bluuebunny/crossref_metadata_2025 huggingface dataset:
Anastomotic Complications after Esophagectomy
Authors: Lerut T. , Coosemans W. , Decker G. , De Leyn P. , Nafteux P. , van Raemdonck D.
Published: April 2003

Anastomotic complications after esophagectomy continue to be a burden jeopardizing the quality of life and of swallowing. However, incidence, mortality and morbidity of anastomotic complications have substantially decreased in recent years. It seems that this is not so much related to the use of a particular conduit, approach or route for reconstruction, but rather related to refinement in anastomotic techniques and perhaps even more to progress in modern perioperative management. Knowledge of surgical anatomy and meticulous technique are of paramount importance and obviously related to individual expertise. As to the management, most leaks can be treated by conservative measures and reintervention surgery today is rather exceptional. Early endoscopy and dilatation seem to decrease the incidence and severity of anastomotic stenosis.
Developing a Profile of Alcohol Consumption Patterns of Police Officers in a Large Scale Sample of an Australian Police Service
Authors: Davey Jeremy D. , Obst Patricia L. , Sheehan Mary C.
Published: April 2003

The current study aimed to examine the prevalence of alcohol use within a large sample (n = 4,193) of Australian police offers. Prevalence and at risk behaviour was measured through the use of a self-report survey containing the AUDIT and standard frequency and quantity questions. Results indicated that although police did not report drinking with high frequency when compared to the national statistics, they did drink in far greater quantities. Further, both males and females in the police sample reported high rates of binge drinking. The 18- to 25-year old age group reported the highest levels of frequency and quantity of alcohol consumed. Twenty-five percent of officers reported having drunk whilst on duty. An alarming proportion of the sample (30%) scored in the ‘at risk of harmful consumption’ category on the AUDIT while a further 3% scored in the ‘alcohol dependant’ category. Examination of demographic variables revealed that males, 18- to 35-year-olds, those divorced or separated, constables, operational personnel and officers who have served between 4 and 10 years were the groups most likely to fall in the risk category on the AUDIT. This was similar for the alcohol-dependant category except that males and females were equally likely to fall in this category. In conclusion, a significant number of police officers displayed at risk alcohol consumption behaviour; in comparison to earlier studies this proportion is not decreasing. Interventions and education programmes are needed within the police workplace, particularly in regard to the dangers of binge drinking for females and youth.
Diagnostic and Classification Criteria for the Guillain-Barré Syndrome
Authors: van der Meché F.G.A. , van Doorn P.A. , Meulstee J. , Jennekens F.G.I.
Published: April 2003

Background: Diagnostic criteria for the Guillain-Barré syndrome (GBS) have been available since 1978. Since then, several variants have been described. More recently, a distinction has been made between pure motor forms, severe sensory forms, primary axonal and primary demyelinating varieties. Associations of clinical characteristics, and specific infections and the presence of antiganglioside antibodies have been found. For further studies on GBS, it is therefore necessary to reconsider the available diagnostic criteria and add additional criteria for subclassification. Methods: A panel of (20) experts was formed. The literature representing the recent developments in GBS subclassification was reviewed. Following a consensus protocol, diagnostic and classification criteria were formulated. Results: The diagnosis of GBS can usually be made on clinical characteristics. A schedule for subclassification has been made to cover also the clinical variants in a systematic manner.
TGF-Alpha mRNA Expression in Renal Organogenesis: A Study in Rat and Human Embryos
Authors: Bernardini N. , Mattii L. , Bianchi F. , Da Prato I. , Dolfi A.
Published: April 2003

The peptides belonging to the epidermal growth factor (EGF) family play a significant role in kidney development by binding the EGF receptor. Transforming growth factor-α (TGFα), a member of this family, is thought to be the fetal ligand of the EGF receptor. The present study aims to localize the TGFα transcripts in rat and human embryonic kidneys using a nonradioactive in situ hybridization method on paraffin-embedded embryonic samples. The results obtained in this study, beside demonstrating the usefulness of the nonradioactive technique for the detection of TGFα mRNA in paraffin sections, allowed TGFα-producing cells to be seen in developing kidneys. TGFα mRNA and its respective peptide were found in the primitive mesonephric structures and within metanephric blastema and ureteric bud cells. The presence of the TGFα gene transcript in the developing rat and human kidney suggests that the TGFα peptide is of embryonic origin and that it may contribute to renal organogenetic processes together with other growth factors.
Renal Matrix Metalloproteinase Activity Is Unaffected by Experimental Ischemia-Reperfusion Injury and Matrix Metalloproteinase Inhibition Does Not Alter Outcome of Renal Function
Authors: Ziswiler Ruth , Daniel Catherine , Franz Eva , Marti Hans-Peter
Published: April 2003

