bluuebunny/crossref_metadata_2025 huggingface dataset:
Flow-Cytometric Determination of Tumor Cells in Lymph Nodes1
Authors: Zoli W. , Barzanti F. , Dal Susino M. , De Paola F. , Tesei A. , Ricotti L. , Padovani F. , Renò F. , Amadori D.
Published: April 2003

In solid tumors, metastasis occurs through the dissemination of tumor cells in the bloodstream and the lymphatic system. In particular, lymph node infiltration gives useful prognostic information and represents one of the most important factors for selecting the type of clinical treatment in disease management. Furthermore, the analysis of lymph node infiltration has become important for identifying patients with breast cancer or malignant melanoma who may be candidates for regional lymph node dissection. Tumor cells in lymph nodes are currently identified in tissue sections using morphological and immunohistochemical analyses, but these approaches are time-consuming, and micrometastases may escape detection. The aim of the present study was to define the potential of a flow cytometric (FCM) determination based on cell size and autofluorescence to shorten the time required for lymph node analysis. The sensitivity of the FCM approach, defined on mixtures of tumor cells from established cell lines and peripheral blood lymphocytes (PBLs) at different concentrations, was 1 tumor cell/1,000 PBLs. FCM analysis was performed on 89 lymph nodes, 29 from breast, 41 from lung and 19 from colon cancer patients. Agreement between FCM and morphological results, used as gold standard, was observed in 83% of the cases, and there was a 90% sensitivity to the FCM approach for each tumor type. Disagreement was observed for 15 lymph nodes and was due, in the majority of cases (80%), to FCM-positive and morphologically negative results. A large number of patients and a more accurate pathological examination of consecutive histological sections of lymph nodes are needed to further evaluate the validity of the FCM approach.
Adie’s Tonic Pupil-Induced Angle-Closure Glaucoma
Authors: Leibovitch Igal , Kurtz Shimon , Almog Yehoshua
Published: April 2003

A 52-year-old woman was diagnosed as having Adie’s tonic pupil in her right eye. She reported few episodes of blurring of vision in her right eye in the recent few months. On one of the routine follow-up visits, right intraocular pressure (IOP) was 70 mm Hg and on gonioscopy the angle was closed 360°. Medical treatment resulted in IOP reduction and laser iridotomy was then performed. This is, to our knowledge, the first description of intermittent angle-closure glaucoma attacks induced by a tonic pupil. The possibility of angle-closure glaucoma should be considered in patients with a tonic pupil, especially with symptoms of blurred vision or ocular pain.
Eye Health Care in the Czech Republic
Authors: Kocur Ivo , Kuchynka Pavel
Published: April 2003

Objective: An analysis of eye health care in the Czech Republic as of 1998 was performed. Methods: A questionnaire was used to obtain information from all 59 in-patient eye departments. Results: The number of ophthalmologists per 1 million inhabitants was 95. The number of cataract operations per 1 million inhabitants was 4,209: phaco-emulsification (36,926 surgeries, 85.2%), extracapsular extraction (6,094 surgeries, 14.1%) and intracapsular extraction (90 surgeries, 0.2%). Intra-ocular lenses were implanted in 99% of cases; 404 corneal transplantations and 1,220 operations for retinal detachment were performed. The number of pars plana vitrectomies for diabetic eye complications was 661. Conclusion: Selected regional clinical centres should be equipped and preferred by health insurance companies to provide comprehensive eye health care services and training.
L-Carnitine in Experimental Retinal Ischemia-Reperfusion Injury
Authors: Alagoz Gursoy , Celiker Ulku , Ilhan Nevin , Yekeler Hayrettin , Demir Tamer , Celiker Huseyin
Published: April 2003

The effect of L-carnitine on retinal ischemia-reperfusion injury was evaluated in guinea pigs. 90 min of pressure-induced retinal ischemia followed by 24 h of reperfusion was established in both eyes of 2 groups of animals receiving either L-carnitine (100 mg/kg repeated in 5 doses) or saline intraperitoneally. After enucleation of all the eyes, including those of a control group, malonyldialdehyde (MDA) levels and the thickness of the retinal tissue were measured in 3 groups. The mean MDA value and the tissue thickness of the L-carnitine-treated group were statistically insignificant versus the control group (p > 0.05 and p > 0.05, respectively). However, these values were significantly different in the group receiving saline versus the control group and that receiving L-carnitine (p < 0.001, p < 0.001 and p < 0.001, p < 0.001 respectively). L-Carnitine might be an alternative drug for ischemia-reperfusion injury of the retina.
In vitro Toxicity of Rivastigmine and Donepezil in Cells of Epithelial Origin
Authors: Goldblum David , Gygax Monika , Böhnke Matthias , Garweg Justus G.
Published: April 2003

Neurospecific acetylcholinesterase inhibitors have been shown to lower intraocular pressure (IOP) in normal rabbits and might have additional neuroprotective effects. This study was set out to explore and compare the toxicity of two selective acetylcholinesterase inhibitors, rivastigmine and donepezil, on two standardized cell lines of epithelial origin. Chang and Vero cells were incubated with various concentrations of rivastigmine or donepezil. Acute toxicity (4 h) was assessed by monitoring the permeability of cells to propidium iodide. Chronic toxicity (7 days) was determined by monitoring the effect of the two drugs on esterase activity and cell proliferation. The viability of cells was also assessed morphologically by microscopic inspection. Signs of acute toxicity became manifest at a rivastigmine concentration of 50 mg/ml in both Chang and Vero cells. Indications of chronic toxicity became obvious at concentrations of as low as 1 × 10–5 mg/ml. In contrast, degenerative morphological changes became manifest only at a concentration of as high as 1 mg/ml. In donepezil-treated cells, acute toxicity was not observed in the concentration range tested, whereas chronic toxicity was detected at 1 × 10–1 mg/ml in both Chang and Vero cells, a concentration at which degenerative morphological changes became evident as well. In contrast to rivastigmine, donepezil elicited no signs of acute or chronic toxicity in either Chang or Vero cells at the IOP-lowering concentration of 1 × 10–4 mg/ml. At this dose, the drug is therefore unlikely to evoke deleterious effects on ocular surface tissues in the clinical setting.
Intracranial Salmonella Infections: Meningitis, Subdural Collections and Brain Abscess
Authors: Mahapatra Ashok K. , Pawar Sanjay J. , Sharma Rewati Raman
Published: April 2003

