bluuebunny/crossref_metadata_2025 huggingface dataset:
Misuse of Antimicrobial Agents in Neonatal Units: A Cross-Sectional Survey in Kuwait
Authors: Al-Sawan Rima M.Z. , Soni Amrit L. , Al-Saleh Qusai , Al-Alfy AblaA. , Al-Essa Mazin , Rajaramu Usha , Deverajan Lekshminarayanapuram V.
Published: April 2003

Objective: To evaluate the justification for the use of antimicrobial agents and to verify the possibility of its misuse among inpatient neonates. Methods: A cross-sectional 1-day study was conducted. Two questionnaires A and B relating to inpatient neonates were filled by registrars working in the four neonatal units of the main regional hospitals (Maternity, Farwaniya, Adan, and Jahra). The objectives of the study were not revealed to the registrars. Results: Of the 119 patients, 57 (48%) were on antimicrobial agents, and the cultures yielded positive in 25/57 (44%). The organisms were reported not to be susceptible to the antimicrobial agents in use in 19/25 (76%) of the cases, but it was continued in 4/19 (21%). Antimicrobial agents were also continued in another 9/32 (28%) despite negative culture results. Conclusion: Misuse of antimicrobial agents was homogeneously observed at various levels in all neonatal units. This implies that urgent action should be taken to overcome this problem.
Transesophageal Doppler Echocardiographic Pattern of Pulmonary Venous Flow in Severe Mitral Stenosis
Authors: Al Kandari Fawzia Y. , Salama Abdul-Latif , Cherian George
Published: April 2003

Objectives: Analysis of the pulmonary venous flow enables an evaluation of cardiac hemodynamics. This study was conducted to evaluate the effect of severe mitral stenosis on the pulmonary venous flow both in sinus rhythm and atrial fibrillation. Methods: We studied 38 patients with isolated severe mitral stenosis (mitral valve area index ≤0.75 cm2) by pulsed wave Doppler transesophageal echocardiography of the left upper pulmonary vein. Twenty-six patients (68%) were in sinus rhythm and 12 (32%) in atrial fibrillation. Results: The peak systolic flow velocity was significantly lower in atrial fibrillation patients with blunted systolic flow pattern in 67%, while the normal flow pattern with higher systolic-to-diastolic flow ratio was found in 69% of sinus rhythm patients. Pulmonary venous flow was significantly delayed in its onset and termination with atrial fibrillation compared to sinus rhythm even after correction for heart rate (p < 0.02, p < 0.04, respectively). The pulmonary venous peak systolic flow velocity showed a significant negative correlation with the mean pulmonary pressure (r = –0.424, p = 0.011). Finally, there was a correlation between the pulmonary venous diastolic pressure half-time and the peak mitral gradient (r = –0.327, p = 0.045), mean mitral gradient (r = –0.369, p = 0.022) and Doppler mitral valve area (r = –0.422, p = 0.008). Conclusion: Severe mitral stenosis is associated with a decreased pulmonary venous systolic flow and prolonged decay of the diastolic flow, and these changes are more marked in atrial fibrillation. These results can help to understand the hemodynamics of mitral stenosis and its interaction with the pulmonary circulation.
Evaluation of Efficacy and Toxicity of Treatment Using Rhenium-186 HEDP in Metastatic Bone Disease
Authors: Ziada Gaber , Faris Lila , Yacoub Shreif , Elgazzar Abdelhamid
Published: April 2003

Objective: To assess the efficacy and toxicity of rhenium-186 HEDP in treating metastases. Patients: Twenty-six patients with bone pain from metastatic cancer were treated with 35 mCi of 186Re HEDP administered intravenously in the outpatient clinic. Methods: Patients were followed with pain diaries, records of medication, morbidity, sleep patterns, serial bone scans and a Karnofsky index. Twenty-five patients with complete records were evaluated. Patients were grouped according to the extent of bone metastases as seen in the bone scans. Results: Sixteen patients (64%) showed clinical responses of which 4 became completely pain-free. Pain relief typically began 10–20 days after 186Re HEDP was administered, while maximum benefit was normally achieved by 6 weeks. Relief of pain was maintained for 4–15 months (mean 6 months). No immediate adverse reactions were observed following the administration of 186Re HEDP. Only a mild transient fall in platelet levels was noted, which normalized by 6 weeks. Conclusion: 186RE HEDP appears as a safe, convenient and an effective palliative for pain secondary to bone metastases in cancer patients.
Prevalence of Obesity among 6- to 13-Year-Old Kuwaiti Children
Authors: Moussa Mohamed A.A. , Shaltout Azza A. , Al-Sheikh Nashami , Agha Nizam
Published: April 2003

