bluuebunny/crossref_metadata_2025 huggingface dataset:
Monoclonal Antibodies against Blo t 13, a Recombinant Allergen from Blomia tropicalis
Authors: Labrada Mayrel , Uyema Keiko , Sewer Minerva , Labrada Alexis , González Maritza , Caraballo Luis , Puerta Leonardo
Published: April 2003

Background: The recombinant allergen of Blomia tropicalis, rBlo t 13, shows 11% of IgE reactivity to sera from allergic patients. This allergen belongs to the fatty acid-binding protein family and its natural equivalent remains to be isolated. Monoclonal antibodies (MAbs) are important tools for specific determination and isolation of natural allergens as well as for characterization of recombinant proteins. Methods: Mice were immunized with partially purified preparation of rBlo t 13 allergen expressed in the yeast Pichia pastoris. Spleen cells were fused with myeloma cells using polyethylene glycol. Hybridoma screening was performed using a direct ELISA with recombinant allergen. MAb specificity to rBlo t 13 was tested by immunoblotting. Topography of binding sites and binding of MAb to native allergen was studied by ELISA. Reactivity of MAb against allergenic extract of B. tropicalis and Dermatophagoides siboney was analyzed by ELISA inhibition. In addition, the reactivity of MAbs against rBlot 13 from Escherichia coli and P. pastoris expression was compared. Results: Two MAbs, 5G3 and 3G4 with IgG1 isotype, were generated. These MAbs specifically recognized the 16-kD band, which corresponds to the molecular weight shown by rBlo t 13 on SDS-PAGE. In ELISA, the binding of 5G3 MAb to B. tropicalis and D. siboney extracts was inhibited by rBlo t 13. Both MAbs showed the highest reactivity when the allergen was expressed in P. pastoris. Conclusion: Two MAbs specific for Blo t 13 were obtained. These MAbs recognized the same or close epitopes on the rBlo t 13 molecule. The occurrence of homologous allergens to Blo t 13 in D. siboney is suggested by the ELISA inhibition assay.
Single-Dose Oral Tolerance Test with Alternative Compounds for the Management of Adverse Reactions to Drugs
Authors: Passalacqua Giovanni , Milanese Manlio , Mincarini Marcello , Ciprandi Giorgio , Guerra Laura , Scordamaglia Antonio , Canonica Giorgio Walter
Published: April 2003

Background: Adverse reactions to drugs are common in the clinical practice. Many outpatients are frequently referred to allergists in order to determine which drugs they can safely take in the future. Objective: We set up an oral single-dose tolerance test procedure to find out for each patient one or more alternative drugs that can be taken when needed. Methods: 452 outpatients (130 male, 322 female) with well-documented reactions (urticaria/angioedema, respiratory symptoms, laryngeal edema, anaphylaxis, exfoliative skin diseases) underwent the challenge. All tests were preceded by a single-blind placebo: if a reaction occurred, a second placebo was administered. Otherwise, a single dose (1/10 of the therapeutic one) of an alternative drug was given blindly and the patient was then observed for 6 h. The drugs used were different in structure from those suspected of having caused the adverse reaction. The patients were followed up at 4- to 6-month intervals, in order to detect any reaction that may have occurred with the tested drugs. Results: 98 patients (89 women) had untoward reactions after the first placebo and 34 out of them reacted to the second placebo, too. During challenges the reaction rate ranged between 4.6 and 9.0%; these reactions were easily managed and none of them was severe. We followed up 407 patients: 87.2% of them were able to use one or more of the suggested drugs without reactions, 9.3% did not take the drugs and only 3.5% reported reactions to the previously tested drugs. Conclusion: The challenge procedure proved to be a simple tool for managing patients with adverse reactions to drugs. Its safety and reliability were validated by a long-term follow-up.
Immunobiology of Fungal Allergens
Authors: Kurup Viswanath P. , Shen Horng-Der , Vijay Hari
Published: April 2003