Focal intracranial infections due to Salmonella are rare. So far, around 80 cases have been reported in the world literature. The authors present their experience of 6 cases of intracranial Salmonella infections, mainly subdural empyema in 5 and effusion in 1. In 1 case, subdural empyema was bilateral, and in another case, there was an associated brain abscess. Positive blood cultures and positive Widal tests were noticed in 2 patients each. Early diagnosis and prompt evacuation of subdural collections and brain abscess and antibiotic therapy lead to satisfactory results. This study suggests that a high index of suspicion, early diagnosis and quick evacuation lead to success; this point is highlighted with the help of a review of the literature.
Developmental Deep Venous System Anomaly Associated with Congenital Malformation of the Brain
Authors: Desai Ketan , Bhayani Rajendra , Nadkarni Trimurti , Limaye Uday , Goel Atul
Published: April 2003

We report a rare case of developmental deep venous system anomaly. The great vein of Galen and the straight sinus were absent. Both internal cerebral veins and the basal veins of Rosenthal drained into a large frontal interhemispheric falcine vein, which eventually drained into the superior sagittal sinus. The patient also had an associated neuronal migration anomaly.
Posterior Fontanelle Giant Encephalocele
Authors: Mahapatra A.K. , Gupta P.K. , Dev E.J.
Published: April 2003

A 4-day-old baby was admitted with a large posterior fontanelle encephalocele. The baby was the third child of a consanguineous marriage. Two older siblings, 5 and 3 years old, were normal. The baby had a small head with a circumference of 30 cm only and an encephalocele with a circumference of 37 cm. The baby was active and there was no other neural tube defect or any other congenital anomalies. Noncontrast CT scan of the head with bone window showed a large posteriorly located encephalocele above the occipital bone, containing a small amount of brain tissue and a large volume of CSF. The baby was operated on in the lateral position and the encephalocele was excised. The dural defect was closed directly. The baby had an uneventful postoperative recovery. Twenty months later, the baby was well with no gross neurological deficits
Predictors of Outcome following Traumatic Brain Injury in Young Children
Authors: Prasad Mary R. , Ewing-Cobbs Linda , Swank Paul R. , Kramer Larry
Published: April 2003

The relationship between clinical and neuroimaging variables and multiple outcome measures was examined in a longitudinal, prospective study of 60 children less than 6 years of age who sustained either inflicted or noninflicted traumatic brain injury. Hierarchical multiple regression indicated that the modified Glasgow Coma Scale score, the duration of impaired consciousness and the number of intracranial lesions visualized on CT/MRI accounted for a significant amount of the variance in the Glasgow Outcome Scale (GOS), cognitive and motor scores at baseline, 3- and 12-month evaluations. Inflicted brain injury adversely affected both GOS and cognitive outcomes. Pupillary abnormalities were associated with poorer motor outcome. Neither age at injury nor the Injury Severity Score accounted for significant variability in outcomes.
Acute Hydrocephalus following a Chiari I Decompression
Authors: Elton Scott , Tubbs R. Shane , Wellons, III John C. , Blount Jeffrey P. , Grabb Paul A. , Oakes W. Jerry
Published: April 2003

Complications of posterior cranial fossa decompression for Chiari malformations are uncommon. We present three patients who developed infratentorial supracerebellar hygromas causing acute hydrocephalus after posterior cranial fossa decompression.
Cerebral Protection before, during and after Neurosurgical Procedures
Authors: Matula C. , Schoeggl A.
Published: April 2003

Not only the pathology but also the neurosurgical procedure itself can lead to an impairment of cerebral structures. This may cause neurological symptoms like confusion, disorientation or cognitive deficits which have hardly been noticed until now. Neuroprotective substances can help to reduce this. As an example of the effectiveness, based on our own experiences and international trials, two different medical drugs, Nimodipine® and Cerebrolysin®, are presented. In conclusion one has to realize that nowadays neurosurgeons have to focus their interest more and more to neuroprotective adjuvant treatment possibilities.
Temporal Sequence of Response to Unilateral GPi Pallidotomy of Motor Symptoms in Parkinson’s Disease
Authors: Goto Satoshi , Hamasaki Tadashi , Nishikawa Shigeyuki , Okamura Akira , Yoshikawa Makoto , Yamada Kazumichi , Soyama Naohiro , Mita Shuji , Ushio Yukitaka
Published: April 2003

The present study was performed to determine the temporal sequence of the response to unilateral MRI/microelectrode-guided pallidotomy of each cardinal symptom in Parkinson’s disease (PD). For this purpose, we performed a quantitative assessment of motor functions in 19 patients with PD at several time points up to 6 months following surgery. We here report that although all the motor signs were significantly improved 6 months after pallidotomy, the temporal sequence of tremor response was different from those of other symptoms.
Personal-Computer-Based System for Three-Dimensional Anatomic-Physiological Correlations during Stereotactic and Functional Neurosurgery
Authors: Teijeiro Juan , Macías Raúl J. , Morales Juan M. , Guerra Eritk , López Gerardo , Alvarez Lázaro M. , Fernández Fernando , Maragoto Carlos , García Iván , Alvarez Eduardo
Published: April 2003

