bluuebunny/crossref_metadata_2025 huggingface dataset:
Detection of Point Mutation for Human Growth Hormone in Patients with Anti-Pituitary Antibody Positive Type 1 Diabetes Mellitus
Authors: Koike H , Motooka M , Kanda T , Onigata K , Murakami M , Suzuki T , Kobayashi I
Published: February 2013

We investigated genetic mutations in the coding region of the human growth hormone (hGH) gene in anti-pituitary antibody (APA)-positive patients with type 1 diabetes mellitus ( n = 6) or autoimmune thyroid diseases ( n = 10) and in APA-negative, healthy controls ( n = 10). A point mutation in the hGH gene was discovered in two patients with type 1 diabetes mellitus. No mutations were found in the hGH gene in control subjects, patients with autoimmune thyroid diseases (Hashimoto's thyroiditits, Graves' disease) or in the remaining four patients with type 1 diabetes mellitus. The mutation was located in the coding region for the second amino acid in the N-terminal region of hGH. This point mutation was identified in codon 2 in exon 2 of the hGH gene. We successfully developed an allele-specific amplification method for detecting this mutation using the polymerase chain reaction.
Bacterial Lipopolysaccharide Induces Transforming Growth Factor β and Hepatocyte Growth Factor through Tolllike Receptor 2 in Cultured Human Colon Cancer Cells
Authors: Yoshioka T , Morimoto Y , Iwagaki H , Itoh H , Saito S , Kobayashi N , Yagi T , Tanaka N
Published: February 2013

This study examined, in human cancer cell lines, the pattern of cytokine production stimulated by lipopolysaccharide (LPS), a major component of the outer surface of Gram-negative bacteria, and characterized the expression pattern of CD14, cell surface LPS receptor antigen, and toll-like receptors (TLRs), which appear to be key regulators of the innate immune response system. Two colon cancer cell lines (DLD and LoVo), a hepatocellular carcinoma cell line and a myelomonocytic cell line were incubated with LPS for 0–72 h, and transforming growth factor (TGF) β1 and β2, hepatocyte growth factor (HGF) and interleukins 6, 8 and 15 were assayed. The only changes induced by incubation with LPS were significant increases in TGFβ1 production at 12 h, and in HGF production at 72 h, in LPS-stimulated DLD cells, and significant increases in TGFβ2 production after 12 h and in HGF after 72 h in LoVo cells. Using reverse transcriptase-polymerase chain reaction analysis, expression of CD14 and TLR-2 mRNA was detected in DLD and LoVo cells, and expression of TLR-4 mRNA was detected in PLC/PRF/5 and KG-1 cells. These results suggest that LPS induces TGFβ and HGF production mediated by CD14/TLR-2 in cultured human colon cancer cell lines.
Cost-Effectiveness of Minimally Invasive Intervention in Aortofemoral Revascularization
Authors: Silistreli E , Çatalyürek H , Karabay Ö , Hepağuşlar H , Açıkel Ü
Published: February 2013

Minimally invasive surgical procedures have become popular recently because they offer several advantages over conventional operative techniques. A person undergoing a minimally invasive procedure usually experiences less pain, is discharged earlier from hospital, returns to work sooner and has a less obtrusive postoperative scar. Excluding highly technical techniques (e.g. laparoscopic surgery), operations performed using mini-laparotomy are usually more cost-effective than conventional procedures, largely because they are less expensive to perform. Our paper investigates cost-effectiveness and other parameters relating to minimally invasive aortofemoral revascularization procedures performed at our clinic. We compared 20 similar cases, half where revascularization was undertaken using mini-laparotomy and half where conventional laparotomy was selected. From our findings we conclude that mini-laparotomy is safe and reliable for aortobifemoral bypass procedures and has several advantages over traditional techniques; namely, shorter operating time, earlier resumption of intestinal function, shorter duration of in-patient stay and reduced costs.
What Kind of Hepatitis?
Authors: Santolamazza M , Marinelli RMA , Bacosi M , D'Innocenzo S , Miglioresi L , Patrizi F , Monache M Delle , Ricci GL
Published: February 2013

Finding one major hepatotropic virus may not be enough to identify the aetiology of liver disease when risk factors are present, particularly in patients with past or present infection with other viral agents, or chronic liver disease. The pathogenic process in these cases is often complex. In the five cases we report, acute hepatitis (initiated by halothane, cytomegalovirus or Epstein-Barr virus) preceded the reactivation of hepatitis B infection, and these events occurred in patients with chronic hepatitis C infection. Each case demonstrates how several viruses can be implicated in the development of hepatitis, either as single agents or via cross-activation of T cells. The nosography of hepatitis, therefore, and the optimum therapeutic choices, can puzzle the clinical team.
Comparative Efficacy and Safety of Celecoxib and Naproxen in the Treatment of Osteoarthritis of the Hip
Authors: Kivitz AJ , Moskowitz RW , Woods E , Hubbard RC , Verburg KM , Lefkowith JB , Geis GS
Published: February 2013

