binding assay to PBP5 and with real‐time PCR quantification of pbp5 mRNA expression. Using multiple logistic regression analysis the amino acid substitution Met 485 was linked to ampicillin MIC and levels of 14C‐radiolabeled penicillin bound to PBP5; however, there were isolates with identical PBP5 alleles and different ampicillin MICs. There was no relation between the quantity of pbp5 mRNA transcripts and ampicillin resistance. The results cannot explain ampicillin resistance in Norwegian clinical strains of E. faecium and indicate that other factors besides the properties of the C‐terminal part of PBP5 are most likely involved.
Gastric fibromyxoma, a distinct entity of pure fibroblastic tumor – an ultrastructural study
Authors: FUKUNAGA MASAHARU
Published: July 2004

A rare case of fibromyxoma arising in the stomach of a 78‐year‐old male is presented. A well‐defined, encapsulated tumor measuring 27×17×8 cm showed a lobular growth in the submucosa and muscularis propria, with no association with the propria mucosa. Histologically, the tumor was characterized by a diffuse, widely spaced proliferation of small spindle, stellate and round cells with dendritic outlines with fibromyxoid stroma. Neither cellular atypia nor mitotic figures were observed. Immunohistochemically, the tumor was positive for vimentin and CD34 but negative for CD117, alpha‐smooth muscle actin, muscle actin, desmin and S‐100 protein. Ultrastructurally, the tumor cells had irregularly shaped nuclei and cytoplasm containing moderate amounts of mitochondria, rough endoplasmic reticulum, subplasmalemmal densities, and short interdigitating processes. These findings indicated the fibroblastic nature of the tumor. The patient was well without recurrence 20 months after surgery. It is important to recognize that gastric fibromyxoma is a distinct entity and to include it in the differential diagnosis of gastric mesenchymal tumors, as the tumors show a different clinical behavior and as limited surgery with local excision is possible.
Infection with Cryptosporidium hominis and reinfection with Cryptosporidium parvum in a transplanted ileum
Authors: POZIO EDOARDO , RIVASI FRANCESCO , CACCI SIMONE MARIO
Published: July 2004

A transplanted ileum was found to be infected with Cryptosporidium hominis 6 days after transplantation. Although the infection resolved, the ileum was later found to be infected with Cryptosporidium parvum. The presence of the parasite was not always correlated with diarrhea. No other gastrointestinal symptom was ever detected. Treatment with azithromycin and paromomycin apparently failed.
Papillary endothelial hyperplasia within synovial haemangioma of the flexor tendon sheath of the wrist
Authors: CHOW LOUIS T. C. , HO P. C. , KUMTA S. M.
Published: July 2004

A 60‐year‐old housewife presented with a painful and slowly enlarging swelling in the left wrist for 3 months. Plain X‐ray showed mild soft tissue swelling and ultrasonography tenosynovitis of the flexor tendons. Exploration revealed a vascular growth involving the synovium of the flexor tendon sheath of the left little finger. Synovectomy and excision of the entire growth led to the diagnosis of synovial haemangioma with areas of recent haemorrhage and florid papillary endothelial hyperplasia. The recent haemorrhage corresponded to the sudden increase in size, while the papillary endothelial hyperplasia accounted for the persistence and gradual enlargement of the lesion. The patient made an uneventful recovery and remained well more than 2 ½ years after the operation.
Reported bruxism and biopsychosocial symptoms: a longitudinal study
Authors: Ahlberg J. , Savolainen A. , Rantala M. , Lindholm H. , Könönen M.
Published: July 2004

Abstract –  Objectives and Methods:  In this follow‐up study of 30–50‐year‐old employees (n=211) of the Finnish Broadcasting Company (YLE), respondents completed questionnaires in both 1999 and 2000 containing items on demographic data, tobacco use, levels of perceived bruxism, affective disturbance, sleep disturbance, somatic symptoms, pain symptoms and temporomandibular disorder (TMD) symptoms.

Results:  Bruxism was significantly more prevalent among smokers (P=0.005). Age, marital status, and gender were not associated with bruxism. Subjects in the frequent bruxism group (n=74) reported the TMD‐related painless symptoms, affective disturbance and early insomnia significantly more often than average. In the multivariate analyses, clustered pain symptoms (P=0.001), TMD‐related painless symptoms (P=0.004) and smoking (P=0.012) were significantly positively associated with frequent bruxism, when the independent effects of age and gender were controlled for.

Conclusions:  It was concluded that successful management of TMD necessitates smoking cessation, as tobacco use may both amplify the patient's pain response and provoke bruxism. Psychosocial factors and perceived stress should not be ignored, however.
Consumption of nonpublic water: implications for children's caries experience
Authors: Armfield Jason M. , Spencer A. John
Published: July 2004

Abstract –  There are concerns that the consumption of unfluoridated bottled and tank water may put children at increased risk of developing caries.