Objective: To determine the prevalence of obesity among 6- to 13-year-old Kuwaiti children, and to investigate the familial and behavioural factors associated with obesity. Method: A cross-sectional multi-stage stratified random sample of 2,400 schoolchildren (1,256 males and 1,144 females) of ages 6–13 years was selected from the five governorates in Kuwait, between September 1995 and June 1996. Obesity was defined as body mass index (BMI, weight in kilograms per height in metres squared) >90th percentile of the age/sex-specific value of the National Centre of Health Statistics reference population. Data on sociodemographic characteristics, children’s behavioural factors, and family history of related diseases in parents were collected by questionnaire. Results: Prevalence of obesity was 26.5% (95% confidence interval 24.7–28.3%). Obesity was more prevalent among the female children from urban areas. BMI was negatively correlated with the number of siblings and child birth order, and positively correlated with blood pressure, after controlling for age and sex. Logistic regression analysis showed significant associations between obesity and family history of obesity (odds ratio = 3.36, p < 0.0001), family history of hypertension (odds ratio = 1.37, p = 0.024), family history of diabetes (odds ratio = 1.57, p = 0.0004) in parents, child birth order (odds ratio = 1.82, p = 0.0002), and respiratory diseases in children (odds ratio = 2.08, p < 0.0001). Conclusion: The prevalence rate of obesity in Kuwaiti children is considered to be high. Obesity which is related to family, environment, and individual characteristics needs to be detected and corrected at a young age to prevent its consequences in adulthood.
Gene-Toxin Interaction as a Putative Risk Factor for Parkinson’s Disease with Dementia
Authors: Hubble J.P. , Kurth J.H. , Glatt S.L. , Kurth M.C. , Schellenberg G.D. , Hassanein R.E.S. , Lieberman A. , Koller W.C.
Published: April 2003

We had previously examined environmental, sociodemographic and clinical variables as predictors for Parkinson’s disease with dementia (PD + D) and found that lower educational attainment, greater motor impairment and advanced age at disease onset were more common in PD + D than in subjects with Parkinson’s disease without dementia (PD – D). We now explore the hypothesis that genetic traits coupled with nongenetic factors may raise the risk of development of PD + D. The study cohort of 43 PD + D and 51 PD – D subjects was analyzed examining environmental, sociodemographic and clinical variables along with 3 candidate gene markers: poor debrisoquine metabolizer allele (CYP 2D6 29B+), monoamine oxidase B allele 1, and apolipoprotein E ε4 allele. Variables were initially entered into a multivariate model singly. Again lower education, age at onset and motor impairment appeared as predictors of PD + D while other variables (including allele status) failed to emerge as significant individual risk factors for dementia. We then examined environmental and genetic variables analyzed in tandem to look for potential variable interactions. Subjects who had pesticide exposure and at least 1 copy of the CYP 2D6 29B+ allele had 83% predicted probability of PD + D (stepwise logistic regression model: p = 0.0491). This case-control study provides preliminary evidence that a gene-toxin interaction may play an etiological role in PD + D. Further assessment of the role of these putative risk factors in incident dementia in PD is indicated.
Stroke Incidence and Case Fatality in Two Populations: The Auckland Stroke Study and the Copenhagen City Heart Study
Authors: Truelsen Thomas , Bonita Ruth , Grønbæk Morten , Schnohr Peter , Boysen Gudrun
Published: April 2003

Comparison of stroke incidence and case fatality in different parts of the world provides information that may lead to a better understanding of the disease. In this report we have investigated these two aspects in two large populations, one in Auckland, New Zealand, and the other in Copenhagen, Denmark (the Copenhagen City Heart Study, CCHS). Incidence rates of stroke are higher for men than women in both studies. The stroke incidence rate ratios between Auckland men and CCHS men are significantly different in most age groups, whereas in women the incidence rates differ only in one age group. The age- and sex-adjusted incidence rates are higher in the CCHS for both men and women as compared to the Auckland Stroke Study. The age-adjusted incidence rate ratio is higher for men than women in both studies: 1.29 in the Auckland Stroke Study and 1.54 in the CCHS. The 28-day case fatality is also higher in the CCHS than in Auckland and is higher for women than men in both studies. The incidence rate of stroke and the 28-day case fatality is higher in the CCHS as compared to the Auckland Stroke Study in both men and women. A very high proportion of smokers in CCHS may explain some of the differences in incidence rates in the two populations.
Stroke Recurrence Is More Frequent in Blacks and Hispanics
Authors: Sheinart K.F. , Tuhrim S. , Horowitz D.R. , Weinberger J. , Goldman M. , Godbold J.H.
Published: April 2003

This study was designed to measure recurrent stroke rates and identify their determinants in a mixed ethnic population. A cohort of 299 patients (110 black, 57 Hispanic and 132 white) admitted to a large urban hospital with an acute stroke between November 1, 1991, and July 1, 1993, was followed for a mean of 17.8 months. Demographic and historical data and stroke subtype and severity were recorded at the time of the index stroke. The main outcome measure was stroke recurrence. The unadjusted relative risk of stroke recurrence for blacks, relative to whites, was 2.0 (95% CI: 0.9–4.4) and for Hispanics, relative to whites, it was 2.6 (95% CI: 1.08–6.0). Ethnicity appeared to be associated with recurrence risk only among first-ever strokes: the risk for blacks, relative to whites, was 2.4 (95% CI: 1.02–5.5) and for Hispanics it was 2.9 (95% CI: 1.2–7.4). None of the other putative risk factors for stroke recurrence identified at the time of initial hospitalization were associated with risk of recurrence.
A Uniform Histological Cluster Scheme for ICD-O-Coded Primary Central Nervous System Tumors
Authors: van der Sanden Gitty A.C. , Wesseling Pieter , Schouten Leo J. , Teepen Hans L.J.M. , Coebergh Jan-Willem W.W.
Published: April 2003