Osteoarthritis (OA) is responsible for more disability of the lower extremities in the elderly than any other disease in the US. The pain associated with OA is the primary symptom leading to disability in these patients. Current ACR guidelines recommend consideration of acetaminophen for mild-to-moderate pain and conventional non-steroidal anti-inflammatory drugs (NSAIDs) or COX-2 specific inhibitors for moderate-to-severe OA symptoms. The aim of this study was to compare the efficacy and safety of the COX-1 sparing, COX-2 specific inhibitor, celecoxib, with the conventional NSAID naproxen, and placebo, in the treatment of OA of the hip. In this multicenter, randomized, placebo-controlled trial, 1061 patients with symptomatic OA of the hip were randomized to receive celecoxib at doses of 100 mg, 200 mg, or 400 mg/day; naproxen 1000 mg/day; or placebo, for 12 weeks. Patients were evaluated using standard measures of efficacy at baseline, 2–4 days after discontinuing previous NSAID or analgesic therapy, and after 2, 6, and 12 weeks of treatment. All doses of celecoxib and naproxen significantly improved the symptoms of OA, at all time points compared with placebo. This sustained treatment effect of celecoxib was dose dependent. In terms of pain relief and improvement in functional capacity, celecoxib 200 mg/day and 400 mg/day were similarly efficacious and were comparable to naproxen. Both drugs were generally well tolerated. Celecoxib at a dose of 200 mg/day is as effective as a standard therapeutic dose of the conventional NSAID, naproxen, in reducing the pain associated with OA of the hip.
Increased Soluble CD4 Molecules and the Role of Soluble CD4 Production in Patients with Rheumatoid Arthritis
Authors: Ohkubo T , Takei M , Mitamura K , Horie T , Fujiwara S , Shimizu K , Ryu J , Shiraiwa H , Sawada S
Published: February 2013

We investigated the concentration of soluble CD4 molecules (sCD4) in serum, and the mechanism of sCD4 production from T lymphocytes, in patients with rheumatoid arthritis (RA). The concentration of sCD4 molecules was determined using a solid-phase enzyme-linked immunosorbent assay method. Using reverse transcription polymerase chain reaction (RT-PCR) techniques, we studied the presence of alternatively spliced mRNA encoding the transmembrane site of CD4, and the mRNA encoding a conservative region of the CD4 binding site of the human immunodeficiency virus (HIV), in the serum of RA patients. Levels of sCD4 found in RA patients were higher than in normal controls (199 U/ml compared with 8.4 U/ml, respectively), and correlated with additional medical parameters. The results of RT-PCR suggested that the higher sCD4 levels may be due to shedding from the cell membrane after protease digestion, not to alternative splicing or a reaction to viral binding to sCD4.
Evaluation of Apoptosis as a Factor Affecting the Growth of Non-Polypoid Colorectal Adenomas
Authors: Yamada H , Hasegawa H , Iino H , Eguchi H , Fujii H , Matsumoto Y
Published: February 2013

Some colorectal adenomas show non-polypoid features endoscopically, e.g. nodule-aggregation or lateral spreading. To understand the developmental mechanism of non-polypoid adenomas better, we evaluated apoptosis indices in the upper and lower parts of 26 colorectal adenomas of non-polypoid appearance using TUNEL or single-stranded DNA (ssDNA) immunohistochemical staining. Regression analysis showed an extremely strong positive correlation between the apoptosis index (AI) values generated using each method. The AI of the lower section of lesion (4.54 ± 1.86) was significantly higher than that of the upper part (1.21 ± 1.47). In conclusion, ssDNA immunostaining is as useful as the TUNEL method in the evaluation of apoptosis in colorectal adenomas. It seems that vertical growth in non-polypoid adenomas is inhibited by apoptosis allowing horizontal growth to dominate and resulting in the characteristic, laterally spreading morphology.
Influence of Theophylline on Activated Lymphocytes and Eosinophils in Peripheral Blood and Sputum
Authors: Tohda Y , Kubo H , Iwanaga T , Fukuoka M , Nakajima S
Published: February 2013

The influence of a once-a-day sustained-release theophylline (Uniphyl®) on lymphocytes and eosinophils in the peripheral blood and sputum of patients with bronchial asthma was investigated. The peripheral blood lymphocytes included CD4, CD8, CD25 and HLA-DR. The sputum lymphocytes and eosinophils included CD4, CD8, CD25 and HLA-DR, and EG2, respectively. The results revealed that theophylline administration did not affect the numbers of activated CD4 and CD8 T lymphocytes in peripheral blood. No significant change in the lymphocyte count was observed in sputum, but the eosinophil count in the sputum decreased significantly after theophylline administration. EG2-positive eosinophils also decreased in number. CD4+HLA-DR+ and CD4+CD25+ T lymphocytes were significantly decreased, whereas CD8+ T lymphocytes in the sputum were not significantly reduced in number. Respiratory function test showed that forced expiratory volume in 1 s was significantly increased after theophylline administration. The results suggest that a new once-a-day sustained-release theophylline formulation would be useful in the treatment of chronic respiratory tract inflammation.
Concentration of Roxithromycin in the Lesions of Acne Vulgaris
Authors: Akamatsu H , Horio T
Published: February 2013

Roxithromycin, a macrolide antibiotic, is used in the treatment of acne vulgaris, although there have been no reports on its concentration in lesions when administered orally. We investigated the concentration of roxithromycin in acne vulgaris lesions in five patients who received 150 mg roxithromycin orally twice daily for 2 weeks. The mean concentration of roxithromycin in the lesions was 0.54 μg/ml. These results suggest that roxithromycin accumulates at therapeutic levels in the pilosebaceous system.
Trial Protocol and Sample Result of a Study Comparing the ClearPlan Easy™ Fertility Monitor with Serum Hormone and Vaginal Ultrasound Measurements in the Determination of Ovulation
Authors: Behre HM
Published: February 2013