Background: Ischemia-reperfusion injury can lead to organ damage, such as delayed graft function in kidney transplantation. Reactive oxygen species that play a key role in this disorder may directly activate latent matrix metalloproteinases (MMP). In the kidney, little is known about the role of MMP in ischemia-reperfusion. Therefore, the aim of our study was to analyze activity/expression of MMP and to assess their functional role by the use of the MMP inhibitor BB-94 (Batimastat). Methods:  Renal ischemia was induced by left renal pedicle occlusion for 60 min, preceded by right nephrectomy. Thirty-two female Sprague-Dawley rats were analyzed: sham-operated rats (n = 8), treated sham-operated rats (n = 4), ischemic rats (n = 12), and treated ischemic rats (n = 8). Batimastat therapy (30 mg/kg body weight/day) was initiated 2 days prior to induction of ischemia. Animals were sacrificed 12 h (n = 8) and 24 h (n = 24) after ischemia for analyses of MMP activity/expression and of plasma creatinine levels. Results:  We found no evidence for an alteration in the activity or expression of MMP as a result of renal ischemia-reperfusion. Importantly, plasma creatinine levels significantly increased to a mean of 374 ± 61 µmol/l in ischemic rats after 24 h, almost identical to the BB-94-treated ischemic rats (384 ± 36 µmol/l). The creatinine levels in sham-operated rats remained within normal limits. Conclusion: MMP play no role during the early phase of experimental renal ischemia-reperfusion injury.
Rapid Isolation of Tissue-Specific Genes from Rat Kidney
Authors: Hu Erding , Chen Zunxuan , Fredrickson Todd A. , Spurr Nigel , Gentle Simone , Sims Matthew , Zhu Yuan , Halsey Wendy , van Horn Stephanie , Mao Joyce , Sathe Ganesh M. , Brooks David P.
Published: April 2003

A systematic effort to isolate kidney-specific genes was performed using recently described PCR-select methodology. Using this technique, a kidney-specific mini-gene library was generated and a number of kidney-specific genes that share significant homology to previously characterized kidney genes from rats and other species were isolated. These included three renal-specific transporters (an ADH water channel, the anion transporters RST and ROAT1), a cell adhesion molecule (K-cadherin) and a kidney-specific protein upregulated in renal carcinoma (DD96). In addition, we isolated two novel genes from a rat kidney. One of the genes shares limited homology to rat profilin-1 while the other did not share any similarity to genes in the Genbank. Northern blot analysis revealed that the mRNA for each of these genes is expressed in a highly kidney-restricted fashion. Our results suggested that tissue-specific genes can be rapidly isolated and characterized using PCR-select techniques and this methodology may be generally applicable to isolate specific genes from a variety of tissues.
Chemokine Expression in the Obstructed Kidney
Authors: Crisman Jacqueline M. , Richards Laura L. , Valach Daniel P. , Franzoni David F. , Diamond Jonathan R.
Published: April 2003

Chemokines are chemotactic cytokines that are important mediators of leukocyte extravasation and chemotaxis. Herein, we provide evidence that after 1 day of unilateral ureteral obstruction (UUO), the mouse obstructed kidney (OBK) expresses MCP-1 (monocyte chemoattractant protein-1), RANTES (Regulated on activation normal T-cell expressed and secreted) and IP-10 (interferon-γ-induced protein-10). In addition, by day 7, MIP-2 (macrophage inflammatory protein-2) expression is elevated in the obstructed kidneys compared to the contralateral control kidneys (CLK). After 7 days of obstruction, RANTES was the most abundant of the four chemokines detected in the OBK. In situ hybridization results indicate that several cellular compartments contribute to the expression of RANTES in the OBK. However, clearly cortical tubules within the OBK contribute substantially to the elevated expression of RANTES. These data support the contention that the cortical tubular epithelium plays a pivotal role in the inflammation associated with experimental hydronephrosis.
Methylprednisolone Accelerates the Resolution of Glomerulonephritis by Sensitizing Mesangial Cells to Apoptosis
Authors: Maruyama Keisuke , Kashihara Naoki , Yamasaki Yasushi , Sato Minoru , Sugiyama Hitoshi , Okamoto Kazunori , Maeshima Yohei , Odawara Masahiro , Sasaki Junzo , Makino Hirofumi
Published: April 2003

Glucocorticoid has long been used to treat patients with glomerulonephritis because it ameliorates mesangial cell proliferation and proteinuria, in part by suppressing nuclear factor-kappa B (NF-ĸB) activation, which regulates the transcription of various pro-inflammatory genes. Recent evidence shows that NF-ĸB activation increases the resistance to TNF-α-induced apoptosis in mesangial cells. We examined glomerular cell proliferation and apoptosis along with NF-ĸB activation in the Thy-1.1 nephritis model. We also evaluated TNF-α-induced apoptosis in cultured mesangial cells. Methylprednisolone treatment ameliorated mesangial hypercellularity in Thy-1.1 nephritis by decreasing proliferating cells and increasing apoptosis in the glomeruli. These effects were associated with suppressed NF-ĸB activation. This in vitro study revealed that treatment with methylprednisolone and TNF-α induced cultured mesangial cell apoptosis. These results suggest that methylprednisolone may accelerate the resolution phase of Thy-1.1 nephritis in part by sensitizing mesangial cells to apoptosis.
Naloxone Inhibits A6 Cell Na+/H+ Exchange by Activating Protein Kinase C via the Mobilization of Intracellular Calcium
Authors: Di Sole F. , Guerra L. , Bagorda A. , Reshkin S.J. , Albrizio M. , Minoia P. , Casavola V.
Published: April 2003

The opioid receptor antagonist, naloxone, has been shown to have beneficial effects in the kidney and to be implicated in renal salt and water balance. In the present study the signal transduction pathways utilized by naloxone were studied in an epithelial cell line model of the cortical collecting duct, A6 cells. We found that naloxone has a dual effect depending on the concentration used: at a low concentration (10–6M) it antagonized the β-endorphin-dependent increase in cytoplasmic calcium [Ca2+]i, while at higher concentrations (>10–5M) it increased [Ca2+]i and intracellular inositol phosphate levels. While naloxone-induced increases in [Ca2+]i occurred in the absence of external calcium, it was significantly stimulated by increasing the external calcium concentration, suggesting that naloxone increases [Ca2+]i via both calcium release and calcium influx. In polarized A6 cell monolayers naloxone inhibited the activity of the Na+/H+ exchanger (NHE) only when added to the basolateral cell surface. This inhibition of the NHE was prevented by pretreatment of the cells with either the intracellular calcium chelator, BAPTA or with the protein kinase C inhibitor, calphostin C. These findings demonstrate that naloxone induces a rapid increase in intracellular calcium which inhibits the NHE via the calcium-dependent protein kinase C regulatory pathway.
Explanted Glomeruli: Utility and Limitations
Authors: Kitamura Masanori , Ishikawa Yoshihisa , Konta Tsuneo
Published: April 2003