This paper describes the automatic three-dimensional (3D) graphic possibilities that are supplied by the Neurosurgical Deep Recording System (NDRS) to facilitate anatomic-physiological targeting during stereotactic and functional neurosurgery using depth recording. This software has been developed to substitute the complex electronic equipment ordinarily used for deep brain electrical recording, display and processing by a personal computer. It may also help to improve on-line graphic analysis, automatic management of the recorded information and flexibility to implement different forms of signal analysis. It can automatically show a 2D or 3D representation of the electrode track, with the electrophysiological findings superimposed as well as the corresponding sagittal, coronal and axial views of a brain atlas using automatic scaling. The NDRS has already successfully been applied during more than 300 neurosurgeries in Spain and Cuba, enabling improved targeting accuracy and safety.
Histological Changes following Two-Step Flap Gastrocystoplasty in Rats
Authors: Campodonico F. , Michelazzi A. , Medica M. , Favre A. , Giglio M. , Merlo F. , Buffa P. , Carmignani G.
Published: April 2003

Introduction: A gastric segment used to increase bladder capacity can undergo considerable changes over time, as can all intestinal segments implanted in the urinary tract and in contact with urine. This experimental study reports the differences between the histological alterations observed in the gastric patch transposed in the bladder both with its own pedicle and after deafferentation from the stomach. Materials and Methods: A group of 30 young male Sprague-Dawley rats underwent gastrocystoplasty. Survivors were divided into 3 groups: gastrocystoplasty alone (8 rats); gastrocystoplasty with vascular deafferentation at 15 days (7 rats), and at 2 months (8 rats). 5 rats were used as controls. Urinary pH was evaluated during a 6-month follow-up. Results: Histology showed that early devascularization hindered the fusion of the two mucosae in the junctional area but reduced papillary hyperplasia (p = 0.013) of the gastric mucosa. No changes were observed in urinary pH after patch devascularization. Conclusions: Vascular deafferentation creates a gastric flap on the bladder which, even if it does not prevent urinary acidification, reduces the frequency of histologically detected changes susceptible for transformation into neoplasms.
Peyronie’s Disease: Corporoplasty Using Saphenous Vein Patch Graft
Authors: Porena M. , Mearini L. , Mearini E. , Costantini E. , Salomone U. , Zucchi A.
Published: April 2003

Objective: To establish who the best candidates for corporoplasty are. The standard guidelines include patients with partial erections, and/or recurvature preventing normal and satisfying intercourse. In our unit we prefer to implant prostheses even in patients with slight erectile dysfunction, therefore patients with full erections routinely undergo corporoplasty. Materials and Methods: We report our experience with corporoplasty using a vein patch graft after plaque incision or excision in 12 patients affected by Peyronie’s disease. Results: The operation is easy to perform. Recovery of normal spontaneous erectile activity was observed in 10/12 (83%) patients at a mean of 1 month postoperatively. The results of checkups with Rigiscan and EchocolorDoppler have confirmed the stability of the graft and recovery of potency. Discussion: Autologous material is easy to harvest and it is elastic enough to support traction during erection. The patch can be modelled to fashion patches in any shape required. The risk of scar shrinkage, with the consequent onset of recurvature, is lower than with other materials such as Gore-tex or Derma. Corporoplasty ensured rapid rehabilitation of sexual functions in all patients. We do not usually perform the Nesbit procedure as shortening of the penis (which is characteristic of Peyronie’s disease) would, in most patients, be accentuated by albuginea plication.
Stone Granuloma – Not to Be Forgotten as a Delayed Complication of Ureteroscopy
Authors: Doddamani Daresh , Kumar Rajeev , Hemal Ashok K.
Published: April 2003

Endoscopic management of urolithiasis is one of the commonest urological procedures today. Its safety and efficacy in the management of ureteral calculi have been proven. A stone granuloma is a rare cause of recurrent ureteral obstruction subsequent to ureteroscopic stone removal. After its initial description by Dretler and Young [J Urol 1993;150:1800–1802] there have been sporadic reports of stone granuloma and paraureteral calculi secondary to iatrogenic perforations of the ureter and subsequent ureteric strictures as the cause of recurrent ureteral obstruction. We report two cases of delayed stone granuloma following pneumatic lithotripsy during ureteroscopy.
Overview of the Clinical Features of Cefixime
Authors: Adam Dieter
Published: April 2003

Third-generation cephalosporins in oral formulations have become an increasingly important first-line choice against common bacterial infections. Cefixime is one such agent, which possesses excellent efficacy against a broad spectrum of pathogens, including Haemophilus influenzae, Streptococcus pneumoniae and Moraxella catarrhalis. Clinical success rates are similar to cefaclor, clarithromycin, and other cephalosporins. Importantly, cefixime also possesses excellent activity against beta-lactamase-producing strains. The pharmacodynamic features of the drug include a half-life of 3–4 h and a Cmax of 4.4 µg/ml, well above the MIC90 for susceptible pathogens, permitting once-daily dosing. In this brief overview, the bacteriological and clinical efficacy of cefixime is discussed, as well as its indications.
Management of Multidrug-Resistant Tuberculosis
Authors: Iseman Michael D.
Published: April 2003