This paper presents a preliminary result from a study designed to evaluate the ability of the ClearPlan Easy™ Fertility Monitor* to predict ovulation, compared with conventional methods of ovulation determination, i.e. serum hormone measurements (estradiol and luteinizing hormone) and vaginal ultrasound scans (follicle size and endometrium thickness). Fifty-five female volunteers will be monitored over 3 consecutive monthly cycles. Preliminary data gathered from one volunteer are included in this presentation. These data indicate that the ClearPlan Easy™ Fertility Monitor predicted ovulation as accurately as serum hormone measurements and vaginal ultrasound scans. The results show that this monitor has potential as a home-based ovulation predictor for couples attempting to conceive.
Effects of Fluvastatin Treatment on Insulin Sensitivity in Patients with Hyperlipidaemia
Authors: Cingözbay BY , Top C , Terekeci H , Keskin Ö , Önde ME
Published: February 2013

This study aimed to determine the effects of fluvastatin treatment on insulin sensitivity in patients with hyperlipidaemia. Non-obese, normoglycaemic, normotensive patients with hyperlipidaemia ( n = 20) and a reference group of healthy subjects of similar age, sex, and body mass index ( n = 20) were evaluated. Patients with other causes of peripheral insulin resistance were excluded. All participants underwent a diagnostic protocol, which included measurements of insulin sensitivity index and other metabolic parameters. Insulin sensitivity was assessed by Homeostasis Model Assessment (HOMA). Serum insulin levels were tested by radioimmunoassay. Patients were treated with fluvastatin 40 mg once daily for 3 months. Before fluvastatin treatment, fasting serum insulin levels were significantly raised in patients with hyperlipidaemia compared with subjects from the reference group (19.1 ± 13.4 versus 8.1 ± 3.4 μlU/ml). The fasting serum insulin levels and HOMA-estimated insulin sensitivity were correlated in the whole group. Correlation analysis showed a significant relationship between HOMA-estimated insulin resistance and plasma cholesterol and triglyceride concentrations. Patients with hyperlipidaemia had reduced insulin sensitivity that was reflected by high serum fasting insulin levels. Anti-hyperlipidaemic treatment with fluvastatin increases insulin sensitivity.
Clinical Correlates of Prolonged Pain in Japanese Patients with Acute Herpes Zoster
Authors: Kurokawa I , Kumano K , Murakawa K ,   The Hyogo Prefectual PHN Study Group
Published: February 2013

To determine which risk factors are relevant to the occurrence of post-herpetic neuralgia in Japanese patients with acute herpes zoster, correlations between the prolongation of pain and various disease factors were examined in 263 adult patients presenting within 10 days of the onset of rash at 17 institutions in the Hyogo region of Japan. All patients in whom pain persisted for more than 3 months were over 60 years of age. The pain also tended to be more prolonged in those with clustered vesicles, disturbed sleep and hypaesthesia. Other factors such as underlying disease states, critically involved regions, scar tissue, generalized rash and allodynia were not relevant to the duration of pain. Although decreased pain persistence was observed in patients in whom acyclovir therapy was initiated within 72 h of the onset of symptoms in comparison with those in whom it was initiated after this time, the difference between the two groups of patients was not statistically significant. Our results suggest that advanced age, the presence of clustered vesicles, and disturbed sleep and hypaesthesia influence the prolongation of herpes zoster pain.
Patient Compliance and Persistence with Anti-Hyperglycemic Therapy: Evaluation of a Population of Type 2 Diabetic Patients
Authors: Dailey G , Kim MS , Lian JF
Published: February 2013

The persistence and compliance of type 2 diabetic patients to different regimens of anti-hyperglycemic therapy were assessed retrospectively. The pharmacy claims from a pharmacy benefit management organization were analysed from the third quarter of 1996 to the fourth quarter of 1999. Of the 23 400 patients enrolled and initiating anti-diabetic therapy, 85% started treatment with monotherapy, 9.5% with insulin alone, 4.1% with polytherapy and 1.3% with insulin plus another therapy. Monotherapy patients were characterized as receiving metformin, sulfonylurea or another agent. For the 1-year follow-up period, 70.5% of the metformin patients, 75.3% of the sulfonylurea patients and 86.8% of the polytherapy patients underwent no regimen modification (except discontinuation). For the patients who had no modification of their medication regimen, persistence with sulfonylurea or metformin monotherapy was 65% greater than with polytherapy over a 1-year period. Compliance with sulfonylurea or metformin monotherapy was 45% greater than with polytherapy.
Serum E-Selectin and β2-Microglobulin Levels in Behçet's Disease
Authors: Karakuzu A , Aktaş A , Akçjay F
Published: February 2013

Behçet's disease is a systemic vasculitis of unknown aetiology. Endothelial cell injury plays an important role in the pathogenesis and immunopathology of systemic vasculitises, but an immunopathogenic basis is also probable in Behçet's disease. E-selectin is an indicator of endothelial injury, and β2-microglobulin (β2M) is increased in immunological disorders. The serum concentrations of these two markers were determined in 40 patients with active Behçet's disease and 40 healthy controls. E-selectin was determined by enzyme-linked immunosorbent assay and β2M was determined by the nephelometric method. The mean (± SD) serum concentration of E-selectin was 122.13 ± 62.32 ng/ml and that of β2M was 0.31 ± 0.05 mg/dl. Both concentrations were statistically significantly increased in patients with Behçet's disease compared with controls. More comprehensive studies are needed to determine whether these parameters are useful indicators of the activity of Behçet's disease.
Circulating Leptin: A Marker of Health in Female Students
Authors: Kondo T , Yoshida A , Okada R , Kanda T , Kobayashi I , Murakami M
Published: February 2013