In recent years, considerable attention has been paid in obtaining purified relevant allergens from fungi associated with allergy. Using molecular biology techniques, a number of mold allergens have been obtained by cloning the genes encoding the allergens. Currently, about 70 fungal allergens have been approved by the International Allergen Nomenclature Committee. In this review, we have presented major allergens from Aspergillus, Penicillium, Cladosporium, and Alternaria and discussed their immunochemical characteristics and their role in the diagnosis of allergy and possible usefulness in understanding the pathogenesis of the disease. The structure-function properties and the potential role of these recombinant allergens in the immunomodulatory therapy also are presented.
Protein Kinase C Beta Isoenzymes in Diabetic Kidneys and Their Relation to Nephroprotective Actions of the ACE Inhibitor Lisinopril
Authors: Pfaff Imke L. , Vallon Volker
Published: April 2003

Inhibitors of angiotensin-converting enzyme (ACE) or beta isoforms of protein kinase C (PKC) are nephroprotective in diabetes mellitus. We investigated the influence of streptozotocin (STZ)-induced diabetes mellitus and of treatment with the ACE inhibitor lisinopril (4 mg/kg p.o. twice daily for 4 weeks) on the expression of PKC beta 1 and PKC beta 2 in the renal cortex of female Sprague-Dawley rats. Immunohistochemistry indicated an enhanced renocortical accumulation of macrophages expressing both MHC II, a marker for antigen-presenting cells, as well as PKC beta 2 in STZ diabetes which was confirmed by Western blotting demonstrating an enhanced renocortical expression of MHC II (1.8-fold) as well as of membrane-associated PKC beta 2 (1.9-fold). Whereas immunohistochemistry could not detect unequivocal alterations, Western blotting showed a rise in the renocortical expression of membrane-associated PKC beta 1 (1.7-fold) in STZ diabetes. Lisinopril lowered renocortical albumin content and proteinuria in STZ diabetes and attenuated the enhanced accumulation of macrophages expressing PKC beta 2 as well as the increase of membrane-associated expression of PKC beta 1 and PKC beta 2 in the renal cortex. The data suggest that the nephroprotective actions of the ACE inhibitor lisinopril in experimental diabetes mellitus were associated with and thus could be mediated in part by inhibition of diabetes-induced activation of PKC beta isoenzymes in the renal cortex.
Function of the Isolated Perfused Kidney in Young and Adult Spontaneously Hypertensive and Dahl Salt-Sensitive Rats
Authors: Vaněčková Ivana
Published: April 2003

The aim of the study was to find a possible explanation for the development of hypertension in two genetically hypertensive rat strains. Isolated kidneys from spontaneously hypertensive rats (SHR) and Dahl salt-sensitive rats (Dahl-S) kept on a low-salt diet were perfused at normotensive pressure (110 mm Hg). In adult (12-week-old) rats, no significant change in either parameter of kidney function was found in the two strains. In contrast, substantial changes were observed in both strains at the age of 6 weeks. Glomerular filtration rate and filtration fraction were similarly reduced both in SHR and Dahl-S rats. In SHR, the amount of sodium excreted was reduced in parallel to the GFR decrease. Sodium excretion was lower in Dahl-S than in Dahl-R due to the former higher Na+ tubular reabsorption. The same was true for water excretion and its tubular reabsorption in this strain. In conclusion, the decreased amount of sodium excreted found in young SHR and Dahl-S might contribute to the development of hypertension in these strains. However, the reasons for this reduction are different in these two strains. In SHR, it results from decreased GFR whereas, in Dahl-S it is mainly due to increased tubular reabsorption.
Renal Hemodynamics during Development of Hypertension in Young Spontaneously Hypertensive Rats
Authors: Christiansen Rolf E.F. , Roald Anca B. , Tenstad Olav , Iversen Bjarne M.
Published: April 2003