Drug-resistant tuberculosis (TB) originally is the product of inadequate therapy; this may entail noncompliance with treatment, interrupted drug supplies, or inappropriate prescription. Patients may sequentially acquire resistance to several drugs through repetition of this process. Loss of activity of the major drugs greatly compromises the treatment process; most problematic is resistance to both isoniazid and rifampicin, so-called ‘multidrug-resistant tuberculosis’ (MDR-TB). Recent evidence indicates that MDR-TB is being transmitted to others, and particularly to persons with HIV infection/AIDS. Other situations in which epidemic spread of MDR-TB occurs include hospitals and prisons. In several areas of the world, ominous levels of MDR-TB have been identified in a recent WHO survey. Treatment of MDR-TB entails the use of poorly tolerated, second-line medications that are often toxic, and the duration of treatment must be extended to the range of two years. Resectional surgery may be required to effect cures in patients with advanced disease in which most of the first-line agents have been lost to resistance.
Directly Observed Therapy, Short-Course: The Best Way to Prevent Multidrug- Resistant Tuberculosis
Authors: Yew Wing Wai
Published: April 2003

Adherence to therapy in patients with tuberculosis (TB) is a major determinant of their outcomes. Unfortunately, there are no currently known predictors of adherence, given that this phenomenon represents a complex, task-specific behavior. Notwithstanding criticisms from civil liberty advocates, directly observed therapy (DOT), facilitated by education, holistic care, enablers and incentives, is still the best strategy to ensure patient adherence to treatment. To enhance delivery of DOT, short-course chemotherapy (SCC) must be strongly advocated. Monitoring of patient progress, dependable drug supply, and adequate programme funding are other important elements of the entire strategy. Indeed, since the global resurgence of TB and associated rampant drug resistance in the 1990s, directly observed therapy, short-course (DOTS) has now become the WHO strategy for effective TB control. Data obtained so far in different continents worldwide have underscored the unrivalled efficacy of DOTS in ensuring treatment success and preventing development of acquired drug resistance. The recent WHO/International Union against Tuberculosis and Lung Disease (IUATLD) global project on anti-TB drug resistance surveillance has also revealed that countries in which >33–90% of the population has access to the WHO DOTS strategy have, as a group, lower levels of drug resistance: primary multidrug-resistant (MDR) (1.4%; median) and acquired MDR index (0.6; median). The use of SCC was also inversely associated with the prevalence of combined resistance to any drug. Countries with MDR rates >2% reported using SCC in a median of 70% of their patients, compared with 100% in countries with MDR rates <2% (WHO/TB/97.229). Despite greater initial cost, DOTS is a more cost-effective strategy than self-administered therapy because it decreases the re-treatment costs associated with therapy failure and acquired drug resistance. Finally, in addition to harnessing the complementary roles of a national tuberculosis programme and community participation, DOTS might be further enhanced by the use of newly developed drugs with a long duration of action or more potent bactericidal and sterilizing activities.
Pharmacodynamics and Pharmacokinetics of Levofloxacin
Authors: Nightingale Charles H. , Grant Edward M. , Quintiliani Richard
Published: April 2003

Principles of antibiotic pharmacodynamics include factors that are important for effective eradication of bacteria as well as the suppression of resistance. For effective eradication of bacteria and a good clinical outcome, a ratio for the area under the plasma concentration-time curve relative to the minimum inhibitory concentration (AUC/MIC) of greater than 100 is needed for gram-negative organisms, and a level of greater than 30 is required for gram-positive organisms. Pharmacodynamic principles can also be used to devise the optimal administration regimen for specific antimicrobial agents. Pharmacodynamic analysis of the activity of levofloxacin against Streptococcus pneumoniae revealed that, 99% of the time, actual hospitalized patients achieve an AUC/MIC of greater than 30. This indicates that levofloxacin will be very effective in treating S. pneumoniae infections in the majority of patients. Cost of treatment is an increasing concern voiced by healthcare providers and users alike. This has led to a much greater emphasis placed upon the cost of individual drugs used in the management of infections. However, when evaluating the cost of an antibiotic, it is extremely important that not only are the direct acquisition costs assessed, but consideration also given to other aspects incurring a financial burden, such as drug preparation cost, supplies, costs of treating adverse events or any treatment failures. It is only by having such a full assessment of costs that realistic financial comparisons can be made between different antibiotics.
Chelating Agents
Authors: Bergan Tom , Bergan Tom , Klaveness Jo , Klaveness Jo , Aasen Arne Jørgen , Aasen Arne Jørgen
Published: April 2003

The antibacterial activity of metal ions, metal chelates, and molecules with chelating ability for polyvalent cations have been evaluated. The chelator N,N′-ethylenebis[2-(2-hydroxyphenyl)-glycine] (EHPG) exerted moderate-to-good activity against isolates of pathogenic bacteria and fungi. Other chelating agents such as ethylenediamine-tetraacetic acid (EDTA) and diethylene-triamine-pentaacetic acid (DTPA) revealed weak-to-moderate activity. Metal chelation of ligands reduced the activity of EDTA and DTPA.
Acinetobacter Infections in Patients with Human Immunodeficiency Virus Infection: Microbiological and Clinical Epidemiology
Authors: Manfredi R. , Manfredi R. , Nanetti A. , Nanetti A. , Valentini R. , Valentini R. , Chiodo F. , Chiodo F.
Published: April 2003