We studied the relationship between serum leptin concentration and lifestyle factors in female nursing students. Serum leptin was estimated by radioimmunoassay and the correlation between these concentrations with serum lipids, physical fitness and Health-promoting Lifestyle Profile score was investigated. A total of 247 students took part in the study: mean age, 19.0 ± 2.0 years; mean body mass index (BMI), 21.7 ± 2.9 kg/m2; and mean serum leptin concentration, 10.8 ± 11.5 ng/ml. Serum leptin was positively correlated with BMI, systolic and diastolic blood pressure, total cholesterol and serum triglyceride. Serum leptin level concentration inversely correlated with physical fitness score and lifestyle score. When the subjects were grouped according to BMI, the high-BMI group (BMI: ≥ 24 kg/m2; n = 40) showed significantly lower fitness and lifestyle scores than the low-BMI group (BMI ≤ 20 kg/m2; n = 70). Higher leptin, blood pressure, total cholesterol and triglyceride were seen in high-BMI compared with low-BMI subjects. We suggest that leptin is a useful marker for monitoring good health and may be useful as a motivational aid towards achieving and maintaining a healthy lifestyle.
Clinicopathological Characteristics in Large, Non-Polypoid Colorectal Adenomas with Granule-Aggregating Appearance
Authors: Yamada H , Hasegawa H , Iino H , Eguchi H , Fujii H , Matsumoto Y
Published: February 2013

Endoscopically, most large, non-polypoid colorectal adenomas have a granule-aggregating appearance, made up of elevations of small, flat lesions projecting above the surrounding mucosa. In this study we investigated the clinicopathological characteristics in 26 cases of such tumours and proposed the term ‘granuleaggregating tumour’ (GAT). Patients with GATs (16 men and 10 women) had a mean age of 64.3 years (range, 38–83 years). The mean diameter of the GATs was 28 mm (range, 12–62 mm). Histologically, GATs were diagnosed as tubular (15 cases) or tubulovillous (11 cases) adenomas without submucosal invasion. These tumours had a surface morphology comprised mainly of small, flat elevations or granular structures, measuring 1.2 ± 0.3 mm in diameter. Of the 26 patients with GATs, 19 (73.1%) were asymptomatic and 11 of these 19 cases (57.9%) were detected by a faecal occult blood test. In nine of the 26 patients (34.6%) GATs were accompanied by colorectal cancers arising at other sites. GATs show typical endoscopic features, often lack symptoms and are frequently accompanied by other cancers in other organs. An awareness of the existence of GATs should assist in the screening, prevention and therapy of colorectal tumours.
An Open, Pilot Study to Evaluate the Potential Benefits of Coenzyme Q10 Combined with Ginkgo Biloba Extract in Fibromyalgia Syndrome
Authors: Lister RE
Published: February 2013

An open, uncontrolled study was undertaken to measure the subjective effects of coenzyme Q10 combined with a Ginkgo biloba extract in volunteer subjects with clinically diagnosed fibromyalgia syndrome. Anecdotal reports from patients with fibromyalgia syndrome have claimed benefits from the use of these supplements. The aim of this study was to determine if these reports could be substantiated in a pilot clinical trial. Patient questioning had determined that poor quality of life was a major factor in the condition and a quality-of-life questionnaire was used to measure potential benefit. Subjects were given oral doses of 200 mg coenzyme Q10 and 200 mg Ginkgo biloba extract daily for 84 days. Quality of life was measured, using the well-validated Dartmouth Primary Care Cooperative Information Project/World Organization of Family Doctors (COOP/WONCA) questionnaire that measures seven different subjective responses, at 0-, 4-, 8- and 12-week intervals. The subjects were asked for an overall self-rating at the end of the study. A progressive improvement in the quality-of-life scores was observed over the study period and at the end, the scores showed a significant difference from those at the start. This was matched by an improvement in self-rating with 64% claiming to be better and only 9% claiming to feel worse. Adverse effects were minor. A controlled study is now planned.
A Hydatid Cyst of the Thyroid Gland
Authors: Çapoğlu İ , Ünüvar N , Erdogan F , Yilmaz O , Çaydere M
Published: February 2013

Echinococcosis, although eradicated in many countries, is still widespread in communities in which agriculture is dominant, and cystic hydatidosis is a significant public health problem in regions where echinococcosis is endemic. Hydatid cysts may be found in almost any part of the body, but most often in the liver and lungs. Other organs affected occasionally include the brain, muscle, kidney, bone, heart and pancreas. This report documents a rare case with a cystic nodule in the thyroid detected by ultrasonography. The patient was a 40-year-old woman with an euthyroid multinodular goitre. Ultrasonography revealed a cystic nodule, and the ultrasonic appearance of the cyst liquid showed multiple echoes, suggesting that the nodule could be a hydatid cyst. Bilateral subtotal thyroidectomy was performed. Postoperative examination of the nodule showed it to be a solitary primary thyroid hydatid cyst.
Clinical Evaluation of Ramosetron Injections in the Treatment of Cisplatin-Induced Nausea and Vomiting
Authors: Noda K , Ikeda M , Yoshida O , Yano S , Taguchi T , Shimoyama T , Nakashima M
Published: February 2013

A phase III, double-blind, placebo-controlled study was performed to examine the safety and efficacy of ramosetron in cancer patients with cisplatin-induced nausea/vomiting. Patients were divided into two groups: group R received 0.3 mg ramosetron intravenously and group P received placebo. Eighty-eight patients were enrolled, 44 in each group; 84 (43 in group R, 41 in group P) were included in the clinical efficacy analysis and 86 (44 in group R, 42 in group P) in the safety analysis. Ramosetron was significantly more clinically effective than placebo against nausea, vomiting and anorexia; 65.1% of patients in group R experienced no vomiting in the first 6 h of observation compared with 7.3% of those receiving placebo. No serious adverse reactions or significant differences in safety were observed between the groups. Based on these results, ramosetron injection is effective in the treatment of cisplatin-induced nausea/vomiting and its clinical usefulness is demonstrated here.
Increased Heme Oxygenase-1 Gene Expression in the Livers of Patients with Portal Hypertension Due to Severe Hepatic Cirrhosis
Authors: Matsumi M , Takahashi T , Fujii H , Ohashi I , Kaku R , Nakatsuka H , Shimizu H , Morita K , Hirakawa M , Inagaki M , Sadamori H , Yagi T , Tanaka N , Akagi R
Published: February 2013