Comparability of population-based measures of risk and prognosis for primary central nervous system (CNS) tumors, which exhibit marked histological diversity, may be hampered by differences in detection and case ascertainment and by the lack of unequivocal and uniform histological criteria for pathological diagnoses. Furthermore, many cancer registries do not include benign tumors as defined by the International Classification of Diseases for Oncology (ICD-O), such as meningiomas, schwannomas and pituitary adenomas. We propose both a detailed and a rough uniform histological cluster scheme for data coded according to the first or second edition of the ICD-O, published in 1976 and 1990, respectively. Primary CNS tumors, typed and graded according to (modified) classification systems of Bailey and Cushing, Kernohan, Ringertz, the WHO and Daumas-Duport, are clustered as clinically relevant entities on the basis of the second edition of the WHO classification system, published in 1993. The proposed scheme identifies some of the (potential) pitfalls in the descriptive epidemiology of CNS tumors and may facilitate temporal and geographical comparability of population-based data.
Neuroepidemiologic Research Initiatives on Guam: Past and Present
Authors: Wiederholt W.C.
Published: April 2003

Since the middle of this century, a remarkable concentration of cases of neurodegenerative disease(s), referred to as amyotrophic lateral sclerosis and Parkinson-dementia complex (ALS/PDC), has been recognized among Chamorro natives of Guam. Intense investigations over the last 4 decades have failed to determine the etiology of these invariably fatal diseases. Over the same time period, the incidence of ALS has decreased dramatically, the incidence of PDC has decreased, but to a lesser degree, and age at onset has shifted to a later age by about 1 decade. Almost 50% of demented patients present without the classical Parkinsonian features of PDC, and the morphological picture has changed. Results of past and present research initiatives are reviewed.
Parkinson’s Disease and Environmental Factors
Authors: Preux P.M. , Condet A. , Anglade C. , Druet-Cabanac M. , Debrock C. , Macharia W. , Couratier P. , Boutros-Toni F. , Dumas M.
Published: April 2003

The study included 140 patients with Parkinson’s disease (PD) and 280 non-Parkinson age-matched controls to evaluate environmental risk factors associated with PD. The effect of exposure to environmental and dietary factors was determined using conditional logistic regression. This multivariate analysis showed that PD in first-degree relatives and tea drinking were the main risk factors for PD. Smoking appeared to be a protective factor. Exposure to toxic compounds was not a significant risk factor. Further research is needed to validate that tea consumption increases the risk of PD.
Plasticity of GAP-43 Innervation of the Spleen during Immune Response in the Mouse
Authors: Yang Hong , Wang Ling , Huang Chuan-shu , Ju Gong
Published: April 2003

The amount and distribution of growth-associated protein (GAP-43)-like immunoreactive nerve fibers in the spleen of normal and immunized BALB/c mice were studied using immunohistochemical methods. A significant increase in the amount, as well as redistribution and morphological changes, of the GAP-43-like immunoreactive nerve fibers occurred in PPD (purified protein derivative from tuberculin) immunized animals. In the control animals, the GAP-43-like immunoreactive nerve fibers were found mainly distributed in association with vascular plexuses, with minor extension into the parenchyma of the inner zone of the periarterial lymph sheath. In the immunized animals, in addition to denser vascular plexuses, more fibers appeared in the outer zone of the periarterial lymph sheath, the marginal zone, and the red pulp, all known to be the sites where immune responding lymphocytes are located. Furthermore, the nerve fibers tended to have more branches and bear richer varicosities. The results suggest that active nerve remolding takes place in the spleen during immune response, which may serve as a mechanism through which the nervous system regulates immune responses.
Melanoma-Associated Adhesion Molecule MUC18/MCAM (CD146) and Transcriptional Regulator Mader in Normal Human CNS
Authors: Schwarz Markus J. , Müller Norbert , Körschenhausen Dirk , Kirsch Kathrin H. , Penning Randolph , Ackenheil Manfred , Johnson Judith P. , Hampel Harald
Published: April 2003

The proteins MUC18 and Mader have been identified as markers of tumor progression in melanoma cells. MUC18, also known as MCAM (melanoma cell adhesion molecule) and as CD146 (endothelial antigen), is a cell adhesion molecule belonging to the immunoglobulin superfamily. Mader is a transcriptional regulator shown to negatively regulate EGR-1. As it is known that neoplastic cells of neuroectodermal origin frequently express neuron-specific molecules, we studied whether these melanoma-associated antigens are found in normal CNS tissue. We investigated the expression of MUC18/MCAM and Mader in adult human post mortem CNS tissue by immunohistochemistry, immunoblot and two-dimensional gel electrophoresis. Our results show that Mader is preferentially expressed on neurons and glial cells and that the adhesion protein MUC18/MCAM is mainly expressed on vasculature within the CNS. These observations may have important implications for further studies investigating their possible roles in cell adhesion and proliferation control within the CNS.
The Immune-Endocrine Loop during Aging: Role of Growth Hormone and Insulin-Like Growth Factor-I
Authors: Burgess William , Liu Qiang , Zhou Jian-Hua , Tang Qingsong , Ozawa Akihit o , VanHoy Roger , Arkins Sean , Dantzer Robert , Kelley Keith W.
Published: April 2003