Objectives:  The aim of this study was to investigate the relationship between nonpublic water consumption (either from bottles or rainwater tanks) and socioeconomic status (SES) and both deciduous and permanent caries experience.

Methods:  A random sample of children enrolled in the School Dental Service of South Australia participated in the study (response rate = 71.8%, n = 9988).

Results:  Forty‐five per cent of children had greater than 50% lifetime consumption of nonpublic water while 36% of children had 0% lifetime consumption. Increased use of nonpublic water occurred for children from lower socioeconomic groups, two‐parent families and children from nonmetropolitan areas, with these results most likely a result of the residential location of the children. Multivariate modelling revealed a significant positive relationship between deciduous caries experience and consumption of nonpublic water, even after controlling for the age and sex of the child, SES and residential location. This relationship was significant only for those children with 100% lifetime availability of fluoridated water. The effect of consumption of nonpublic water on permanent caries experience was not significant. It is postulated that these findings may result from the lower caries activity in the permanent dentition of children aged 10–15 and possible dietary confounders.

Conclusion:  Recommendations are made for the addition of fluoride to bottled water, especially with regard to the oral health of younger children.
A follow‐up study of the use of DIAGNOdent for monitoring fissure caries in children
Authors: Anttonen V. , Seppä L. , Hausen H.
Published: July 2004

Abstract –  Objectives:  The aim of this study was to evaluate the utility of the laser fluorescence device DIAGNOdent for monitoring occlusal caries longitudinally as part of a routine dental check‐up in a public dental clinic.

Methods:  Children aged 7–8 and 13–14 years at baseline participated in the study. As part of two consecutive dental check‐ups with a mean interval of 1,19, years, 423 permanent molars and 315 primary molars in 81 children were examined visually and using DIAGNOdent by one dentist. In teeth where, as judged by visual examination, caries had emerged or progressed during the follow‐up, the DIAGNOdent values had increased significantly from the baseline.

Results:  In permanent teeth with a change in visual score from sound to enamel or dentin caries, the mean DIAGNOdent value increased from 24 to 37 and in primary teeth from 8 to 40. The increase in DIANGOdent values correlated positively with the increase in visual score. The mean DIAGNOdent value at baseline was significantly higher in teeth that became carious than in those that remained sound during the follow‐up. For permanent teeth with a visual reversal from inactive or acitve enamel caries to a sound surface, the mean DIAGNOdent value decreased from 36 to 24.

Conclusions:  These results suggest that DIAGNOdent is useful in monitoring occlusal caries in both permanent and primary molars.
Systemic and mucosal immunity in rhesus macaques immunized with HIV‐1 peptide and gp120 conjugated to Brucella abortus
Authors: Eller Nancy , Golding Hana , Inoue Satoshi , Beining Paul , Inman John , Matthews Natasha , Scott Dorothy E. , Golding Basil
Published: July 2004

Abstract:  HIV vaccine testing in primates is an important method for determining the possibility of vaccine benefit in humans. Goals of HIV‐1 vaccination include establishing neutralizing antibodies and a strong CD8+ T‐cell response. We tested a novel vaccine conjugate for its ability to elicit relevant immune responses to HIV proteins and peptides in rhesus macaques. A neutralizing epitope, V3 loop peptide from HIV‐1 envelope, was coupled to heat‐inactivated Brucella abortus (V3‐HKBA). Rhesus macaques were immunized with this conjugate in the anterior thigh. After two immunizations V3‐specific antibodies were found in the sera and at mucosal sites. Neutralizing activity of these antibodies was demonstrated by syncytia inhibition assays. Cellular immune recall responses were demonstrated by antigen‐specific induction of interferon‐gamma and Regulation on Activation Noraml T Cell Expressed and Secreted (RANTES) secretion in vitro. These results confirm and extend preliminary studies in mice that suggest HKBA is an effective carrier that promotes neutralizing antibody secretion at relevant mucosal sites, as well as cellular immune responses that are correlated with viral protection.
Changes in hematology, biochemical values, and restraint ECG of rhesus monkeys (Macaca mulatta) following 6‐month laboratory acclimation
Authors: Hassimoto Masatoshi , Harada Tsuyoshi , Harada Takuma
Published: July 2004