Surgical bleeding associated with splanchnic hyperaemia due to portal hypertension complicates the anaesthetic management of hepatic transplantation. Although the mechanism(s) of portal hypertension are not fully understood, carbon monoxide, a product of the heme oxygenase (HO) reaction, is thought to be one of the endogenous vasodilators in the liver. In this study, the expression of mRNA encoding inducible HO isozyme (HO-1) in the livers of patients with portal hypertension undergoing hepatic transplantation was determined in comparison with those without portal hypertension. HO-1 mRNA levels were significantly greater in the portal hypertension group than in the group without portal hypertension. In contrast with HO-1, the gene expression of non-specific δ-aminolevulinate synthase (ALAS-N), which is down-regulated by heme in the liver, was the same in both groups. These results suggest that HO-1 is up-regulated through heme-independent stimuli according to the development of portal hypertension, and that induced HO-1 plays a pathophysiological role in portal hypertension through carbon monoxide production.
The Effectiveness of Anti-Retroviral Drug Therapy for HIV-1 is Associated with HIV-1 Proviral DNA Levels and Viral Selection
Authors: Ariyama I , Chong Y , Murata M , Nabeshima S , Ikematsu H , Kashiwagi S , Hayashi J
Published: February 2013

The effect of combination anti-retroviral therapy regimens on HIV-1 proviral DNA levels in peripheral blood mononuclear cells was examined in 12 HIV-1-positive patients, using endpoint dilution polymerase chain reaction and serial cloning, and sequencing of the gag region of HIV-1. The major clone was defined as the most numerous of 10 analysed clones, and observation periods ranged from 8 months to 32 months (mean 19.7 ± 10.2 months). In five patients (one with primary-stage HIV-1 infection) receiving three anti-retroviral drugs, HIV-1 RNA reduced to undetectable levels (i.e. ≤ 100 copies/ml). HIV-1 proviral DNA and the number of major clones reduced in four of these patients. HIV-1 RNA levels reduced, but remained detectable, in five other patients. In the two remaining patients (both receiving two rather than three anti-retroviral drugs), HIV-1 RNA levels increased. These results suggest that the population of major clones may be affected when HIV-1 RNA levels reduce following combination regimens of anti-retroviral therapy.
Gastrointestinal Tolerability of Ibuprofen Compared with Paracetamol and Aspirin at Over-the-Counter Doses
Authors: Rampal P , Moore N , Van Ganse E , Le Parc J-M , Wall R , Schneid H , Verrière F
Published: February 2013

This multicentre, randomized, investigator-blinded, parallel-group study compared the gastrointestinal (GI) tolerability of ibuprofen, paracetamol and aspirin at over-the-counter doses for common pain indications. Patients (of whom 8633 were evaluable) took either ibuprofen up to 1200 mg daily, or paracetamol or aspirin, each up to 3000 mg daily, for 1–7 days. The main outcome was the proportion of patients with GI adverse events. There were significantly more patients who suffered GI adverse events, principally abdominal pain, dyspepsia, nausea and diarrhoea, with aspirin (18.5%) than with ibuprofen (11.5%), but the difference between ibuprofen and paracetamol (13.1%) was not significant. Significantly more of those patients with a history of non-ulcer GI disease ( n = 371) developed GI adverse events than did those with no such history; the incidence of GI adverse events in both groups was lowest with ibuprofen. More women than men experienced GI adverse events (15.5% versus 12.8%). The higher incidence of GI adverse events with aspirin was evident from the first day of treatment. In conclusion, the GI tolerability of ibuprofen, at over-the-counter doses of up to 1200 mg daily for up to 7 days, was at least as good as that of paracetamol and significantly better than that of aspirin.
Serum Interleukin 1α and Interleukin 2 Levels in Patients with Schizophrenia
Authors: Ebrinç S , Top C , Öncül O , Başoğlu C , Çavuşlu Ş , Çetin M
Published: February 2013

It has been suggested that altered interleukin (IL) regulation may be involved in the pathogenesis of schizophrenia. In this cross-sectional, case-controlled study, patients with schizophrenia and a control group of healthy subjects, matched by age, sex and body mass index, were evaluated. The levels of IL-1α and IL-2 in blood serum were measured by enzyme-linked immunosorbent assay. The fasting serum IL-2 levels were significantly higher in patients with schizophrenia compared with the control subjects, but there was no difference between the fasting serum levels of IL-1α in patients with schizophrenia and the control subjects. Our results suggest that patients with schizophrenia have altered IL-2, but not IL-1α, regulation.
The Effect of Midazolam Pre-Medication on Rocuronium-Induced Neuromuscular Blockade
Authors: Hepağuşlar H , Öztekin S , Mavioğlu Ö , Tuncali B , Elar Z
Published: February 2013