Background/Aims: Cross-transplantation studies between animals with genetic hypertension and normotensive animals indicate a key role of the kidney in development of hypertension, and studies in young spontaneously hypertensive rats (SHR) have shown reduced glomerular filtration rate (GFR) and renal blood flow (RBF) for a short period at the age of 4–6 weeks during blood pressure increase. We tested the hypothesis that a decline in GFR during development of hypertension in SHR might be more pronounced in juxtamedullary cortex than other cortical zones. Methods: By use of the aprotinin method, total and zonal cortical GFR was measured in anaesthetized Wistar-Kyoto (WKY) rats and SHR at the ages of 2, 4, 6, 8 and 10 weeks. RBF was measured by a transit time flowmeter. Results: Body and kidney weights in SHR and WKY were not significantly different in any age group (p >0.05). Mean arterial blood pressure (MAP) was not different at the age of 2 weeks (79 ± 6 mm Hg in SHR and 74 ± 5 mm Hg in WKY, p > 0.05), but was significantly higher in 4-week-old SHR (104 ± 1 mm Hg) compared to 4-week-old WKY (77 ± 3 mm Hg) (p < 0.01). The difference in blood pressure increased with age from 4 to 10 weeks. RBF, total GFR, and outer, middle, and inner cortical GFR increased with age but were not different in SHR and WKY in any age group (p >0.05). Renal vascular resistance was increased from 4 weeks of age in SHR (21.5 ± 1.8), significantly higher than WKY (14.4 ± 0.9 mm Hg·ml–1·min·g) (p < 0.01) and stayed at higher values in older age groups (p ≤ 0.01). Conclusion: RBF, total and zonal GFR are not significantly different in anaesthetized SHR compared to WKY at ages from 2 to 10 weeks and GFR in juxtamedullary cortex is not decreased in SHR during onset of hypertension. The results from the present study indicate that development of hypertension cannot be explained by a temporary decline in RBF or total or zonal GFR.
Up-Regulation of the Human Serum and Glucocorticoid-Dependent Kinase 1 in Glomerulonephritis
Authors: Friedrich B. , Wärntges S. , Klingel K. , Sauter M. , Kandolf R. , Risler T. , Müller G.A. , Witzgall R. , Kriz W. , Gröne H.J. , Lang F.
Published: April 2003

Glomerulonephritis is paralleled by excessive formation of transforming growth factor-beta (TGF-β), which participates in the pathophysiology of the disease. Recently, a novel downstream target of TGF-β has been identified, i.e. the human serum and glucocorticoid-dependent kinase 1 (hSGK1), a serine/threonine kinase participating in the regulation of Na+ transport. The present study was performed to elucidate transcriptional regulation of hSGK1 in glomerulonephritis. To this end, in situ hybridization was performed in biopsies from patients with clinical diagnosis of glomerulonephritis. hSGK1 transcript levels were moderately enhanced in 5 out of 9 patients and strongly enhanced in 4 out of 9 patients. Distal nephron epithelial cell hSGK1 transcript levels were low or absent in 7 of the 9 patients but markedly enhanced in 2 of the 9 patients. In conclusion, glomerulonephritis leads to glomerular and in some cases to epithelial up-regulation of hSGK1 transcription.
Effect of Mycophenolate Mofetil on Kallikrein Expression in the Kidney of 5/6 Nephrectomized Rats
Authors: Ardiles Leopoldo G. , Ehrenfeld Pamela , Quiroz Yasmir , Rodriguez-Iturbe Bernardo , Herrera-Acosta Jaime , Mezzano Sergio , Figueroa Carlos D.
Published: April 2003