Background: We evaluated the role of complications caused by Acinetobacter spp. in the setting of HIV infection. Methods: Clinical records of 1,923 consecutive HIV-infected patients hospitalized in a 9-year period were retrospectively reviewed, in order to identify all cases of Acinetobacter spp. complications, and to assess their occurrence and outcome according to several epidemiological, clinical and laboratory parameters. Results: Ten patients out of 1,923 (0.52%) developed Acinetobacter spp. infections: sepsis in four cases, urinary tract infection in three, pneumonia in two and septicaemic pneumonia in the remaining patient. All patients were severely immunocompromised, as shown by a mean CD4+ lymphocyte count of 122 cells/µl and a frequent prior diagnosis of AIDS. As opposed to other infections, septicaemia was associated with a significantly lower CD4+ cell count and a more frequent occurrence of neutropenia. Hospital-acquired Acinetobacter spp. infections were significantly more frequent than community-acquired ones, and prevailingly involved patients with AIDS and leucopenia, being responsible for frequent blood dissemination. Antimicrobial, corticosteroid and cotrimoxazole treatment were frequently carried out during the month preceding disease onset. Antibiotic susceptibility studies proved the complete resistance of microbial isolates to ampicillin and cephalothin and poor sensitivity to second-generation cephalosporins and gentamicin, while greater susceptibility was shown to ceftazidime, netilmicin and amikacin, followed by piperacillin, cotrimoxazole and quinolones. Appropriate antimicrobial treatment led to clinical and microbiological cure in all cases, with no related mortality or relapses. Conclusions: Since only 23 episodes of HIV-associated Acinetobacter spp. infections have been described to date in 11 different reports (nine cases of bacteraemia, eight of pneumonia, two of urinary tract involvement, one of intravenous access device infection, one of meningitis and two with unspecified localization), our series represents the largest one dealing with HIV-associated Acinetobacter spp. infections. According to our experience, Acinetobacter spp. may be responsible for appreciable morbidity among patients with HIV infection, above all when a low CD4+ cell count, neutropenia and hospitalization are present. Clinicians and microbiologists who work in the field of HIV infection should consider the potential pathogenic role of Acinetobacter spp. organisms even in the absence of some presumed risk factors, because of the relationship between these infections and immunodeficiency, hospitalization, other infectious complications, prior antibiotic and steroid treatment and extended antimicrobial resistance patterns.
Influence of Antiestrogens on NIH-3T3-Fibroblast-Induced Motility of Breast Cancer Cells
Authors: Rajah Talitha T. , Rajah Talitha T. , Rambo Dennis J. , Rambo Dennis J. , Dmytryk John J. , Dmytryk John J. , Pento J. Thomas , Pento J. Thomas
Published: April 2003

The motile behavior of tumor cells is regulated in part by growth factors, cytokines, and other endogenous factors. In some instances, stromal tissue surrounding the tumor cells produces these growth factors which interact with tumor cells and thus may play an important role in tumor proliferation and progression. We and others have shown that conditioned media from NIH 3T3 fibroblasts (3T3-CM) increases the invasiveness of breast cancer cells. The present study characterized the influence of 3T3-CM on breast cancer cell motility and examined the hypothesis that antiestrogens inhibit this 3T3-CM-induced effect. In this study we observed that 3T3-CM added to MCF-7 cells produced an immediate cell-scattering effect as determined by time-lapse videomicroscopy, scanning electron microscopy, and F-actin labeling. The results of this study indicate that keratinocyte growth factor in 3T3-CM is largely responsible for the 3T3-CM-induced scattering motility of MCF-7 cells. These results emphasize the importance of stromal-tumor cell (epithelial-mesenchymal) interactions in the motility of breast cancer cells. Further, our results demonstrate that antiestrogens (tamoxifen, ICI-182,780 and Analog II) inhibit 3T3-CM-induced motility of MCF-7 breast cancer cells. Antiestrogen treatment reduced membrane movements and the motile morphology of MCF-7 cells induced by 3T3-CM. These results suggest that antiestrogens inhibit breast cancer cell motility and that antiestrogen treatment may be used to reduce the metastatic spread of breast cancer.
Suppression by Verapamil of Bombesin-Enhanced Peritoneal Metastasis of Intestinal Adenocarcinomas Induced by Azoxymethane in Wistar Rats
Authors: Iishi Hiroyasu , Iishi Hiroyasu , Tatsuta Masaharu , Tatsuta Masaharu , Baba Miyako , Baba Miyako , Yano Hiroyuki , Yano Hiroyuki , Sakai Noriko , Sakai Noriko , Uehara Hiroyuki , Uehara Hiroyuki , Nakaizumi Akihiko , Nakaizumi Akihiko
Published: April 2003

Background: The effects of combined administration of bombesin and verapamil hydrochloride (verapamil), a calcium channel blocker, on the incidence of peritoneal metastasis of intestinal adenocarcinomas induced by azoxymethane (AOM) and the labeling index of intestinal cancers were investigated in male Wistar rats. Methods: From the beginning of the experiment, rats were given 10 weekly subcutaneous injections of AOM (7.4 mg/kg body weight) and subcutaneous injections of bombesin (40 µg/kg body weight) every other day, and from week 16, intraperitoneal injections of verapamil (10 or 20 mg/kg body weight) every other day until the end fo the experiment in week 45. Results: Bombesin significantly increased the incidence of intestinal tumors and cancer metastasis to the peritoneum. Although verapamil administered at either dose had little or no effect on the enhancement of intestinal carcinogenesis by bombesin or on the location, histologic type, depth of involvement, labeling index, apoptotic index or tumor vascularity of intestinal cancers, it significantly decreased the incidence of cancer metastasis. Verapamil also significantly decreased the incidence of lymphatic invasion of adenocarcinomas, which was enhanced by bombesin. Conclusion: These findings indicate that verapamil inhibits cancer metastasis through actions that do not affect the growth of intestinal cancers.
Is Levofloxacin as Active as Ciprofloxacin against Pseudomonas aeruginosa?
Authors: Bonfiglio Giovanni
Published: April 2003