We investigated the effect of midazolam pre-medication on rocuronium-induced neuromuscular blockade during sevoflurane anaesthesia. Twenty-two patients scheduled for elective surgery were randomly divided to receive either no pre-medication (control group) or pre-medication with 0.1 mg/kg midazolam intramuscularly (midazolam group). Anaesthesia was induced with fentanyl and propofol, and maintained with sevoflurane and nitrous oxide in oxygen. Neuromuscular responses were monitored using acceleromyography. The onset and clinical duration of action, time to recovery of first twitch of train-of-four (TOF) response to 75% of control, recovery index and time for TOF recovery to 25% and 50% were recorded. Patient-related data were similar in both groups. The parameters recorded were not significantly different between the groups. Midazolam pre-medication does not influence the time-course of action of rocuronium during sevoflurane anaesthesia.
Use of OM-85 BV for the Prevention of Acute Respiratory Tract Infections in Occupational Medicine
Authors: Carmona-Ramírez MA , Alvárez-Gómez V , Berber A
Published: February 2013

This study evaluated the safety and efficacy of the immunostimulatory agent OM-85 BV in 112 male car-factory workers who were highly susceptible to acute respiratory tract infections (ARTIs), each having experienced ≥ 4 ARTIs during 1999. From January to March 2000, each worker received one capsule of OM-85 BV (7 mg) per day for 10 consecutive days each month. The patients were followed for a further 9 months. Mean number of ARTIs decreased from 8.2 ± 2.1 per worker in 1999 to 5.3 ± 2.9 in 2000; i.e. a difference of −2.9 (95% confidence intervals, −3.5 to −2.4). Similar effects were observed in men who had different job roles, and no adverse events were reported during drug administration. We concluded that OM-85 BV appears to be safe and effective in reducing the incidence of ARTIs in susceptible workers, although further double-blind, placebo-controlled clinical trials are required.
Efficacy and Safety of Barnidipine Compared with Felodipine in the Treatment of Hypertension in Chinese Patients
Authors: Liau CS , Chien KL , Chao CL , Lee TM
Published: February 2013

The efficacy and safety profiles of barnidipine in the treatment of hypertension were evaluated in an open parallel-group study. Fifty-nine Chinese patients with mild-to-moderate essential hypertension were randomized to receive either barnidipine or felodipine (5 mg once daily, titrated to 10 mg or 15 mg once daily, as indicated) for 12 weeks. Both drugs reduced blood pressures significantly with ≥ 68% of cases obtaining marked or moderate blood pressure reduction. Mean reductions in systolic and diastolic blood pressure for barnidipine treatment were 23.7 ± 13.5 mmHg and 12.7 ± 7.9 mmHg, and for felodipine, 24.3 ± 18.4 mmHg and 14.5 ± 10.0 mmHg, respectively. There was no significant difference between these two drugs in anti-hypertensive effect, heart rate, laboratory measurements or incidence of adverse events. The only difference was that more patients taking felodipine experienced palpitations. We conclude that barnidipine has similar efficacy and a similar safety profile to felodipine in the treatment of mild-to-moderate essential hypertension in Chinese patients.
Clinical Management of Hydatid Disease of the Urinary Tract
Authors: Özbey İ , Aksoy Y , Polat Ö , Atmaca AF , Demirel A
Published: February 2013

This study reviews urinary hydatid disease in seven males and three females (mean age, 32.1 ± 17.7 years; range, 7–67 years). Cysts were located in the kidney in six cases (one also involved the liver), the paravesical and retrovesical region in two cases (one coexisted with a bladder tumour), the adrenal gland (one case) and in the right parapelvic region (one case). Investigations included urinalysis, eosinophil count, Casoni skin test, indirect haemagglutination test (IHA), abdominal ultrasonography, intravenous urography and computed tomography (CT). All patients underwent surgery and were followed for an average of 5.6 years. Lumbar or abdominal pain was the most common symptom. Eosinophilia was seen in five patients (50%), IHA positivity occurred in four patients (40%) and the Casoni skin test was positive in four patients (40%). Abdominal CT was the most useful diagnostic method of radiological investigation (100%). No complications or recurrences were seen on follow-up. Urinary hydatid disease is uncommon and is likely to cause considerable diagnostic difficulties, and should therefore be considered in the differential diagnosis of space-occupying lesions of the urinary tract.
Generalized Gingival Hyperplasia Occurring during Pregnancy
Authors: Güngörmüş M , Akgül HM , Yilmaz AB , Dağistanli S , Erciyas K
Published: February 2013

In this report, we present a case of generalized gingival hyperplasia related to pregnancy causing chewing, speaking, breathing and cosmetic problems. The patient was a 26-year-old woman in the fourth month of her second pregnancy, with generalized gingival hyperplasia affecting both buccal and lingual aspects of the maxilla and mandible. The hyperplastic tissues, together with mobile teeth, were excised completely; no recurrence was observed for the remainder of the pregnancy. Hormonal changes occurring during pregnancy have long been known to be associated with generalized gingival hyperplasia. Pregnancy does not cause the condition, but altered tissue metabolism in pregnancy accentuates the response to local irritants. This case was of clinical interest because of the extent of tissue proliferation, with the teeth in both the upper and lower jaw completely submerged.
Dishonesty, Misconduct and Fraud in Clinical Research: An International Problem
Authors: Ankier SI
Published: February 2013

Clinical research misdemeanours include a broad spectrum of misdeeds that misappropriate an unfair advantage or harm the rights of others. There is no internationally accepted definition of such malpractices and no generalized procedure to facilitate their reporting or correction. Those who do report research misdemeanours are often stigmatized as ‘whistleblowers’, a term that has acquired many negative connotations. Frequently, whistleblowers encounter many personal conflicts and/or may suffer victimization in their working environment. There remains a need for an internationally harmonized approach to manage these unacceptable problems. Resolution of such important issues should be catalysed by the impending need for European Union states to implement Good Clinical Practice Directive 2001/20/EC into national law.
Coryneform Bacteria Isolated from Blood Cultures and Their Antibiotic Susceptibilities
Authors: Balci I , Ekşi F , Bayram A
Published: February 2013