Ex vivo incubation of isolated glomeruli has been used for many years to investigate biochemical properties of glomeruli. However, little has been understood about whether and how isolation and explanation per se affect the structure and function of the glomerulus. We recently reported that ex vivo incubation of isolated normal glomeruli results in severe apoptosis of podocytes, activation of the family of mitogen-activated protein kinase and expression of several genes regulated by activator protein 1. In this article, we summarize our current findings and discuss the utility and limitations of explanted glomeruli.
Induction of Urokinase Receptor Expression in Nephrotoxic Nephritis
Authors: Xu Yichun , Berrou Jeannig , Chen Xin , Fouqueray Bruno , Callard Patrice , Sraer Jean-Daniel , Rondeau Eric
Published: April 2003

The urokinase receptor (uPAR) is a multifunctional molecule involved in pericellular, fibrinolytic, and proteolytic activities, as well as in cell adhesion and chemotaxis and may play a role in the pathogenesis of tissue remodeling occurring during glomerulonephritis. We analyzed sequentially the expression of uPAR by immunohistochemistry and in situ hybridization in an accelerated model of nephrotoxic nephritis in rats. A strong induction of uPAR mRNA expression was observed in glomeruli as soon as 1 h after nephrotoxic serum injection. The intensity of glomerular uPAR mRNA and antigen expression increased and peaked at 24 h. At that time, numerous glomerular fibrin deposits, monocyte/marcrophage infiltration, and heavy proteinuria were observed. Fibrin deposition was detected at 6 h, peaked at 24 h, and progressively declined over the next 3 weeks, while uPAR antigen expression remained elevated until the end of the study (3 weeks). By double labeling, we showed that the expression of uPAR was mediated by both intrinsic glomerular cells and infiltrating macrophages. Severe podocytic lesions developed within 3 days after antiserum injection, and glomerulosclerosis rapidly progressed within 2–3 weeks. These results show that glomerular uPAR expression is induced in nephrotoxic nephritis and suggest that uPAR may promote local proteolysis and also tissue remodeling, leading to the late development of glomerulosclerosis.
Acoustic and Intelligibility Characteristics of Sentence Production in Neurogenic Speech Disorders
Authors: Weismer Gary , Jeng Jing-Yi , Laures Jacqueline S. , Kent Ray D. , Kent Jane F.
Published: April 2003

The purpose of this study was to examine the relationship between scaled speech intelligibility and selected acoustic variables in persons with dysarthria. Control speakers and speakers with amyotrophic lateral sclerosis (ALS) and Parkinson’s disease (PD) produced sentences which were analyzed acoustically and perceptually. The acoustic variables included total utterance durations, segment durations, estimates of the acoustic vowel space, and slopes of formant transitions; the perceptual variables included scaled speech intelligibility and severity of speech involvement. Results indicated that the temporal variables typically differentiated the ALS group, but not the PD group, from the controls, and that vowel spaces were smaller for both neurogenic groups as compared to controls, but only significantly so for the ALS speakers. The relation of these acoustic measures to scaled speech intelligibility is shown to be complex, and the composite results are discussed in terms of sentence vs. single-word intelligibility estimates and their underlying acoustic bases.
Cognitive and Linguistic Profiles of Specific Language Impairment and Semantic-Pragmatic Disorder in Bilinguals
Authors: Jordaan Heila , Shaw-Ridley Gill , Serfontein Jean , Orelowitz Kerry , Monaghan Nicole
Published: April 2003

This study explored the notion that the extent to which language-impaired children can become bilingual depends on the type of language impairment. Single-case studies were conducted on two 7-year-old bilingual children, who had both been exposed to English and Afrikaans consistently and regularly from an early age. The subjects presented with specific language impairment (SLI) and semantic-pragmatic disorder (SPD), respectively. They were assessed on a battery of cognitive and linguistic tests in both their languages. Results indicate that the SLI subject, who presented with a deficit in successive processing on the Cognitive Assessment System, had difficulty in acquiring the surface features of both languages. She developed much better proficiency in English than in Afrikaans, despite substantial exposure to the latter. The SPD subject, whose cognitive profile was characterised by planning and attention deficits, but a strength in successive processing, presented with equal proficiency in both languages. The theoretical and clinical implications of this research are discussed.
The Effects of Post-Loading Rest on Acoustic Parameters with Special Reference to Gender and Ergonomic Factors
Authors: Vintturi Juha , Alku Paavo , Lauri Eija-Riitta , Sala Eeva , Sihvo Marketta , Vilkman Erkki
Published: April 2003