Why a primary lymphoid organ such as the thymus involutes during aging remains a fundamental question in immunology. Aging is associated with a decrease in plasma growth hormone (somatotropin) and IGF-I, and this somatopause of aging suggests a connection between the neuroendocrine and immune systems. Several investigators have demonstrated that treatment with either growth hormone or IGF-I restores architecture of the involuted thymus gland by reversing the loss of immature cortical thymocytes and preventing the decline in thymulin synthesis that occurs in old or GH-deficient animals and humans. The proliferation, differentiation and functions of other components of the immune system, including T and B cells, macrophages and neutrophils, also demonstrate age-associated decrements that can be restored by IGF-I. Knowledge of the mechanism by which cytokines and hormones influence hematopoietic cells is critical to improving the health of aged individuals. Our laboratory has recently demonstrated that IGF-I prevents apoptosis in promyeloid cells, which subsequently permits these cells to differentiate into neutrophils. We also demonstrated that IL-4 acts much like IGF-I to promote survival of promyeloid cells and to activate the enzyme phosphatidylinositol 3′-kinase (PI 3-kinase). However, the receptors for IGF-I and IL-4 are completely different, with the intracellular β chains of the IGF receptor possessing intrinsic tyrosine kinase activity and the α and γc subunit of the heterodimeric IL-4 receptor utilizing the Janus kinase family of nonreceptor protein kinases to tyrosine phosphorylate downstream targets. Both receptors share many of the components of the PI 3-kinase signal transduction pathway, converging at the level of insulin receptor substrate-1 or insulin receptor subtrate-2 (formally known as 4PS, or IL-4 Phosphorylated Substrate). Our investigations with IGF-I and IL-4 suggest that PI 3-kinase inhibits apoptosis by maintaining high levels of the anti-apoptotic protein Bcl-2. The sharing of common activation molecules, despite vastly different protein structures of their receptors, forms a molecular explanation for the possibility of cross talk between IL-4 and IGF-I in regulating many of the events associated with hematopoietic differentiation, proliferation and survival.
Effect of Secretion of Splenocytes after Superior Ovarian Nerve Section on the Ovarian Steroidogenesis
Authors: Forneris Myriam , Oliveros Liliana , Aguado Luis
Published: April 2003

It is known that ovary and spleen are innervated extensively by afferent and efferent noradrenergic sympathetic nerve fibers from the celiac ganglion. Furthermore, immune cells located in the ovary influence the ovarian physiology. However, the peripheral interaction between the immune and neuroendocrine system is poorly understood. This work was undertaken to study the effect of superior ovarian nerve (SON) transection, in adult rats, on the number of splenocyte β-adrenergic receptors and their possible relation to ovarian steroidogenesis, measuring the effect of secretions of those splenocytes on progesterone and estradiol release from the ovary. Seven days after SON transection, the splenocytes were isolated and then cultured for 48 h. Their number of β-adrenergic receptors, measured using [125I]-cyanopindolol as ligand, increased, and their culture media, used to stimulate ovaries from 60-day-old intact (neither SON-transected nor sham-operated) rats in vitro on diestrous day 2 showed a decrease in progesterone release and an increase in estradiol release in relation to splenocyte culture media of control rats (sham-operated; p < 0.001, respectively). The effects of in vivo SON transection were simulated by an in vitro system modulating the splenocyte β-adrenergic receptor number. The splenocytes from SON-transectioned rats were preincubated with and without norepinephrine (NE) 10–6 M for 48 h, a low and high number of β-adrenergic receptors respectively, and then were stimulated with NE 10–6 M for 24 h. After that, the culture medium from splenocytes with a low number of β-adrenergic receptors induced progesterone release from the ovaries of intact rats (p < 0.001), but produced no change in estradiol release. The data suggest that splenocyte secretions, which participate in the ovarian steroidogenic response, particularly in progesterone release, might be controlled by adrenergic influences since the number of splenocyte β-adrenergic receptors changes through SON-celiac ganglion-noradrenergic postganglionic innervation of the spleen. In estradiol release, probably other neurotransmitters than norepinephrine (NE) are involved when the SON is sectioned. In this paper we also show functional evidence for modulation of immune function by the sympathetic nervous system and its principal neurotransmitter, NE.
Electrical Sources of P300 Event-Related Brain Potentials Revealed by Low Resolution Electromagnetic Tomography
Authors: Anderer Peter , Pascual-Marqui Roberto D. , Semlitsch Heribert V. , Saletu Bernd
Published: April 2003

The P300 event-related potential (ERP) is considered to be closely related to cognitive processes. Previous reports regarding major generators contributing to the scalp-recorded P300 suggested widely distributed multiple sources. Based on ERPs recorded in 172 normal healthy subjects aged between 20 and 88 years in an auditory oddball paradigm, electrical activity in the brain corresponding to N1 and P300 components was localized by means of low resolution electromagnetic tomography (LORETA). The N1 LORETA generators, located in both auditory cortices, did not change over age. On the other hand, the P300 LORETA generators, located predominantly in the frontal neocortex and less pronounced in the posterior parietal cortex, decreased over age both in frontal and parietal source strength.
Smooth Pursuit Eye Movement Dysfunction in Substance-Dependent Patients: Mediating Effects of Antisocial Personality Disorder
Authors: Costa Laura , Bauer Lance O.
Published: April 2003

Smooth pursuit eye movements were evaluated in 21 healthy volunteers and 126 patients meeting criteria for one of the following DSM-III-R dependence diagnoses: alcohol (n = 10), cocaine (n = 44), heroin (n = 34), or dual alcohol and cocaine (n = 38). A significant reduction in tracking accuracy was found in the heroin and the dually dependent groups relative to controls. Interestingly, the eye movement dysfunction in the drug-dependent groups was no longer detectable when the effects of antisocial personality disorder were statistically removed. The magnitude of the dysfunction also correlated with several antisocial personality-related features, including an increased number of criminal charges and months of incarceration, increased problems associated with drug abuse, and lower intellectual functioning. The relationship demonstrated presently between antisocial personality disorder and eye movement dysfunction may have implications beyond studies of substance dependence.
Plasma and Platelet Amino Acid Concentrations in Patients Affected by Major Depression and under Fluvoxamine Treatment
Authors: Mauri Massimo C. , Ferrara Alessandra , Boscati Luigi , Bravin Silvia , Zamberlan Federica , Alecci Michela , Invernizzi Giordano
Published: April 2003