The in vitro activity of levofloxacin against 300 Pseudomonas aeruginosa isolated from hospitalized patients, with the exception of those recovered in intensive care or hematology units, was compared to ofloxacin, ciprofloxacin, piperacillin, amikacin, ceftazidime and imipenem. Imipenem showed the best activity (81.6%), followed by piperacillin (80.7%). The activity of levofloxacin was equal to that of ciprofloxacin (75.3%) but was more active than ofloxacin (58.1%). Moreover, the MIC values of levofloxacin did not show any statistical difference using two different inocula. Levofloxacin shows an excellent bactericidal activity being generally within one doubling dilution of the MIC. These results were also confirmed by the time-killing studies. In conclusion, according to the in vitro activity, levofloxacin could be considered a good option for the treatment of infections sustained by Pseudomonas aeruginosa, and clinical experiments are required to corroborate our in vitro data.
Inhibitory and Bactericidal Effects of Telithromycin (HMR 3647, RU 56647) and Five Comparative Antibiotics, Used Singly and in Combination, against Vancomycin-Resistant and Vancomycin-Susceptible Enterococci
Authors: Baltch Aldona L. , Smith Raymond P. , Ritz William J. , Bopp Lawrence H.
Published: April 2003

The inhibitory and bactericidal effects of telithromycin (HMR 3647, RU 66647) were compared with those of gentamicin, ampicillin, erythromycin, azithromycin and vancomycin against 74 strains of enterococci (34 Enterococcus faecalis and 40 Enterococcus faecium) by agar dilution, broth dilution, time kill assays and postantibiotic effect (PAE). The telithromycin MIC90 for vancomycin-sensitive (VSE) E. faecalis strains tested using the agar dilution method was 8 µg/ml. For a different group of VSE E. faecalis strains tested using the broth dilution method it was 0.06 µg/ml The telithromycin MIC90s for vancomycin-resistant (VRE) and VSE E. faecium strains, determined using the agar dilution method, were 4 and 8 µg/ml, respectively, while for a different set of VRE and VSE E. faecium strains tested using the broth macrodilution method, they were 32 and 16 µg/ml, respectively. Telithromycin MBC90s for E. faecalis were 4–6 tubes higher and for E. faecium 3–5 tubes higher, respectively, than the MIC90s. In time kill assays, telithromycin had bactericidal activity against only 1 of 7 E. faecium strains; for all other E. faecium and E. faecalis strains, only inhibitory activity was demonstrated. Neither synergy nor drug interference was observed when telithromycin was used in combination with ampicillin, vancomycin or gentamicin. At 10 times the MIC, the PAE of telithromycin against E. faecalis was 2.8 h, while for E. faecium it was 1.6 h. Telithromycin should be evaluated for therapy of enterococcal infections, including those caused by VRE organisms. However, because of the strain-to-strain variability in susceptibility to telithromycin, MIC determinations are important, especially for erythromycin-resistant strains.
Systemic Chemotherapy with Epirubicin for Treatment of Advanced or Multifocal Hepatocellular Carcinoma
Authors: Pohl Jürgen , Zuna Ivan , Stremmel Wolfgang , Rudi Jochen
Published: April 2003

Background: The purpose of this retrospective study was to determine the response rate and effect on survival of chemotherapy with epirubicin in non-resectable advanced hepatocellular carcinoma (HCC). Methods: Fifty-two patients with non-resectable disease were treated with epirubicin. A treatment cycle consisted of 20 mg/m2 i.v. on days 1, 8 and 15 and was repeated every 4 weeks to a maximum dose of 1,000 mg/m2. Forty-four patients were eligible for analysis. Results: Out of 44 patients, 1 (2.3%) achieved a complete response, 3 (6.8%) had partial responses and 16 (36%) had stable disease (SD). For patients with successful disease control (complete and partial responders and patients with SD), the median survival was 16.2 months; for non-responders, it was 6.1 months (p < 0.003). Eight (88.9%) of 9 patients with alpha-fetoprotein (AFP) levels <50 µg/l achieved successful disease control compared to 12 (34.9%) out of 35 patients with initially elevated AFP (p < 0.0001). Conclusion: Epirubicin appears to be an active therapeutic option for patients with non-resectable HCC. Especially the subgroup of patients with low levels of AFP may benefit from this treatment.
Antimicrobial Resistance Surveillance of Gram-Negative Bacteria Isolated from Intensive Care Units of Four Different Hospitals in Turkey
Authors: Kocazeybek Bekir Sami
Published: April 2003