It is a common experience that vocal quality changes during a break in vocal loading. The purpose of the present study was (1) to analyse the effects of a short post-loading vocal rest in terms of changes in a large variety of voice parameters and (2) to assess the possible effects of gender and exposure factors on these changes. The voices of a randomly chosen group of 40 female and 40 male young students were loaded by having them read aloud a novel. Two sets of voice samples were recorded: a post-loading sample after three times 45-min vocal loading during the morning and a post-resting sample after a 45-min lunch break. The material recorded consisted of /pa:ppa/ words produced normally, as softly and as loudly as possible in this order. The long /a/ vowel of the test word was inverse-filtered to obtain the glottal flow waveform. Time-domain parameters of the glottal flow [open quotient, closing quotient (ClQ), speed quotient (SQ), fundamental frequency (F₀)], amplitude-domain parameters of the glottal flow [glottal flow, minimum of the first derivative of glottal flow, amplitude quotient (AQ)], intraoral pressure and sound pressure level (SPL) values of the phonations were analysed. Voice range profiles and the singer’s formant (g/G, a/A, c∣/c, e∣/e, g∣/g for females/males) of the loud phonations were also measured. The subjects were divided into eight exposure groups (5 females and 5 males per cell) according to different combinations of the following exposure factors: (1) low (25 ± 5%) or high (65 ± 5%) relative humidity of ambient air, (2) low [<65 dB(A)] or high [>65 dB(A)] speech output level during vocal loading and (3) sitting or standing posture during vocal loading. Statistically significant differences between the post-loading and post-resting samples could be observed in many parameters (the values of intraoral pressure in the soft phonations decreased, the values of SPL and SQ in the normal phonations decreased and the values of AQ, F₀ and ClQ in the normal phonations increased). Most of the differences reflected a shift towards softer phonation. Gender and exposure factors also had significant effects.
Diet, Body Size and the Energy Costs of Locomotion in Saltatory Primates
Authors: Warren Ruth Dorcas , Crompton Robin Huw
Published: April 2003

We report the energetic costs of locomotion in five nocturnal, saltatory prosimians. Using data on nightly travel distance, locomotor frequencies, distance and height change in each locomotor mode, we calculated absolute and relative costs of locomotion. Locomotion contributes at most 2% to total daily metabolic energy costs, consistent with most estimates for quadrupedal species. Tarsius, the smallest, has the lowest absolute and relative cost of locomotion, but the third smallest, Avahi, has the highest absolute and relative costs of locomotion, followed by the largest species, Otolemur crassicaudatus, which incurs particularly high costs in upwards-directed locomotion. Lepilemur’s costs of locomotion are maintained at an unexpectedly low level by remarkably short nightly travel distances.
A Summary of Adapiform Systematics and Phylogeny
Authors: Godinot Marc
Published: April 2003

The systematics of all adapiforms is reviewed at the generic and specific levels. A new classification is proposed for the 30 genera of adapiforms, containing three families: Notharctidae, Adapidae and Sivaladapidae; and one subfamily of uncertain affinities, the new Pronycticebinae. A stratophenetic schema summarizing the distribution and phylogenetic relationships of all European adapiforms, Cercamoniinae, Notharctinae and Adapidae, is given. The particular characters of the skull of Pronycticebus gaudryi warrant its isolation in a separate subfamily Pronycticebinae, nocturnal adapiforms which are of special significance for lemuriform ancestry. Agerinia might pertain to the same group. Four genera are proposed as adapids outside the European adapine radiation. Amphipithecinae and several other Asiatic genera of uncertain affinities are discussed.
Neuropsychiatric Symptoms and Cholinergic Therapy for Alzheimer’s Disease
Authors: Levy M.L. , Cummings J.L. , Kahn-Rose R.
Published: April 2003

Neuropsychiatric abnormalities, as well as the commonly associated neuropsychological symptoms, are clinical characteristics of Alzheimer’s disease (AD), the most common form of dementia. Thus, in addition to a general cognitive and functional decline, neuropsychiatric manifestations, such as agitation, apathy, anxiety, psychoses and disinhibition, are frequently evident in AD patients. Such neuropsychiatric symptoms of AD are the source of considerable patient and caregiver distress, resulting in the prescription of neuroleptics, benzodiazepines or other psychotropic agents, and are a major factor in the decision to transfer the care of patients into nursing homes. Recent evidence suggests that some neuropsychiatric changes associated with AD are related to the cholinergic deficits in the brains of AD patients and that such abnormalities may be responsive to cholinergic therapy. Cholinergic drug therapies indicated for the symptomatic treatment of AD, for example tacrine and the newer cholinesterase (ChE) inhibitors such as donepezil, have been demonstrated to improve memory, language and praxis. Furthermore, although less is known about the effect of ChE inhibitors on the neuropsychiatric symptoms of AD, preliminary evidence suggests that they reduce apathy, anxiety, hallucinations, disinhibition and aberrant motor behaviour. Thus, the newer-generation ChE inhibitors that are well tolerated, easy to administer and show promise in reducing the cognitive, as well as neuropsychiatric disturbances of AD, may emerge as important treatments for some neuropsychiatric symptoms in patients with central cholinergic deficits, including AD.
Telemedicine: A Pilot Study in Nursing Home Residents
Authors: Hui Elsie , Woo Jean , Hjelm Magnus , Zhang Y.T. , Tsui H.T.
Published: April 2003

Background: Telemedicine has been applied successfully in various fields of medicine. This mode of health care delivery may potentially be useful in supporting frail nursing home residents who require multidisciplinary geriatric services. Objective: To assess the feasibility of telemedicine in providing geriatric services to nursing home residents, and whether this mode of care resulted in increased productivity and savings. Methods: A local 200-bed nursing home supported by the Community Geriatric Assessment Team (CGAT) was recruited. Over a 1-year period, teleconferencing was used to replace conventional geriatric outreach services. The feasibility of telemedicine was evaluated by participating specialists. Productivity gains, consumption of hospital services and user satisfaction were measured. Results: Telemedicine was adequate for service delivery in up to 99% of cases, depending on the specialty. A greater number of clients were served and follow-up intervals were shortened. The service was cheaper than conventional outreach or clinic activities, and acceptable to users and clients. In particular, savings were made through a 9% reduction in visits to the Accidents and Emergency Department and in 11% fewer admissions to acute hospital wards. Conclusion: Telemedicine is a feasible means of delivering multidisciplinary care to frail nursing home residents, and may result in increased productivity and significant savings.
Changes in Antioxidative Mechanisms in Elderly Patients with Non-Insulin- Dependent Diabetes mellitus
Authors: Yanagawa Kiyotaka , Takeda Hiroshi , Egashira Toru , Matsumiya Teruhiko , Shibuya Takeshi , Takasaki Masaru
Published: April 2003