We aimed to determine the types of corynebacteria isolated from the blood of patients at Gaziantep University Hospital, Turkey, and their antibiotic susceptibilities. Between February 1999 and June 2001, 3530 blood samples were cultured, of which 915 were found to be positive, and these were further investigated in the bacteriology laboratory. Among positive blood cultures, coryneform bacteria were identified in 31 (3.4%) isolates. Of these, 16 (51.6%) were Corynebacterium jeikeium, six (19.4%) were Corynebacterium striatum, four (12.9%) were Corynebacterium amycolatum, two (6.5%) were Cellulomonas species, two (6.5%) were Corynebacterium afermentans and one isolate (3.2%) was Corynebacterium propinquum. Antibiotic susceptibility tests showed that C. jeikeium was resistant to various antibiotics, whereas all isolates were susceptible to vancomycin and teicoplanin. This study illustrates the importance of taking coryneform bacteria into consideration when culturing blood samples. The need to identify the species and determine its antibiotic sensitivity is emphasized.
The Effect of the Herbal Medicine Dai-Kenchu-to on Post-Operative Ileus
Authors: Itoh T , Yamakawa J , Mai M , Yamaguchi N , Kanda T
Published: February 2013

Post-operative ileus (PI) is an inevitable adverse consequence of abdominal surgical procedures. We performed a randomized study of the effects of the herbal medicine dai-kenchu-to (DKT) on 24 patients with PI. Patients received either 15 g of oral DKT or placebo daily for 14 days. The effects on upper gastrointestinal motility, frequency of secondary operation and recurrence of PI were investigated. The frequency of surgical operation was significantly lower in patients receiving DKT compared with placebo. Oral administration of DKT was clinically effective for PI in reducing both the need for further surgery and the recurrence of PI.
The Effects of High Haematocrit Levels on Glucose Metabolism Disorders
Authors: Çapoğlu I , Ünüvar N , Bektaş Y , Yilmaz Ö , Kaya MD
Published: February 2013

There has been only limited research investigating the possible association between raised haematocrit levels, glucose intolerance and type 2 diabetes. In the present study, we explored the association between high haematocrit levels and impaired glucose tolerance by performing oral glucose tolerance tests in 46 patients with chronic obstructive pulmonary disease and no previous history of diabetes mellitus or glucose intolerance. A glucose metabolism disorder was observed in 12 (26%) patients (type 2 diabetes in six patients and impaired glucose tolerance in a further six). There was a significant association between high haematocrit levels and the presence of a glucose metabolism disorder, which was independent of other risk factors. High haematocrit levels may be an independent risk factor for type 2 diabetes and impaired glucose tolerance.
Primary Hydatidosis of the Gracilis Muscle in a Girl
Authors: Keskin D , Ezirmik N , Karsan O , Gürsan N
Published: February 2013

Primary muscle hydatidosis is very rare. Rupture and spreading of the cyst contents by improper handling may later cause secondary cyst or allergic reactions. Pre-operative recognition of a hydatid cyst is therefore critical. It often presents as a soft-tissue mass, however, and pre-operative recognition of this rare entity is clearly difficult. Here, a case of primary hydatidosis affecting the gracilis muscle is presented, and the magnetic resonance imaging, clinical and pathological findings are described.
Appendiceal Mucocele of Mucinous Cystadenocarcinoma with a Cutaneous Fistula
Authors: Nakao A , Sato S , Nakashima A , Nabeyama A , Tanaka N
Published: February 2013

We report a novel case of cystadenocarcinoma forming an appendiceal mucocele with development of a skin fistula. The patient was a 75-year-old Japanese woman who originally presented with a skin ulcer on the right flank (inferior to the ribs and superior to the iliac bone) with mucus discharge. The serum concentration of carcinoembryonal antigen was elevated (57.4 ng/ml). Ultrasonography and computed tomography demonstrated a cystic mass with septations in the right iliac fossa. Fistulography from the skin ulceration showed a communication via the fistula to the caecum. A right hemicolectomy and enbloc resection of the skin fistula was performed. The histological findings revealed a well-differentiated mucinous cystadenocarcinoma of the appendix. The patient has been alive for 7 years following surgery without any sign of recurrence. This report is of interest as it demonstrates that tumour rupture to the extraperitoneal space could result in a good outcome by preventing the development of pseudomyxoma peritonei.
Ruptured and Non-Ruptured Sinus of Valsalva Aneurysms: Five Case Studies
Authors: Ateş A , Yekeler İ , Özyazicioğlu A , Vural Ü , Yilmaz M
Published: February 2013

Between 1987 and 2000, we observed retrospectively a series of five cases of surgically treated sinus of Valsalva aneurysms (SVAs) at the Department of Cardiovascular Surgery, Atatürk University, Erzurum, Turkey. The mean age of the five patients was 32.6 years (range, 18–48 years). Three were male and two were female. Aneurysms originated from the right coronary sinus in four patients, and from the non-coronary sinus in one. Three aneurysms fistulized to the right ventricle, one to the right atrium and the last, originating from the right coronary sinus, was non-ruptured. Two aortic insufficiencies, two ventricular septal defects, one patent ductus arteriosus and one left ventricular outlet obstruction were found as concomitant lesions. All cases were symptomatic. Ruptured SVAs were repaired by double approach involving both the chamber and aortic root. There was no late mortality either in the hospital or during the follow-up period (mean 40.4 months, range 13–66 months). No patient required re-operation.
A Case of Refractory Hypothyroidism Requiring Daily Intravenous Thyroxine
Authors: Nagaoka T , Miyakoshi H , Takamura T , Nagai Y , Matsushita S , Kaneko S , Kobayashi K
Published: February 2013