It has recently been proposed that tubulointerstitial damage plays a key role in the pathogenesis of sodium-dependent hypertension. Since components, enzymes and substrates, of the kallikrein-kinin system (KKS) are synthesized by connecting and collecting tubules, respectively, it is expected that damage of any origin, involving the tubulointerstitial compartment, may affect the functionality of these nephron segments and impair blood pressure control. Therefore, we analyzed renal kallikrein expression in the 5/6 renal ablation model, which is characterized by a progressive tubulointerstitial damage and systemic hypertension. In addition, we studied the renal expression of this enzyme after treatment of healthy and 5/6 nephrectomized rats with mycophenolate mofetil (MMF), an immunosuppressive drug known to reduce tubulointerstitial damage in this model. Twenty-six male Sprague-Dawley rats were included in this study. Seven 5/6 nephrectomized rats (Nx), 4 sham-operated (Sham) rats and 5 Nx rats treated with MMF (Nx + MMF) were studied 4 weeks after surgery. For comparison, 6 healthy rats treated with MMF at the same dose were compared with 4 vehicle-treated controls. Tubulointerstitial damage was significantly high in Nx compared with Nx-MMF and sham-operated rats. Blood pressure was significantly higher in Nx (178 ± 7.8 mm Hg) than in Sham (120 ± 2.0 mm Hg, p < 0.05) and Nx + MMF animals (154 ± 5.6 mm Hg, p < 0.05). Renal kallikrein expression, quantified by a computer image system was significantly lower in the Nx group (1,696 ± 437 density/mm2) than in Sham (9,779 ± 4,068 density/mm2, p < 0.05), and in Nx + MMF groups (4,640 ± 1,578 density/mm2, p < 0.05). Healthy animals treated with MMF did not show tubulointerstitial damage, changes in blood pressure nor changes in the expression of immunoreactive renal kallikrein suggesting that improvement in kallikrein expression after MMF treatment of 5/6 nephrectomy was not due to a direct effect of the drug on kallikrein-producing cells. Our results suggest that protection of the KKS after 5/6 nephrectomy may have additional renoprotective effects and may reduce the progression of renal disease.
Long Nocturnal Dialysis
Authors: Alloatti S. , Molino A. , Manes M. , Bonfant G. , Pellu V.
Published: April 2003

Background/Aims: The continuous growth of the dialysis pool in our unit induced us to organize a third long nocturnal dialysis (LND) session, considering the excellent survival and rehabilitation results reported with this method. This paper analyzes the results and assesses the role of LND among the different dialytic treatment options. Methods: Out of 18 patients on LND, 13 (12 males and 1 female, mean age 52 ± 13 years, time on dialysis 21.8 ± 23.8 months) with >6 months’ experience were studied, and 9 underwent a further metabolic evaluation. LND was performed using 1- to 1.4-m2 Hemophan membranes, bicarbonate buffer, 200–250 ml/min blood flow, and 300–500 ml/min dialysate flow, 8 h three times a week. Kt/V and protein catabolic rate (3-point classic urea kinetics), postdialytic weight, serum albumin, total protein, hemoglobin, Ca2+, phosphate, intact parathyroid hormone, bioimpedance body water, blood pressure, and drug use (antihypertensives, phosphate binders, erythropoietin, vitamin D, hypnotics) were evaluated in each patient during hemodialysis and LND. In the metabolic study (done twice), sodium (compared with the Kimura model), potassium, phosphate, and urea were analyzed in blood and inlet and outlet dialysate after 0, 2, 4, 6, and 8 h. Results: The mortality was low (1 death every 247 patient-months). After 19 ± 8.1 months of LND, the postdialytic weight rose from 68.5 ± 9.6 to 70.8 ± 10.7 kg (p ≤ 0.01), and the hemoglobin concentration rose from 10.8 ± 2.2 to 11.8 ± 1.8 g/dl (p ≤ 0.05); phosphate dropped from 5.6 ± 2.0 to 4.4 ± 1.3 mg/ dl (p ≤ 0.01) and the systolic blood pressure from 152 ± 15 to 143 ± 19 mm Hg (p ≤ 0.05). In the metabolic study, the sodium profile was significantly lower during the last 4 h than in the Kimura model. The potassium concentration, stable between 4 and 6 h, rose against the gradient during the last 2-hour period. The behavior of sodium and potassium during the last part of the dialysis session can be taken to indicate exhaustion of the sodium/potassium pump. Phosphate showed a gradual reduction with no intradialytic and only a moderate postdialytic rebound. The postdialytic urea rebound was 23.4%. Conclusions: LND is a useful additional tool for nephrologists in treating chronic renal failure, it is easy to organize, and it shows overall good results. Together with other dialysis methods, this schedule permits individualized treatment for each uremic patient.
In vitro Studies on Endometrial Adhesiveness for Trophoblast: Cellular Dynamics in Uterine Epithelial Cells
Authors: Thie Michael , Denker Hans-Werner
Published: April 2003