Background: Recently, it has been suggested that the onset and aggravation of diabetes are closely related to free radicals. Also, vitamin E is a lipophilic free radical scavenger that is localized mainly in biomembranes. Objective: The purpose of this study was to clarify the defensive mechanisms against oxidative stress by investigating the differences in the redox dynamics of α-tocopherol in plasma and erythrocyte membranes between elderly patients with non-insulin-dependent diabetes mellitus (NIDDM) and healthy elderly subjects. Methods: Total, α-, β-, γ- and δ-tocopherol and α-tocopherolquinone concentrations were determined by high-performance liquid chromatography with a redox detection mode using a series of four coulometric working electrodes. Results: The α-tocopherolquinone/α-tocopherol ratio in plasma and erythrocyte membranes was not different between the two groups. Both the α-tocopherol concentrations in erythrocyte membranes and ratio of α-tocopherol in erythrocyte membranes to α- tocopherol in plasma was significantly lower in elderly NIDDM patients than in healthy subjects. Conclusion: These findings suggest that α-tocopherol is used normally in both plasma and erythrocyte membranes and α-tocopherol uptake in erythrocyte membranes is significantly decreased in elderly NIDDM patients. The functional disorder of the antioxidative activity of α-tocopherol in erythrocyte membranes due to impairment of this transfer mechanism may be associated with the pathogenesis of NIDDM.
Lung Cancer in the Octogenarian
Authors: Kurishima Koichi , Satoh Hiroaki , Ishikawa Hiroichi , Yamashita Yuko T. , Ohtsuka Morio , Sekizawa Kiyohisa
Published: April 2003

Background: Older patients with lung cancer tend to have significant coexisting diseases and less aggressive treatment is often advisable. Objective: To investigate the clinicopathological features of lung cancer in patients aged 80 years and over. Methods: The medical records of 966 patients with lung cancer between 1976 and 1999 were reviewed retrospectively. Results: There were 56 (5.8%) patients 80 years old or over. Thirty-nine (70%) were male, and 22 (39%) patients had poor performance status (2–4). Some of the patients had a medical history of cardiovascular disease (n = 23; 41%), cerebrovascular disease (n = 5; 9%), diabetes mellitus (n = 11; 20%), or malignant disease (n = 8; 14%). Twenty-one (35%) patients were diagnosed as having surgically resectable disease and 20 patients underwent radiotherapy, but 25 patients only received supportive care because of concomitant illnesses. Only 9 and 2 patients, respectively, had chemotherapy and surgery. There was no statistical difference in the survival rate of the two groups of patients receiving radiotherapy or supportive care. Conclusion: Adequate palliative care to provide prolonged quality survival is an appropriate primary goal of therapy for lung cancer in the octogenarian until less invasive treatments are developed.
Antioxidant Enzyme Levels in Red Blood Cells from Cataract Patients
Authors: Casado A. , de la Torre R. , Lopéz-Fernández E.
Published: April 2003

Background: It seems very likely that oxidative mechanisms play a major role in aetiology and pathogenesis of senile cataract. In particular, lens proteins are subject to extensive oxidative modifications. Objective: The purpose of this work was to analyze the activities of the protective enzymes superoxide dismutase (SOD) and catalase (CAT) in patients of both sexes affected by cataract. Methods: The SOD activity was measured in red blood cells using the Minami and Yoshikawa method, and the CAT activity was measured in haemolysates by the method of Aebi. The results were compared with those obtained in a group of healthy subjects of both sexes and matched ages. Results: The SOD activity shows a significant increase when compared with controls, whereas the CAT activity was not modified. Conclusion: The balance of the anti-oxidants in red blood cells from cataract patients is altered.
Plasma Insulin-Like Growth Factor I Levels in the Elderly: Relation to Plasma Dehydroepiandrosterone Sulfate Levels, Nutritional Status, Health and Mortality
Authors: Raynaud-Simon Agathe , Lafont Sylviane , Berr Claudine , Dartigues Jean-François , Baulieu Emile-Etienne , Le Bouc Yves
Published: April 2003