Most patients with hypothyroidism respond to administration of oral thyroxine at a maintenance dose of 50–175 μg/day. This is the first documented patient with post-operative hypothyroidism who required about 10 times the standard dose of thyroxine, and whose symptoms only resolved when intravenous thyroxine was administered daily. Our findings support the benefits of daily intravenous therapy with thyroxine in this case.
Angiotensin-Converting Enzyme Insertion/Deletion Polymorphism and Polyneuropathy in Type 2 Diabetes without Macroalbuminuria
Authors: Ito H , Tsukui S , Kanda T , Utsugi T , Ohno T , Kurabayashi M
Published: February 2013

Angiotensin-converting enzyme (ACE) gene polymorphism is thought to be a potent risk factor for nephropathy and retinopathy in diabetes. We investigated the association between polyneuropathy and gene polymorphisms of both the ACE insertion/deletion (I/D) and angiotensinogen (AGT) M235T genes in 84 type 2 diabetic patients without macroalbuminuria (21 with polyneuropathy and 63 without). ACE genotype distribution did not differ significantly between patients with and without polyneuropathy, but the frequency of the I allele was significantly higher in those with polyneuropathy than in those without. In contrast, neither the genotype distribution nor the allele frequencies of the AGT gene differed between the two groups. In logistic regression analysis using a D-additive model, the D allele had a protective effect on polyneuropathy (odds ratio [OR], 0.34; 95% confidence interval [CI], 0.13–0.88). A D-dominant model hypothesis also gave a significant OR (0.28; 95% CI, 0.09–0.90). ACE I/D polymorphism, but not AGT M235T polymorphism, may affect polyneuropathy development in type 2 diabetes without macroalbuminuria.
The Incidence of Metamizole Sodium-Induced Agranulocytosis in Poland
Authors: Maj S , Lis Y
Published: February 2013

Metamizole sodium continues to be used extensively as an analgesic in Poland. This study was the first undertaken to quantify the incidence of agranulocytosis associated with metamizole sodium in Poland, and to compare the findings with those from other countries. Based on data obtained retrospectively from medical records covering the period 1997–2001 in six haematology centres representative of Poland as a whole, the crude estimate obtained was a rate of 0.2 cases per million person-days of use. This is the same order of magnitude as the value from an epidemiological study covering several countries (0.3–4.0).

W Polsce w dalszym ciągu na dużą skalę stosuje się sól sodową metamizolu jako lek przciwbólowy. Przeprowadzone badanie było pierwsżą próbą ilościowego ustalenia związku pomiędzy wystąpieniem nowych przypadków agranulocytozy a stosowaniem soli sodowej metamizolu w Polsce í porównania rezultatów badania z wynikami uzyskanymi w innych krajach. Na podstawie danych uzyskanych retrospektywnie, z historii chorób obejmujących okres 1997–2001 z sześciu ośrodków hematologicznych będących reprezentacyjnymi dla calej Polski, uzyskana surowa ocena wynosiła 0.2 przypadki na milion osobo/dni stosowania. Otrzymany rząd wielkości mieśći się w dolnym zakresie wyników badań epidemiologicznych w innych krajach (0.3–4.0).
Early Post-Operative Feeding after Caesarean Delivery
Authors: Göçmen A , Göçmen M , Saraoğlu M
Published: February 2013

The objective of this trial was to evaluate the safety and efficacy of early oral feeding after Caesarean delivery performed under general anaesthesia. During a 1-year period, 182 pregnant women undergoing Caesarean section under general anaesthesia were enrolled in a controlled trial of early compared with traditional post-operative oral feeding. Patients were allocated to early feeding of low-residue diets 6 h post-operatively ( n = 95) or traditional dietary management of clear liquids once normal bowel sounds were heard ( n = 87). Demographic data, post-operative and intra-operative complications and gastrointestinal symptoms were evaluated. Age, gravidity, parity, gestational age, surgery length and post-operative incidence of ileus were similar in the early- and traditional-feeding groups. Time to development of bowel sounds, time to initiation of oral intake and hospital stay were significantly shorter in the early-feeding group. Complications including wound infection, blood transfusion and febrile morbidity occurred at a similar rate in each group. Early post-operative feeding in women undergoing Caesarean section is safe and well tolerated.
Spatial Distribution of Nociceptive Neuropeptide and Nerve Growth Factor Depletion in Experimental Diabetic Peripheral Nervous System
Authors: Kanbayashi H , Itoh H , Kashiwaya T , Atoh K , Makino I
Published: February 2013

This study investigated the time-course of the nociceptive neuropeptide substance P and nerve growth factor (NGF), which facilitates substance P production, in lumbar and cervical dorsal root ganglia (DRG) of streptozotocin-induced diabetic rats. Levels of substance P and NGF were measured by radioimmunoassay and sandwich enzyme-linked immunosorbent assay, respectively, 2 months, 4 months and 8 months after induction of diabetes, and compared with age-matched non-diabetic control rats. At 2 months and 4 months, substance P and NGF levels were lower in the lumbar DRG of the diabetic rats than in controls. At 8 months, substance P and NGF were lower in both the lumbar and cervical DRG of the diabetic rats than in controls. These data demonstrate that a decrease in substance P levels in primary sensory neurons with NGF depletion occurs in an axonal length-dependent manner in diabetic rats, and that this decrease may be correlated with the duration of diabetes.