Plasma and platelet levels of 18 amino acids were measured in 29 outpatients (mean age ± SD 47.41 ± 10.85 years; 14 F, 15 M) affected by major depression (DSM IV) and in 28 healthy volunteers (mean age 42.46 ± 14.19 years; 12 F, 16 M). Plasma and platelet levels of amino acids tended to be higher in depressed patients than in healthy controls. In particular, glutamate, taurine and lysine plasma levels and aspartate, serine and lysine platelet levels were significantly higher. Tryptophan/large neutral amino acids ratio (trp/LNAAs) was significantly lower in depressed patients. Fluvoxamine treatment did not influence plasma and platelet levels of amino acids or trp/LNAAs ratio.
The Influence of Polypharmacological Antidepressive Treatment on Central Nervous Information Processing of Depressed Patients: Implications for Fitness to Drive
Authors: Grabe H.J. , Wolf T. , Grätz S. , Laux G.
Published: April 2003

Antidepressive medication may cause impairment of psychomotor functioning relevant to psychosocial adaptation and fitness to drive. This impairment seems to be less severe by activating antidepressants (SSRI, MAOI). In clinical settings, however, polypharmacological treatment of depressive disorders is frequent. This study evaluates the influence of antidepressants and common comedications on central nervous information processing concerning the ability to drive. Inpatients (n = 44) with major depression (ICD-10) were investigated under steady state plasma level condition. The data were recorded by the Act & React Testsystem ART-90 and analyzed according to medication, severity of illness and age. 88.6% of the patients failed to pass all the tests. With respect to different groups of antidepressants, no differences in psychomotor reaction performance were observed in polydrug treatment. The impact of these results on the patients’ fitness to drive is discussed.
Pathophysiologically Correlated Deficits of Information Processing in Obstructive Sleep Apnea Patients
Authors: Gresele Christiane , Hein Holger , Eggert Frank
Published: April 2003

In obstructive sleep apnea patients, who intermittently stop breathing at night for some seconds, functions of vigilance and attention seem to be impaired. The aim of our study was to investigate if nocturnal hypoxia as one possible detrimental factor is associated with the degree of modality shift effect expressing attention function at a very basic level of information processing. For the first time an experimental approach was applied to examine attention deficits in sleep apnea patients. Correlation analyses between pathophysiological parameters and attention function revealed a stronger association for the modality shift effect than for simple reaction times.
No Effects of Pulsed High-Frequency Electromagnetic Fields on Heart Rate Variability during Human Sleep1
Authors: Mann Klaus , Röschke Joachim , Connemann Bernhard , Beta Harald
Published: April 2003

The influence of pulsed high-frequency electromagnetic fields emitted by digital mobile radio telephones on heart rate during sleep in healthy humans was investigated. Beside mean RR interval and total variability of RR intervals based on calculation of the standard deviation, heart rate variability was assessed in the frequency domain by spectral power analysis providing information about the balance between the two branches of the autonomic nervous system. For most parameters, significant differences between different sleep stages were found. In particular, slow-wave sleep was characterized by a low ratio of low- and high-frequency components, indicating a predominance of the parasympathetic over the sympathetic tone. In contrast, during REM sleep the autonomic balance was shifted in favor of the sympathetic activity. For all heart rate parameters, no significant effects were detected under exposure to the field compared to placebo condition. Thus, under the given experimental conditions, autonomic control of heart rate was not affected by weak-pulsed high-frequency electromagnetic fields.
Efficiency of Continuous Positive Airway Pressure versus Theophylline Therapy in Sleep Apnea: Comparative Sleep Laboratory Studies on Objective and Subjective Sleep and Awakening Quality
Authors: Saletu B. , Oberndorfer S. , Anderer P. , Gruber G. , Divos H. , Lachner A. , Mandl M. , Parapatics S. , Popp W. , Saletu M. , Saletu-Zyhlarz G. , Sertl K. , Strobl R. , Tschida U. , Winkler A.
Published: April 2003

Sleep apnea is the most common sleep-related breathing disorder characterized by repetitive episodes of hypoxemia. Therapies include behavioral, surgical, orthodontic, pneumological, and pharmacological interventions. The aim of the present study was to compare the efficiency of pneumological therapy by nasal continuous positive airway pressure (CPAP) versus a pharmacological approach with theophylline (Respicur retard® 400 mg) on respiratory variables as well as objective and subjective sleep and awakening quality in patients with moderate sleep apnea measured by polysomnography and psychometry. Under CPAP therapy all respiratory variables improved and normalized, while under theophylline only the apnea-hypopnea index and the desaturation index improved but still did not return to normal values. Regarding sleep initiation and maintenance, CPAP therapy prolonged sleep latency and reduced movement time, while patients treated with theophylline showed reduced total sleep period, total sleep time and sleep efficiency. Sleep architecture demonstrated an increase in deep sleep and REM stages under CPAP therapy, and remained unchanged under theophylline. Concerning subjective sleep and awakening quality, both treatments improved well-being in the morning. Regarding objective awakening quality, reaction time performance was improved in both groups. In conclusion, CPAP treatment is more effective than theophylline regarding respiratory variables as well as the normalization of sleep maintenance and sleep architecture in sleep apnea patients.
Changes in Platelet Alpha-2-Adrenoceptors in Fibromyalgia: Effects of Treatment with Antidepressants
Authors: Maes Michael , Libbrecht Isabelle , Delmeire Laure , Lin Aihua , De Clerck Luc , Scharpe Simon , Janca Aleksander
Published: April 2003