Background: Insulin-like growth factor I (IGF-I) has beneficial metabolic effects. Because plasma IGF-I levels have been reported to be enhanced by dehydroepiandrosterone (DHEA) administration, it has been suggested that the IGF-I may be implicated in some of the reported associations between low DHEA sulfate (DHEAS) levels and impaired health measures in elderly subjects. The nutritional status, which also regulates plasma IGF-I levels, is also an important determinant of health outcome. Objective: We sought to investigate the associations between plasma IGF-I levels and plasma DHEAS levels, nutritional status, health, and mortality in the elderly. Methods: In 256 community-dwelling subjects aged 65–101 years, enrolled in the Paquid study, a health questionnaire was used to acertain their functional disabilities, any history of medical disorders, self-perceived health, depressive symptoms, and their cognitive function. Biological measurements included levels of plasma IGF-I, albumin, transthyretin, and DHEAS. Mortality data were available for 6 years following blood sampling. Results: In this elderly population with no impairment in nutritional status, the plasma IGF-I levels decreased significantly with age (p = 0.02). The plasma IGF-I levels correlated positively with those of transthyretin (p = 0.0001). IGF-I also correlated with DHEAS (p = 0.04), but the correlation did not remain significant after adjustment for age. As opposed to SDHEA, the plasma IGF-I levels did not correlate with the results from the health questionnaire. The baseline IGF-I values in the highest tertile were associated with a higher risk of short-term mortality than those in the lowest tertile (RR = 8.4 at 2 years, p = 0.007). Conclusions: Our results suggest that IGF-I is not connected with the association between low plasma DHEAS levels and the impaired results from the health questionnaire. The relationship between plasma IGF-I highest levels and mortality should be further explored.
Effects of Age on the Relationship between Drinking and Atherosclerotic Risk Factors
Authors: Wakabayashi Ichiro , Kobaba-Wakabayashi Rie
Published: April 2003

Background: Drinking modulates the progress of atherosclerotic cardiovascular diseases by affecting atherosclerotic risk factors. However, age-dependent effects of drinking on atherosclerotic risk factors have not been clarified in detail. Objective: In this cross-sectional study, we investigated whether the relationship between drinking and atherosclerotic risk factors is influenced by age in male workers (12,386 men aged from 20 to 69 years) in Yamagata, a district of Japan. Methods: The subjects were divided into five age groups, and each group was further divided into three subgroups according to ethanol consumption. The mean levels of each atherosclerotic risk factor were compared among the groups. Results: Neither body mass index nor fasting blood glucose levels were significantly affected by drinking at any age. In the heavy drinkers (ethanol consumption of 30 g per day or more) in all age groups, blood pressure, serum triglyceride and HDL cholesterol levels were significantly higher and serum LDL cholesterol level and the atherogenic index were significantly lower than in the nondrinkers. In the light drinkers (ethanol consumption of less than 30 g per day) in all age groups, serum HDL cholesterol level and the atherogenic index were also higher and lower, respectively, than in the nondrinkers. However, light drinking significantly increased blood pressure only in the middle aged and relatively elderly groups (40–49, 50–59, 60–69 years of age) and significantly decreased the serum LDL cholesterol level only in relatively young and middle aged groups (30–39, 40–49, 50–59 years of age). Thus, the effects of light drinking on blood pressure and serum LDL cholesterol are dependent on age. The serum triglyceride level was not significantly affected by light drinking in any age group. Conclusions: Our results suggest that light drinking increases blood pressure in the middle-aged and the elderly but not in the young, while its beneficial effects on serum HDL cholesterol and atherogenic index are not changed with age.
Intercellular Adhesion Molecule-1 and Hepatocyte Growth Factor in Human Endometriosis: Original Investigation and a Review of Literature
Authors: Fukaya Takao , Sugawara Junichi , Yoshida Hidemune , Murakami Takashi , Yajima Akira
Published: April 2003

Defects in the cell-mediated immune system may play a role in the pathogenesis or progression of pelvic endometriosis. Possible mediators include macrophages, interleukins-1 and -6, and tumor necrosis factor-α. More recent work points to the involvement of adhesion molecules and growth factors. To clarify the pathogenesis of endometriosis, we compared the characteristics of soluble intercellular adhesion molecule-1 (soluble ICAM-1) and hepatocyte growth factor (HGF) in women with and without endometriosis. We found that, in patients with endometriosis, the concentrations of soluble ICAM-1 in peritoneal fluid increased and interfered with the activity of natural killer cells. We also found that HGF secretion was significantly increased in cultured endometrial stromal cells, and that HGF stimulated the proliferation and migration of, and morphogenic changes in, endometrial epithelial cells. HGF and ICAM-1 play important roles in the initiation and regulation of endometriotic lesions on the microenvironment level. The increased secretion of HGF by eutopic endometrial stromal cells may contribute to the pathogenesis of endometriosis, whereas the increased levels of soluble ICAM-1 may impair natural killer cell activity and accelerate the progression of the disease.
Paracrine Regulation of Matrix Metalloproteinase Expression in the Normal Human Endometrium
Authors: Osteen Kevin G. , Keller Nancy R. , Feltus F. Alex , Melner Michael H.
Published: April 2003

Endometrial expression of matrix metalloproteinase (MMP)-3, MMP-7 and MMP-11 occurs during menstrual breakdown and subsequent estrogen-mediated growth, but not during the secretory phase. These enzymes are suppressed by progesterone treatment. Paracrine factors, including transforming growth factor-β (TGF-β) and retinoic acid, are also critical for MMP regulation in the endometrium. In contrast, inflammatory cytokines such as interleukin-1α may block or interfere with steroid-mediated MMP regulation at ectopic sites of growth. Using in vitro models, our laboratory has investigated the complex interactions between progesterone and locally produced cytokines that may affect MMP expression during the development of endometriosis. Our results indicate that targeting the regulation of MMPs may represent an appropriate therapeutic strategy for the treatment of endometriosis.
Pseudomyxoma Peritonei: A Review of Current Literature
Authors: Sherer David M. , Abulafia Ovadia , Eliakim Rami
Published: April 2003