Abstract:  The aim of this study was to determine if 6‐month acclimation would enable accurate evaluation of hematological, biochemical data, and ECG recorded under restraint for conscious rhesus monkeys of both sexes. Periodic evaluation of these parameters was made during the 6‐month period of acclimation. The platelet count, alkaline phosphatase, glucose, and sodium levels significantly decreased, whereas creatinine increased, compared with pre‐acclimation values. The heart rate was significantly reduced compared with pre‐acclimation values. QT–RR relation followed the square root regression function, which means modification of Bazett's QTc formula can be applied even if the ECG is recorded under restraint. In conclusion, 6‐month acclimation was effective for stabilizing the blood data and for allowing accurate evaluation of the ECG even under restraint. Current results show that an acclimation period at least 3 months may be necessary prior to using rhesus monkeys for chronic studies.
Descriptive urological record of chimpanzees (Pan troglodytes) in the wild and limitations associated with using multi‐reagent dipstick test strips
Authors: Kaur Taranjit , Huffman Michael A.
Published: July 2004

Abstract:  Ten urine chemistry parameters were measured on 74 voided urine samples from 34 wild chimpanzees (Pan troglodytes). Multi‐reagent urine dipstick tests were performed and results determined using colorimetric scales. Urine pH measured between 8 and 9 units in 91% of the chimpanzees. Test pads detected protein, erythrocytes, leukocyte esterase activity, and nitrites, ketones and bilirubin in 47, 32, 29, and <10% of the chimpanzees, respectively. No apparent association between positive test results for blood in adult females and reproductive status was found. Overall, 17 of the 34 chimpanzees had positive urine test results for protein, hemoglobin, erythrocytes, leukocytes, nitrites, ketones, and/or bilirubin. Dipstick urinalysis alone is an unreliable method for assessing health and physiological status of wild chimpanzees. However, if combined with other diagnostics it could prove to be a valuable health‐monitoring tool. Limitations associated with this methodology need to be considered when interpreting urinary dipstick test results.
Sebaceous gland adenoma in a rhesus monkey (Macaca mulatta)
Authors: Mahesh Kumar M.J. , Nagarajan P. , Venkatesan R. , Sakthivelan S.M. , Majumdar S.S.
Published: July 2004

Abstract:  A tumor mass was identified below the shoulder region of a 5‐year‐old male rhesus monkey (Macaca mulatta). The mass was excised and diagnosed as sebaceous gland adenoma based on the microscopic findings. Morphologically it appeared as an elevated, dome‐shaped, circumscribed mass of 3.6 × 2.8 × 3.2 cm in dimension with tan speckled color. Histologically, the tumor was composed of mature, sebaceous cells (sebocytes), basal cells arranged in a mass of irregular shapes and sizes, with a characteristic appearance of poly or multilobular structure. Sebocytes were well differentiated with foamy cytoplasm in the center of the lobules and poorly or undifferentiated densely staining basal cells in the periphery of the lobules. Cellular changes in the adjacent lymph node included hyperplasia of plasma cells, macrophages and lymphoid elements with typical mitosis.
CYP2C19 Polymorphism and Proton Pump Inhibitors
Authors: Klotz Ulrich , Schwab Matthias , Treiber Gerhard
Published: July 2004

Abstract: Proton pump inhibitors such as omeprazole (esomeprazole), lansoprazole, pantoprazole and rabeprazole are eliminated by the hepatic route and the polymorphic CYP2C19 is mainly involved in their metabolism. In different populations three phenotypes have been identified: extensive metabolizers, poor metabolizers and individuals carrying one wild type and one mutant allele (het extensive metabolizers). Systemic exposure to the proton pump inhibitors as expressed by the AUC (area under the plasma level time profiles) is 5–12‐times higher in poor metabolizers than in extensive metabolizers. As the pharmacodynamic response (elevation of intragastric pH) to the proton pump inhibitors is related directly to their AUC, a much higher pH can be monitored over 24 hr in poor metabolizers than in extensive metabolizers. Furthermore, clinical efficacy of all proton pump inhibitors depend on maintaining intragastric pH above certain threshold levels and significantly higher eradication rates of Helicobacter pylori have been observed in patients of the poor metabolizers and het extensive metabolizers phenotype if compared to extensive metabolizers. Likewise, limited data suggest that proton pump inhibitors‐induced healing rates in gastro‐oesophageal reflux disease are apparently higher in poor metabolizers/het extensive metabolizers than in extensive metabolizers of CYP2C19. Therefore initial genotyping for this enzyme and higher dosage in extensive metabolizers is likely to improve the clinical efficacy of proton pump inhibitors.
The ozone layer
Authors: Van Der Leun Jan C.
Published: July 2004

Background/Purpose: The intention of this paper is to stimulate the interest for the ozone layer, especially among young colleagues in photobiology; the “layer” is not only important, but also fascinating.

Conclusion: In spite of remarkably effective action, the recovery of the ozone layer will be a long‐term process. It will need the attention, also of scientists, for decades to come.
Oral PUVA and topical steroids for treatment of oral manifestations of chronic graft‐vs.‐host disease
Authors: Wolff D. , Anders V. , Corio R. , Horn T. , Morison W.L. , Farmer E. , Vogelsang G.B.
Published: July 2004

Background: Oral manifestations of chronic graft‐vs.‐host disease (cGVHD) can significantly affect the quality of life and severity often does not correlate with systemic manifestations. We evaluated the use of topical corticosteroids and the intraoral application of psoralen‐UVA (PUVA) for treatment of oral manifestations of cGVHD.