The aim of this study was to determine platelet α2-adrenergic receptor (α2-AR) binding sites in fibromyalgia both before and after treatment with sertraline or placebo. The maximum number of binding sites (Bmax) and their affinity (Kd) for [3H]rauwolscine, a selective α2-AR antagonist, were measured in 13 normal volunteers and 22 fibromyalgia patients. Severity of illness was evaluated by means of the Hamilton Depression Rating Scale (HDRS) and dolorimetric assessments of tenderness at tender points. Fibromyalgia patients had repeated measurements of [3H]rauwolscine binding characteristics both before and after subchronic treatment with sertraline or placebo for 12 weeks. [3H]rauwolscine binding Kd values were significantly higher in fibromyalgia patients than in normal volunteers. There were significant inverse correlations between [3H]rauwolscine binding Kd values and duration of illness, age and lower energy. Significantly higher [3H]rauwolscine binding Kd values were found in fibromyalgia patients in an early phase of illness (<3 years) than in fibromyalgia patients with a protracted illness (>3 years). Repeated administration of sertraline had no significant effects on [3H]rauwolscine binding Bmax or Kd values. The results suggest that fibromyalgia and, in particular, fibromyalgia in an early phase of illness, is accompanied by lowered affinity of platelet α2-ARs.
Behavioral Effects of Aluminum in Mice: Influence of Restraint Stress
Authors: Colomina M. Teresa , Sanchez Domenec J. , Sanchez-Turet Miquel , Domingo Jose L.
Published: April 2003

The influence of restraint stress on potential aluminum (Al)-induced behavioral changes was assessed in CD-1 mice. Three groups of adult mice were given 0, 300 and 600 mg Al/kg body weight per day in drinking water for 2 weeks. One-half of the animals in each group were concurrently subjected to restraint stress during 1 h per day throughout the study. After cessation of treatment, open-field activity, active avoidance learning, and motor resistance and coordination of the animals were evaluated. At the end of the behavioral testing period, mice were killed and Al concentrations were determined in a number of tissues. There were no remarkable effects of Al, restraint stress or their combined administration on either open-field activity or on the number of avoidances in an automatic reflex conditioner. However, a lower motor resistance and coordination in a rotarod were observed following exposure to Al at 600 mg/kg/day, restraint alone or concurrent administration of Al (300 and 600 mg/kg/day) plus restraint stress. The levels of Al in whole brain and cerebellum were significantly enhanced in mice exposed to Al plus restraint. Although the present results scarcely show Al-induced neurobehavioral effects, the influence of restraint stress on Al levels in whole brain and cerebellum can be the basis for further studies on the potential role of this element in certain neurological disorders.
Age-Sensitive Cognitive Function, Growth Hormone and Insulin-Like Growth Factor 1 Plasma Levels in Healthy Older Men
Authors: Aleman André , de Vries Wouter R. , de Haan Edward H.F. , Verhaar Harald J.J. , Samson Monique M. , Koppeschaar Hans P.F.
Published: April 2003

Circulating levels of growth hormone (GH) change during the process of aging. Decline of cognitive functioning with aging is also well established. In this study, we investigated whether insulin-like growth factor 1 (IGF-1) and the GH response to a challenge of GH-releasing hormone and GH-releasing peptide 6 were associated with age-sensitive cognitive functions, but not with functions that do not decline with aging, in 17 healthy male subjects aged between 66 and 76 years. In addition, relations with anthropometric measures were examined. Neuropsychological performance was scored on tests of variables not sensitive to aging (general knowledge, vocabulary, basic visual perception and reading ability), and of variables sensitive to aging (visuoconstructive ability, perceptual motor and mental processing speed, and verbal long-term memory). After correcting for education, the serum GH response was significantly associated with two age-sensitive cognitive tests (measures of mental processing speed), but with none of the tests not sensitive to aging. However, the direction of the association was opposite to the relation between IGF-1 and these cognitive tests: higher levels of GH response were associated with poorer cognitive performance, whereas higher levels of IGF-1 were associated with better performance. GH response, but not IGF-1, was inversely correlated with body mass index. The results are in accordance with previous research suggesting a disruption of the relation between IGF-1 and GH secretion in older age.
Increased Inhibitory Activity of Protein Kinase C on the Serotonin Transporter in OCD
Authors: Marazziti Donatella , Masala Irene , Rossi Alessandra , Hollander Eric , Presta Silvio , Giannaccini Gino , Mazzoni Maria R. , Dell’Osso Liliana , Lucacchini Antonio , Cassano Giovanni B.
Published: April 2003

Different observations show a reduced functionality of the serotonin (5-HT) transporter in obsessive-compulsive disorder (OCD) that might be due to a disturbance of its regulation at intracellular level. Protein kinase C (PKC) has been reported to provoke a decrease in the number of the 5-HT transporter proteins. Therefore, we investigated whether OCD patients differed from control subjects in the effect of PKC upon the 5-HT transporter, after stimulation of this enzyme with 4β-12-tetradecanoylphorbol 13-acetate (β-TPA). Fifteen patients affected by OCD, according to DSM-IV criteria, were compared with a similar group of healthy subjects. The determination of 5-HT uptake was carried out according to the method of Arora and Meltzer with slight modifications. At baseline, OCD patients showed a significant decrease in the maximal velocity (Vmax) of 5-HT uptake, as compared with control subjects, with no change in the Michaelis-Menten constant (Km). The activation of PKC with β-TPA provoked a significant decrease in Vmax values in both groups, but the effect was significantly more robust in OCD patients who, in turn, also showed also an increase in Km values. These findings could indicate the presence of hyperactivity of PKC in OCD that could be the result of increased activity of the phosphatidylinositol pathway. In addition, this suggests new potential therapeutic targets in OCD.
Sleep Laboratory Studies in Restless Legs Syndrome Patients as Compared with Normals and Acute Effects of Ropinirole
Authors: Saletu M. , Anderer P. , Saletu B. , Hauer C. , Mandl M. , Oberndorfer S. , Zoghlami A. , Saletu-Zyhlarz G.
Published: April 2003