Background: The aim of this study was to determine the antimicrobial resistance of gram-negative rods (GNRs) isolated from surgical intensive care units and to establish the prevalence of extended-spectrum beta-lactamases (ESBLs) and inducible beta-lactamases (IBLs). We also wished to determine the widespread beta-lactam substrate in ESBL-positive GNRs by two different E-test strips and to discuss the value of the routine utilization of these substrates together. Methods: Out of 348 nosocomial gram-negative strains isolated with similar methods, 236 strains with resistance to the beta-lactam group of antimicrobials using the E-test method were included in this study. Two different strips were used for the detection of ESBLs: cefotaxime/cefotaxime + clavulanic acid (CT/CTL) and ceftazidime/ceftazidime + clavulanic acid (TZ/TZL). For IBLs, the double-disk method was used. Results: The order of frequency of the strains, starting with the most frequent, was Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa. In the 236 strains, the ESBL positivity rate was found to be 19.5% with TZ/TZL and CT/CTL strips, while it was 13.2% for IBL in 348 strains. Seventy-one percent of ESBL-positive strains gave parallel results with TZ/TZL and CT/CTL. ESBL positivity with only TZ/TZL or only CT/CTL was found to be 18 and 8%. Conclusions: Our study showed that except for imipenem, amikacin and ciprofloxacin, there was a high resistance to other antimicrobials, and multiresistance rates were increased in the strains in which ESBLs and IBLs were detected. In particular, the increasing prevalence of ESBLs in K. pneumoniae and IBLs in P. aeruginosa emphasizes the importance of the problem of infection control and antibiotic administration policies. Although it was seen that the prevalence of substrate templates in the detection of ESBL positivity was similar, we think that it is more useful to use two different strips together to obtain precise results.
MEN 10700, a New Penem Antibiotic: In vitro Antibacterial Activity on Clinical Isolates
Authors: Ferrari Lucio , Altamura Maria , De Luca Massimo , Ceruti Tomaso
Published: April 2003

MEN 10700 is a new broad-spectrum penem, currently in preclinical development. In the present study, the activity of MEN 10700 was compared to that of imipenem, meropenem, cefotaxime, ampicillin/sulbactam, amikacin and ciprofloxacin against 619 gram-positive and gram-negative bacterial strains, and to that of imipenem, meropenem, cefotaxime, ceftriaxone, ceftazidime, cefepime and ampicillin/sulbactam against 38 strains of ciprofloxacin-resistant Escherichia coli, and against 19 extended-spectrum-β-lactamase (ESBL)-producing strains of the KES group. MEN 10700 was highly active against most gram-positive and gram-negative strains, and overall demonstrated comparable activity to imipenem and meropenem. Methicillin-susceptible Staphylococcus aureus and methicillin-susceptible Staphylococcus epidermidis were highly susceptible to MEN 10700, which was the most potent among the antibiotics tested. MEN 10700 was less potent than the carbapenem antibiotics on Morganella morganii, Serratia marcescens and Acinetobacter spp. Ciprofloxacin-resistant E. coli were uniformly susceptible to MEN 10700, imipenem and meropenem, with MIC90 values in the range of ≤0.12–0.25 mg/l, while showing much lower susceptibility to the other antibiotics tested, including the fourth-generation cephalosporin cefepime. This feature was even more evident in ESBL-producing strains of the KES group, with an MIC90 of 1– 2 mg/l for MEN 10700, imipenem and meropenem, and a MIC90 of 16–64 mg/l for the other antibiotics tested, including cefepime.
Aerodynamics of Esophageal Voice Production with and without a Groningen Voice Prosthesis
Authors: Schutte Harm K. , Nieboer G.J.
Published: April 2003

Objectives: Aerodynamic aspects of esophageal voice production in laryngectomees have been studied to clarify and compare the physiology of injection (IE) and button-assisted (TE) esophageal voice. Methods: Simultaneous measurements of intratracheal, sub- and suprapseudoglottic pressure, transpseudoglottic flow and sound pressure level (SPL) in laryngectomees were carried out. Efficiency of substitute voice production and pressure loss over the prosthesis were calculated. Relationships between the variables were computed by means of regression analysis, and Pearson’s product-moment correlations. Results: (1) TE speakers use a higher subpseudoglottic pressure and a higher mean airflow rate during phonation than IE speakers; (2) in TE and IE speakers SPL values are about the same; (3) in assessing voice performance of TE speakers intratracheal air pressure is the most important aerodynamic variable. Conclusion: The aerodynamic model of button-assisted esophageal voice production presented here provides a basis for future studies in this field.
Influence de l’attaque sur l’analyse perceptive des dysphonies
Authors: Revis Joana , Giovanni Antoine , Triglia Jean-Michel
Published: April 2003

Nous avons étudié l’analyse perceptive de la voix de 40 sujets dysphoniques et normaux avec la méthode GRBAS et par consensus de trois experts. Afin d’évaluer les effets de l’attaque sur l’évaluation du jury, nous lui avons présenté deux matériaux phonétiques pour chaque sujet: un /a/ tenu et le même /a/ tenu dont nous avons supprimé l’attaque. L’évaluation s’est déroulée à l’aveugle: les deux matériaux phonétiques étaient présentés au cours d’une même session dans un ordre aléatoire. Le jury d’écoute n’a pas remarqué la présence de /a/ tenus sans attaque. L’étude de l’influence de l’attaque sur la perception du jury a reposé sur le pourcentage de réponses identiques retrouvées sur les deux matériaux. Nos résultats ont montré que l’influence de l’attaque varie en fonction du niveau de dysphonie. L’attaque serait déterminante pour la discrimination des dysphonies intermédiaires (G1 et G2) et négligeable dans les cas de voix normales (G0) et de dysphonies sévères (G3).
Single-Nucleotide Variant in Multiple Copies of a Deleted in Azoospermia (DAZ) Sequence – a Human Y Chromosome Quantitative Polymorphism
Authors: Szmulewicz Martin N. , Ruiz Luis M. , Reategui Erika P. , Hussini Saeed , Herrera Rene J.
Published: April 2003