Initiation of embryo implantation involves adhesion of trophoblast cells to the epithelial lining of the endometrium. The mechanisms regulating the adhesive properties of the uterine epithelium for trophoblast during initiation of human embryo implantation, however, are still incompletely understood. We report here on model studies that we have performed in our laboratory, and in particular on certain methodological approaches that seem to yield new insight into basic mechanisms involved. Of central interest is the ability of the uterine epithelium to develop an adhesion competence at its apical cell pole. This confronts us with a cell biological paradox in that adhesion must be established at the pole which in simple epithelia is typically specialized to resist adhesion. Gain of apical adhesion competence by uterine epithelial cells should be related to cellular rearrangements, i.e. a modulation of their apicobasal cell polarity. Here, we used monolayer-cultured uterine epithelial RL95-2 cells as an in vitro model for the human receptive uterine epithelium. We demonstrated that formation of stable cell-to-cell bonds between the free (apical) pole of these cells and attaching trophoblast (modelled by JAr cells) depends on a number of structural and functional peculiarities that RL95-2 cells have in contrast to other uterine epithelial cells (HEC-1-A cells) which resist attachment via this cell pole. RL95-2 cells were shown to lack tight junctions and to exhibit only rudimentary adherens junctions and a non-polar organization of the actin cytoskeleton. Using the atomic force microscope in a force spectroscopy mode, we exactly defined the time dependence of adhesive interactions between RL95-2 cells and trophoblast, measured the pressure force needed to initiate this process, and screened the buildup of the adhesive forces between the binding partners. A dynamic interaction between the actin cytoskeleton and integrins (a prerequisite for functional activity of integrins) was shown to be an important aspect of the adhesive properties of RL95-2 cells. In addition, at least two types of calcium channels in the plasma membrane of RL95-2 cells seem to play a role in activation of a variety of calcium-sensitive response mechanisms including adhesiveness for trophoblast, i.e. diltiazem-sensitive channels seem to contribute to the initiation of JAr cell binding and SKF-96365-sensitive channels to participate in a feedback loop that controls the balance of bonds. By extrapolation, these data suggest an active role of the uterine epithelium in the process of embryo implantation which we are just beginning to understand in terms of its cell biology.
Integrin-Mediated Adhesion and Signaling during Blastocyst Implantation
Authors: Wang Jun , Armant D. Randall
Published: April 2003

Blastocyst implantation in rodents and primates depends on adhesive interactions between trophoblast cells and the endometrial extracellular matrix. As the blastocyst contacts the uterine basal lamina, cells of the trophectoderm become adhesion-competent and conclude their phenotypic conversion from a polarized epithelium to invasive trophoblast cells that anchor the embryo in the uterine wall and eventually infiltrate the endometrium. Trophoblast cells become capable of adhesion to fibronectin as α5β1 integrins traffick to their apical surfaces. While integrin trafficking may be required for trophoblast adhesion to the endometrium, accumulating evidence indicates that, in response to contact with the extracellular matrix, additional molecules must be recruited to the apical surface before strong adhesion is attained. Based on the known interactions of integrins with cytoplasmic regulatory proteins, we propose that extracellular matrix-bound integrins mediate intracellular signaling cascades that strengthen their adhesive activity. We will review some of the known integrin signaling pathways that could regulate trophoblast adhesion and differentiation.
Influence of Breast Feeding, and Adapted and Hydrolyzed Formulas on Biliary Bile Acids in Newborn Guinea Pigs
Authors: Colombo Carla , Setchell Kenneth D.R. , Crosignani Andrea , Biffi Arianna , O’Connell Nancy , Agosti Massimo , Marini Antonio
Published: April 2003