The restless legs syndrome (RLS) is a common sensorimotor disorder which leads to severe sleep disturbances and showed a prevalence of 7.9% in our sleep laboratory. The aim of this study was to investigate periodic leg movements (PLM), arousal and respiratory variables in 12 untreated RLS patients and to measure the acute effects of 0.5 mg ropinirole, a nonergoline dopamine agonist, as compared with placebo. In the target variable PLM/h of total sleep time (PLM/h TST), RLS patients showed an increased value of 40/h (normal 0–5/h). Further, we found an increased number of PLM (368), PLM/h of time in bed (49/h), PLM/h of REM sleep (11), PLM/h of non-REM sleep (46) and PLM/h awake (61). The arousal index was also increased (32/h; normal 0–25/h), as were arousals due to PLM. In the confirmatory part of our descriptive data analysis, ropinirole 0.5 mg significantly improved, as compared with placebo, the index PLM/h TST by 75%. In the descriptive part, all the other PLM variables were improved as well. Arousals due to PLM decreased, while spontaneous arousals increased. Respiratory variables, which had a priori been in the normal range, showed a slight but significant improvement after the dopamine agonist. Thus, 0.5 mg ropinirole significantly improved the target variable PLM/h TST, along with objective and subjective sleep quality and morning noopsychic performance, as described in the preceding paper. Our data encourage further sleep studies including all above-mentioned variables in a larger group of RLS/PLM during sleep patients as well as long-term efficacy trials.
Potential Human Neurotoxicity of MDMA (‘Ecstasy’): Subjective Self-Reports, Evidence from an Italian Drug Addiction Centre and Clinical Case Studies
Authors: Schifano Fabrizio
Published: April 2003

The present paper attempts to give an updated overview of the magnitude of the phenomenon of ecstasy abuse in Italy and other European countries. It gives an account of some clinical case studies and of a larger-scale report on polydrug (including MDMA) consumers attending our Public Health Addiction Treatment Unit in recent years, with a view to clarifying the characteristics and psychopathological consequences (mainly depression, psychotic disorders, cognitive disturbances, bulimic episodes, impulse control disorders, panic disorders, social phobia) of MDMA consumption. Longer-term, larger-dose (acute or cumulative) MDMA consumers were found to be at high risk of developing these psychopathological disturbances. A tentative description of certain personological dimensions of ecstasy consumers is also given (the novelty-seeking dimension was characteristic of those who occasionally experimented with the drug) while those who ingested larger quantities revealed low harm avoidance scores). Results are discussed in the light of the complex and different methodological issues arising from this kind of study, in which MDMA is far from being the only drug of abuse.
Functional Imaging of Conditioned Aversive Emotional Responses in Antisocial Personality Disorder
Authors: Schneider Frank , Habel Ute , Kessler Christoph , Posse Stefan , Grodd Wolfgang , Müller-Gärtner Hans-Wilhelm
Published: April 2003

Individuals with antisocial personality disorder (n = 12) and healthy controls (n = 12) were examined for cerebral regional activation involved in the processing of negative affect. A differential aversive classical conditioning paradigm was applied with odors as unconditioned stimuli and faces as conditioned stimuli. Functional magnetic resonance imaging (fMRI) based on echo-planar imaging was used while cerebral activity was studied during habituation, acquisition, and extinction. Individually defined cerebral regions were analyzed. Both groups indicated behavioral conditioning following subjective ratings of emotional valence to conditioned stimuli. Differential effects were found during acquisition in the amygdala and dorsolateral prefrontal cortex. Controls showed signal decreases, patients signal increases. These preliminary results revealed unexpected signal increases in cortical/subcortical areas of patients. The increases may result from an additional effort put in by these individuals to form negative emotional associations, a pattern of processing that may correspond to their characteristic deviant emotional behavior.
Okuläre Pulsamplitude bei okulärer Hypertension und verschiedenen Glaukomformen
Authors: Schmidt K.-G. , von Rückmann A. , Mittag T.W.
Published: April 2003

The present study was designed to investigate choroidal perfusion in primary open-angle glaucoma patients with statistically elevated (HPG) and statistically normal (NPG) intraocular pressure (IOP) and in ocular hypertensive volunteers (OHT) before and after application of topical antiglaucomatous drugs. When compared to age-matched healthy controls, ocular pulse amplitude (OPA) and IOP were significantly increased in OHT and unchanged in HPG; in NPG, the IOP was unchanged, and the OPA was significantly reduced. The topical antiglaucomatous drugs used in this study reduced IOP, but did not increase OPA. When compared to HPG and NPG, OHT subjects showed increased choroidal perfusion which may help to prevent glaucomatous optic nerve damage.
Ocular Concentrations of Mitomycin C Using Different Delivery Devices
Authors: Mietz Holger , Diestelhorst Michael , Rump A.F.E. , Theisohn Michael , Klaus W. , Krieglstein Günter  K.
Published: April 2003