Methods: Overall, 18 patients with oral manifestations of cGVHD were treated with either intraoral PUVA (n=7) or with topical corticosteroids (n=16). Four patients received intraoral PUVA after failure of topical steroids and one patient was treated with topical corticosteroids after failing treatment with intraoral PUVA. A glass fiber extension of an UVA source was used for manual intraoral application. Treatment with topical corticosteroids consisted of 0.1 mg/ml dexamethasone mouth wash four times a day in combination with antifungal prophylaxis.

Results: Four patients showed complete local response (CR) due to intraoral PUVA, two improved and one did not respond. Topical corticosteroids resulted in nine patients in CR, two improved and five did not respond.

Conclusion: Intraoral PUVA as well as topical corticosteroids are effective in treatment of oral manifestations of oral GVHD with few side‐effects and improve quality of life in patients with cGVHD.
Cellular Mechanisms of Atracurium‐Induced Tetanic Fade in the Isolated Rat Muscle
Authors: Nascimento Dejair C. , Serra Carmen S. M. , Oliveira Antonio C.
Published: July 2004

Abstract: Although atracurium is a widely used neuromuscular blocker, we still lack knowledge regarding some of its cellular mechanisms of action. Thus, similar to other clinically used blockers atracurium induces, both in vivo and in vitro, fade of the tetanic contraction. However, the cellular mechanisms underlying this tetanic fade have never been systematically studied. In the present work these mechanisms were investigated in vitro. A sciatic nerve extensor digitorum longus muscle preparation of the rat was used. A combination of myographical and electrophysiological techniques was employed. Indirect twitches were evoked at 0.1 Hz and tetanic contractions at 50 Hz. Trains of end‐plate potentials were evoked at a frequency of 50 Hz. The electrophysiological variables used in the analysis of the trains of end‐plate potentials were: peak amplitude of the first end‐plate potential in the train, peak amplitude of plateau end‐plate potentials in the train, tetanic run‐down of the end‐plate potentials' train, quantal content of first and plateau end‐plate potentials in the train, quantal size. In the myographical study atracurium, at a concentration of 2.4 μM, induced a complete fade of the tetanic contraction while only slightly affected the twitch. In the electrophysiological study atracurium, at the same 2.4 μM concentration, significantly decreased the amplitude of both first end‐plate potentials in the train (control: 14.4 mV; atracurium: 3.2 mV) and plateau end‐plate potentials (control: 10.8 mV; atracurium: 2.4 mV) and reinforced the tetanic run‐down of the train of end‐plate potentials, evaluated as the percent loss in amplitude of plateau end‐plate potentials compared to first end‐plate potentials in the trains (control: 25.2%; atracurium: 33.2%). Atracurium also significantly decreased the quantal content of first end‐plate potentials in the train (control: 231; atracurium: 68), the quantal content of plateau end‐plate potentials (control: 159; atracurium: 42) and the quantal size (control: 0.119 mV; atracurium: 0.075 mV). In relative terms the decrease in quantal content was about twice as large as the decrease in quantal size. This indicates that the fade of the tetanic contraction induced by atracurium (2.4 μM) is due to both pre‐ and postsynaptic blocking effects, the presynaptic one being stronger.
Aspirin Attenuates the Initiation but Not the Progression of Atherosclerosis in Apolipoprotein E‐Deficient Mice Fed a High‐Fat, High‐Cholesterol Diet
Authors: Tous Mònica , Ferré Natàlia , Vilella Elisabet , Riu Francesc , Camps Jordi , Joven Jorge
Published: July 2004

Abstract: Aspirin has potent antiinflammatory properties and attenuates atherosclerosis in apolipoprotein‐E‐deficient mice fed a high‐fat, high‐cholesterol diet. In an attempt to clarify the contradictory results obtained with normal chow, we studied the effect of aspirin for a prolonged period of time. The mice were fed a commercial chow until the experiment began at 8 weeks of age. Blood samples were then obtained and several mice (n=8) were sacrificed. The diet of the remaining 48 animals was supplemented with 200 g/kg palm fat and 1 g/kg cholesterol. They were then randomly divided into 2 groups, one of which received 0.5 mg/day of aspirin. The aspirin had a time‐dependent effect. First, the extent of lesion decreased; then the effect was neutral; and, finally, after longer periods of being fed the atherogenic diet and receiving aspirin, the extent of the lesion increased. The transitory effect of aspirin should be elucidated in the absence of high dietary lipids.