The evolution of the deleted in azoospermia (DAZ) gene family supports prevalent theories on the origin and development of sex chromosomes and sexual dimorphism. The ancestral DAZL gene in human chromosome 3 is known to be involved in germline development of both males and females. The available phylogenetic data suggest that some time after the divergence of the New World and Old World monkey lineages, the DAZL gene, which is found in all mammals, was copied to the Y chromosome of an ancestor to the Old World monkeys, but not New World monkeys. In modern man, the Y-linked DAZ gene complex is located on the distal part of the q arm. It is thought that after being copied to the Y chromosome, and after the divergence of the human and great ape lineages, the DAZ gene in the former underwent internal rearrangements. This included tandem duplications as well as a T > C transition altering an MboI restriction enzyme site in a duplicated sequence. In this study, we report on the ratios of MboI–/MboI+ variant sequences in individuals from seven worldwide human populations (Basque, Benin, Egypt, Formosa, Kungurtug, Oman and Rwanda) in the DAZ complex. The ratio of PCR MboI– and MboI+ amplicons can be used to characterize individuals and populations. Our results show a nonrandom distribution of MboI–/MboI+ sequence ratios in all populations examined, as well as significant differences in ratios between populations when compared pairwise. The multiple ratios imply that there have been more than one recent reorganization events at this locus. Considering the dynamic nature of this locus and its involvement in male fertility, we investigated the extent and distribution of this polymorphism.
Lifetime Prevalence of Bell’s Palsy in Rural Bolivia: A Door-to-Door Survey
Authors: Nicoletti Alessandra , Sofia Vito , Bartoloni Alessandro , Bartalesi Filippo , Marletta Carmelo , Lo Bartolo Maria Luisa , Rosado José , Le Pira Francesco , Reggio Arturo
Published: April 2003

We carried out a door-to-door survey in rural areas of the Cordillera Province, Bolivia, to determine the prevalence of the most common neurological diseases in a sample of about 10,000 inhabitants. A team of non-doctor health workers administered a standard screening instrument for neurological diseases, a slightly modified version of the World Health Organization protocol. All subjects found positive at the screening phase underwent a complete neurological examination. On screening, we found 1,130 positive subjects, of whom 909 were aged 15 years and above. After the neurological examination, we found 52 cases who had experienced Bell’s palsy during their life in the population aged 15 years and above. The lifetime prevalence on November 1, 1994 was 11.1/1,000 (95% confidence interval 7.8–14.5) for the population aged 15 years and above. The prevalence was higher in women than in men (13.7 and 8.7/1,000, respectively) and increased with age, reaching a peak in the group aged 65 years or more (31.7/1,000). Only 3 cases (5.8%) had received medical therapy.
Individual Quality of Life Factors Distinguishing Low-Burden and High-Burden Caregivers of Dementia Patients
Authors: Coen Robert F. , O’Boyle Ciaran A. , Coakley Davis , Lawlor Brian A.
Published: April 2003

Dementia patient (n = 72) and caregiver characteristics and individual quality of life (IQoL) factors distinguishing low- and high-burden caregivers were evaluated. Measures included patient cognitive, functional and behavioural status, and caregiver burden, well-being, social support appraisal and IQoL. The caregivers were divided by median split into low- and high-burden groups. In the high-burden group daughters were over-represented, psychological morbidity was higher, QoL was lower, the patients were more behaviourally disturbed, and there was a trend towards more negative appraisal of informal social support. Of the many QoL factors elicited from caregivers, only ‘time for self’ and ‘finances’ differed significantly between the groups. A need for more time away from the patient is a major QoL concern for highly burdened caregivers, and a perceived lack of adequate informal support and/or financial constraints are contributory factors.
Inferior Long-Term Outcome of Renal Transplantation in Patients with Diabetes mellitus
Authors: Nampoory M.R. Narayanan , Johny Kaivilayil V. , Costandi Jamal N. , Gupta Ram K. , Nair Madhavan P. , Samhan Mohmoud , Al-Muzairai Ibrahim A. , Al-Mousawi Mustafa
Published: April 2003

Objective: To retrospectively review the long-term outcome of renal transplant in diabetics at Mubarak Al-Kabeer Hospital and Hamad Al-Essa Organ Transplant Center, Kuwait from 1983 to 1998. Methods: There were 631 renal transplant patients, comprising 79 (12.5%) patients with pretransplant diabetes mellitus (pre-TDM), 117 (18.5%) patients with post-transplant diabetes mellitus and 435 (69%) nondiabetics (ND). Subjects with post-transplant diabetes mellitus were excluded from the comparative analysis. Distribution of sex, source of donors and mode of immunosuppression were similar in pre-TDM and ND groups. Results: Fifty-three (67%) recipients in pre-TDM and 90 (20.5%) in the ND group (p < 0.01) were above 45 years of age. However, 26 (33.3%) pre-TDM and 345 (79.5%) ND were below age 45. Among those who died, coronary artery disease led to death in 36% of pre-TDM and 27% in ND. Hyperlipidemia requiring drug therapy was observed in 37% pre-TDM and 6% ND. The incidence of severe infections was nearly twice in pre-TDM over ND recipients (1.9 vs. 1.0 per patient, p < 0.001). Acute rejection episodes were more frequently seen in pre-TDM (43%) than ND (33%), however the difference was not statistically significant. The patient survivals at 1, 5, 10, 14 years were significantly lower in pre-TDM (84, 65, 58 and 58%, respectively) than in ND (97, 93, 86 and 82%, respectively). The major contributory factors were severe infections and coronary artery disease. The cumulative graft survival showed a similar pattern (52% in pre-TDM, 73% in ND at 10 years). However, when death is excluded, the 10-year pure graft survival probability was similar for the pre-TDM and ND groups (76% vs. 80%). Conclusion: Our study indicates poor patient survival in pre-TDM due to coronary artery disease and infections, whereas the pure long-term graft survival was equally good in pre-TDM and ND transplant recipients.