Hypotony and its sequelae are a frequent complication of trabeculectomies performed with mitomycin C (MMC), possibly related to intraocular toxicity of the substance. In an animal model with rabbits, we used different devices for the application of MMC and measured extra- and intraocular concentrations by HPLC. In addition, the concentrations of MMC remaining in the devices were determined. The devices were (1) a regular surgical sponge, (2) a scleral shield, (3) a presoaked soft contact lens, (4) a soft contact lens with MMC application, and (5) subconjunctival injection. Ocular concentrations of MMC were similar within the first 4 groups and were highest in the last. The measurements suggest that MMC penetrates intraocularly regardless of the device used. The variability of remaining MMC concentrations in the devices was lowest in the soft contact lenses suggesting an improved delivery system compared to the usually used surgical sponges.
Visual Field Loss following Blunt Ocular Trauma
Authors: Pahor Dušica , Gračner Bojan
Published: April 2003

14 patients (14 eyes) who sustained hyphema after blunt ocular trauma underwent visual field testing on a Humphrey field analyzer. The severity of field defects based on mean deviation (MD) and corrected-pattern standard deviation (CPSD) p values was correlated with age, presence of hyphema and the extent of angle recession. Over 60% of eyes with blunt ocular trauma suffer from a significant visual field loss (MD < 5%). There was no correlation between severity of field defects and the extent of hyphema or the angle recession. MD p values were found to be associated with older group, but not CPSD p values.
Correlation between Epithelial Healing Rate and Initial Wound Size in Contact Lens-Induced Central Epithelial Abrasion
Authors: Chung Jang-Hyun
Published: April 2003

A correlation between individual epithelial healing rate and corresponding initial wound size was evaluated in 12 cases of contact lens-induced central epithelial abrasion. A fluorescein-stained epithelial defect area was photodocumented using a photo-slit lamp at about 6- to 12- hour intervals and measured by a computer-assisted image analyzer. The range of initial epithelial defect size varied from 4.8 to 47.3 mm2 and the epithelial healing rates calculated by linear regression differed from 0.144 to 1.128 mm2/h. However, the epithelial healing rate (y, mm2/h) was found to be linearly correlated with the initial wound size (x, mm2), i.e. y = 0.019x + 0.186 (r = 0.88). This result indicates that an epithelial healing rate can be estimated by the initial epithelial defect size by applying this formula in contact lens-induced central corneal abrasion.
Direct Measurement of Wound Temperature during Phacoemulsification
Authors: Yamagami Satoru , Yamagami Hiroko
Published: April 2003

We developed a method to measure wound temperature during phacoemulsification with a thermometer and compared the temperature between pulse and nonpulse modes. In cases with partial or complete obstruction of the aspiration port, wound temperature was significantly lower in the pulse mode versus the nonpulse mode. It was ascertained that pulse mode phacoemulsification prevents thermal burn of the wound in the hard nucleus during cataract surgery. This method is useful to evaluate wound temperature during phacoemulsification under various conditions.
Microbiological Investigations to Validate the Preparation of Corneal Transplants
Authors: Christiansen B. , Duncker G.
Published: April 2003

The globe and cornea are colonized by microorganisms and cannot be removed as sterile products. Antiseptic measures and storage of the cornea in medium containing antibiotics lead to an obvious reduction of the microbial flora. Unfortunately there is the possibility of secondary microbial contamination during the preparation. Large amounts of bacteria or resistant bacteria can ruin attempts to reduce the microbial flora. To validate the whole process of preparation we investigated the contamination of removed globes, environment, materials, instruments and media for each sequence of operation and eliminated sources of contamination. Recommendations are given to ensure a virtually sterile product at the end of preparation.
Histopathological Study of the Effect of Phacoemulsification-Aspiration on Iris Muscles
Authors: Komatsu Mari , Uga Shigekazu , Oono Shinji , Shimizu Kimiya , Kohara Makio
Published: April 2003

Phacoemulsification-aspiration (PEA) followed by peripheral iridectomy was performed in 10 patients, and the dissected iris fragments were examined by electron microscopy. Organic changes such as cytoplasmic vacuolation and lamellar formation were observed in both the sphincter and dilator muscles of the pupil. No changes in the axons were detected. The same findings were observed when a simian eye was examined after PEA. These results indicate that PEA causes injury to iris muscles.
Iris Vascular Changes in Newborns of Diabetic Mothers
Authors: Ricci Benedetto , Scullica Maria Gabriella , Ricci Francesco , Santo Alessandro
Published: April 2003

Routine ophthalmic examinations of 600 full-term neonates, including 54 born to mothers with insulin-dependent diabetes mellitus and 12 whose mothers had developed gestational diabetes, revealed significant tortuosity and dilatation of the iris vessels in over half of the infants born to diabetic mothers. Ninety percent of the newborns in the diabetic group presented hypoplasia of the iris stroma and pupil dynamics were altered in 85%. The vessel changes resolved spontaneously within 2 weeks after birth. These changes, which have also been observed in cocaine-intoxicated newborns, should raise the suspicion of adverse vascular effects in the fetus caused by maternal diabetes.
Primary Ethmoidal Sinus Oncocytic Adenocarcinoma Presenting as Proptosis
Authors: Cassidy L. , Cassels-Brown A. , Franks A.
Published: April 2003

This report describes a case of primary oncocytic adenocarcinoma of the ethmoidal sinus presenting as a unilateral proptosis and reduction of visual acuity.