Pseudomyxoma peritonei is an unusual condition more common in females, in which massive amounts of mucinous ascites in conjunction with mucinous peritoneal and omental implants occur. We performed a MEDLINE search of the English-language literature from 1966 to June 2000, utilizing the key words pseudomyxoma peritonei. All case reports, series and studies regarding this condition were reviewed. Cross-referencing was also performed. The etiology and treatment of this condition are currently controversial. Most investigators agree that surgical debulking and appendectomy are adequate initial therapeutic measures. The role of intraperitoneal chemotherapy, radiotherapy or application of mucolytic therapy remains uncertain. Recent molecular genetic studies suggest the appendix as the organ of primary origin of this disease.
Reduced Reproduction with Increased Abortion Rate in Transgenic Mice That Overexpress 15-Lipoxygenase
Authors: Dar Peer , Strassburger Dvora , Shaish Aviv , Levkovitz Hannah , Halperin Reuvit , Harats Dror
Published: April 2003

15-Lipoxygenase (15-LOX) is a lipid-oxidizing enzyme that is involved in cell cycle regulation. To evaluate the effect of 15-LOX on reproduction, we studied transgenic mice that overexpress 15-LOX. The transgene was introduced over the genetic background of the low density lipoprotein receptor deficient mice (LDL-R–/–) and reproduction was compared to LDL-R–/– mice. We found a lower pregnancy rate in the 15-LOX/LDL-R–/– mice as compared to the LDL-R–/– mice (62.74 vs. 79.1%, p < 0.01). Additionally, a remarkably higher number of resorptions per pregnancy was found in the 15-LOX/LDL-R–/– mice (16.7 vs. 3.27%, p < 0.001) and it was accompanied by a significantly higher activity of the 15-LOX enzyme in these resorptions as compared to other tissues. These findings may implicate a role for 15-LOX in the development of spontaneous abortions.
Clinical and Epidemiological Features of Syphilis in Pregnant Women: The Course and Outcome of Pregnancy
Authors: Mavrov G.I. , Goubenko T.V.
Published: April 2003

Clinical and epidemiological features of syphilis and the course and outcome of pregnancy were studied in 155 pregnant women infected with syphilis; 95 (61%) women were unemployed, 47% were unmarried. Syphilis proceeded without clinical manifestations in 121 cases (78%). Discordant results of complement fixation (Wassermann) test, precipitation test, Treponema pallidum immobilization test, and fluorescent antibody test were observed in 22 (14%) of the women. Pregnancy pathology was observed in 75 cases (48.8%) and more often appeared as anemia in 49 (31.5%), stillborn in 46 (29.8%) and toxicosis in 44 (28.4%). Fetal ultrasonic stigmas of infection were evident in 23 cases (49%). There was distension of the brain ventricle system and hepatomegaly each in 1 case (2%), transvascular infiltration of liver in 2 cases (4%), dilation of intestinal loops, gastromegaly, ventriculomegaly and petrifaction in lungs each in 1 case; ultrasonic changes in vessels of organs: of the liver in 4 cases (8%), intestines and stomach in 16 cases (32%), lungs in 4 cases (8%), kidneys in 10 cases (21%) and of the ventricular system in 9 cases (19%). Fetus development retardation was revealed in 3 cases (6%), fetal hypoxia in 1 (2%), hypohydrosis in 2 (4%) and hydropsy in 1 case (2%). The pregnancy pathology in women with syphilis was considered not pathognomonic.
Comparison of Piezo-Assisted Micromanipulation with Conventional Micromanipulation for Intracytoplasmic Sperm Injection into Human Oocytes
Authors: Takeuchi Shigeto , Minoura Hiroyuki , Shibahara Takashi , Shen Xiaoxiong , Futamura Noritaka , Toyoda Nagayasu
Published: April 2003

Objective: To compare the efficacy of piezo-assisted micromanipulation with conventional micromanipulation for intracytoplasmic sperm injection (ICSI) into oocytes in patients with impaired semen parameters and no success with in vitro fertilization (IVF). Study Design: A retrospective randomized study was conducted on 204 cycles for 104 couples with piezo-assisted ICSI and 122 cycles for 96 couples with conventional ICSI. Piezo-assisted ICSI consists of two steps, namely penetration of the zona pellucida alone with a piezo-pulse and then puncturing of the oolemma with a light negative pressure without piezo, as with conventional ICSI. The tips of injection pipettes were prepared after pulling by breakage with a scalpel under a microscope, so that the inner diameter at and near the tip was 5 µm, as for conventional ICSI. Results: Piezo-assisted ICSI demonstrated significantly more favorable results, with a fertilization rate of 90.3% (conventional ICSI: 83.1%, p < 0.01) and a cleavage rate of 88.1% (conventional ICSI: 84.6%, p < 0.01). Conclusion: Piezo-assisted ICSI is easy to incorporate a spermatozoa exactly into the ooplasm with little deformation of the oocyte during insertion. Piezo-assisted ICSI can be used effectively for human oocytes to improve the fertilization, cleavage rates.
Can Myomectomy Be Performed during Pregnancy?
Authors: Çelik Çetin , Acar Ali , Çiçek Nedim , Gezginc Kazim , Akyürek Cemalettin
Published: April 2003

Objective: To evaluate the effectiveness, safety, complications and outcome of pregnancy after myomectomy performed during pregnancy. Material and Methods: Five pregnant women with myomas requiring operation because of severe abdominal pain were included in the series at the Department of Obstetrics and Gynecology, Selçuk University Faculty of Medicine between October 1, 1996 and February 24, 2001. The patients were controlled with ultrasonography and cardiotocography every month up to 32 gestational weeks and then every 2 weeks. Cesarean section was performed on all patients at 37–40 weeks. Complications and fetoneonatal outcome were recorded. Results: The mean age of the patients was 31.4 ± 3.5 years. The mean parity was 1.4 ± 1.6. The median gestational age at the time of myomectomy was 17.8 ± 3.4 weeks. The mean size of the myomas was 14.0 ± 3.8 cm. The main symptom of all patients was severe abdominal pain in spite of analgesic medication. The mean duration of the operation was 40.0 ± 7.9 min. The mean blood loss was 280.0 ± 83.6 ml. The mean number of myomas removed was 2.8 ± 1.3. Conclusion: Myomectomy during pregnancy can be performed if necessary.
Human Endometrial Epithelial Cells Modulate the Activation of Gelatinase A by Stromal Cells
Authors: Goffin F. , Frankenne F. , Béliard A. , Perrier d’Hauterive S. , Pignon M.-R. , Geenen V. , Foidart J.-M.
Published: April 2003

Metalloproteinases (MMPs) are central effectors in endometrial physiology. Their production is tightly regulated by ovarian steroids and cytokines. Using zymography, we investigated MMP-2 production by human endometrial cells treated with estradiol-17β + progesterone (E2+P) and by various key cytokines in endometrial physiology (IL-1β, LIF, TGF-β, and TNF-α). No gelatinase activity was detected in the culture media of epithelial cells. In basal conditions, stromal cells produced the pro form of MMP-2. MMP-2 production/activation was not directly affected by cytokine treatment. Interestingly, activated MMP-2 was only detected after treatment of stromal cells with culture medium from epithelial cells. Cytokine treatment of epithelial cells increased the capacity of conditioned medium to stimulate stromal cells to activate MMP-2. As the tissue inhibitor of MMP-2 (TIMP-2) is a regulator of gelatinase A activity, its concentration was measured by ELISA. TIMP-2 production by stromal cells was not affected by cytokines or by epithelial cell-conditioned medium. These results strongly suggest that regulation of stromal MMP-2 activation involves soluble factor(s) derived from the epithelial compartment.
Transdermal Estradiol in Menopausal Women Depresses Interleukin-6 without Affecting Other Markers of Immune Response
Authors: Saucedo Renata , Rico Guadalupe , Basurto Lourdes , Ochoa Raquel , Zárate Arturo
Published: April 2003

Objective: The aim of this study was to analyze the effect of transdermal estradiol replacement therapy (HRT) on immune function in menopausal women. Study Design:  A prospective comparative study was carried out in 30 women, aged 48–55 years, who were divided into two groups; 20 of them received transdermal estradiol 50 µg/day during 3 months and 10 who refused to receive HRT served as controls. Serum interleukins were quantified by specific immunoenzymatic assays; in addition, hormones of somatotropin axis and prolactin (PRL) were quantified by IRMA and RIA. Results: Baseline elevated interleukin (IL)-6 levels decreased significantly (p < 0.001) after transdermal HRT as compared with the nontreated group. Contrarily, IL-2 and IL-10 levels as well as mitogenic induced T-cell proliferation were unchanged under HRT. Insulin-like growth factor-I, growth hormone and PRL levels were unaltered by transdermal HRT. Conclusion: Decrement of IL-6 in parallel with absent effect on some indices of immune activity suggests a beneficial action of transdermal HRT. These findings contrast with those demonstrating an increment of immune response in women taking oral HRT. Thus, the route of administra tion determines the effect of HRT on immune function.
Three-Dimensional Sonographic Features of Nuchal Edema
Authors: Ohno Masayuki , Kanenishi Kenji , Kuno Atsushi , Akiyama Masashi , Yamashiro Chizu , Tanaka Hirokazu , Shiota Atsuko , Senoh Daisaku , Hata Toshiyuki
Published: April 2003

Objective: To describe the three-dimensional (3D) sonographic features of nuchal edema in the early second trimester of pregnancy. Methods: From 16 to 22 weeks of gestation 5 cases with nuchal edema were studied using transabdominal 3D sonography. Results: Nuchal edema could be easily imaged with both two-dimensional and 3D sonography; however, visualization of the continuity and curvature of structures was more easily accomplished with 3D sonography. Before 20 weeks of gestation, the skin has a transparent structure, so the bony structures are clearly identified. 3D sonography allowed visualization of nuchal edema in all three dimensions at the same time, providing an improved overview and a more clearly defined demonstration of the adjusted anatomical planes. Conclusion: These results suggest that 3D sonography provides a novel means of visualizing nuchal edema in utero.
Genetic Defects in the Control of Growth Hormone Secretion
Authors: Gertner Joseph M. , Wajnrajch Michael P. , Leibel Rudolph L.
Published: April 2003

Since growth hormone deficiency (GHD) causes short stature and metabolic derangements, the processes which control its release are important physiologically. These processes can be illuminated by an understanding of genetically determined GHD. In 2 Indian Moslem cousins from a consanguineous family, GHD resistant to growth hormone releasing hormone (GHRH) stimulation was found. No mutations were found in the growth hormone gene (GH1) (J. Phillips). The receptor for GHRH (GHRHR), implicated in the dwarfism of the little mouse, thus becomes a candidate gene to explain their GHD. Amplification and sequencing a region of GHRHR homologous to that mutated in the little mouse showed a mutation (265G*T) leading to a stop codon at position 72 which would completely prevent GHRHR expression. Subsequently, Maheshwari et al. found an identical mutation in a multiplex kindred from Sindh, Pakistan, about 800 km from the place of origin of our patients. GHD is more commonly caused by recessive or dominant mutations of GH1. The latter are of great interest in understanding the mechanism of GH secretion. In a large kindred with dominant GHD we found a heterozygous 666G*A mutation replacing of Arg with His at amino acid 183. We speculate that the introduced histidine interferes with interactions necessary for correct GH secretion.