Background: The type of feeding can differently influence bile acid ontogeny during the period of physiologic cholestasis that characterizes early human development. Aim: To investigate the effects of feeding from birth, conventional or partially protein hydrolyzed cow’s milk formulas were compared with breast milk regarding bile acid concentration and the composition of gallbladder bile in newborn guinea pigs. Methods: Forty newborn guinea pigs were allocated to one of three different feeding regimens: breast milk (n = 14), intact protein formula (n = 13) and partially protein hydrolyzed formula (n = 13). After 8 days, one third of the pups from each group was sacrificed; another third was sacrificed on the 14th day and the remainder on the 20th day of life. Bile acids in gallbladder bile were analyzed by gas chromatography/mass spectrometry and HPLC. Results: During the first 2 weeks of life, weight gain was significantly higher in breast-fed than in artificially fed pups. An age-related increase in total biliary bile acid concentrations was evident for breast-fed and hydrolyzed formula-fed animals, but not for those fed intact protein formula. Breast-fed animals had the highest total biliary bile acid concentrations on day 20 of life, with significant increases in chenodeoxycholic and 7-oxo-lithocholic acid concentrations, which were absent in the other two groups. Concentrations of 7-oxo-lithocholic acid on day 8 were significantly higher in animals fed intact protein formula compared with breast-fed and partially protein hydrolyzed formula-fed animals. Conclusions: In newborn guinea pigs, breast feeding is associated with a marked increase in biliary bile acid concentrations, which was not observed in artificially fed animals. The higher biliary bile acid concentrations and better weight gain in our breast-fed animals may reflect a greater feed efficiency associated with natural feeding. Biliary bile acid composition on day 8 suggests more rapid intestinal bacterial bile acid biotransformation in animals fed intact protein formula compared to other feeding regimens.
Can the Administration of Antithrombin III Decrease the Risk of Cerebral Hemorrhagein Premature Infants?
Authors: Fulia F. , Cordaro S. , Meo P. , Gitto P. , Gitto E. , Trimarchi G. , Adelardi S. , Barberi I.
Published: April 2003

This study was carried out to determine whether the administration of antithrombin III decreases the risk of intraventricular hemorrhage in premature infants. In a randomized study, 60 infants born before 30 weeks of gestation were assigned to receive a loading dose of antithrombin III or placebo. There was no significant difference in the incidence of intraventricular hemorrhage between the antithrombin III and the placebo group (27.5 vs. 32%). Partial thromboplastin time, Quick’s prothrombin time and platelet count were also not significantly different between the 2 groups. We conclude that the administration of antithrombin III during the first 2 days of life does not decrease incidence of intraventricular hemorrhage. Antithrombin III is a very expensive therapy and its benefits should be carefully investigated before being recommended as valuable therapy.
Reproducibility of Cerebral Near Infrared Spectroscopy in Neonates
Authors: Menke Jan , Voss Uta , Möller Gerhard , Jorch Gerhard
Published: April 2003

Near infrared spectroscopy (NIRS) allows to study cerebral hemodynamics and oxygenation in neonates, which may be useful for early detection of cerebral hypoxemia. So far this method is not reliable enough to be used clinically. Reproducibility is one of the prerequisites for reliable quantitative monitoring. The aim of this study was to assess the reproducibility of the NIRS parameters HbO2 and HbD (oxygenated and deoxygenated hemoglobin concentration) and the derived NIRS parameters HbT (tissue hemoglobin concentration, HbT = HbO2 + HbD) and rSO2 (regional cerebral oxygen saturation, rSO2 = HbO2/HbT). Two observers repeated a total number of 500 measurements in 25 neonates. Additionally, a baseline measurement was done to assess the physiological variation in every neonate. For all NIRS parameters, the inter-patient variance contributed most to the total variance, while the interobserver variance was the smallest variance component. The cerebral oxygen saturation parameter rSO2 showed a good reproducibility, with an inter-measurement variance slightly but not significantly higher than the physiological baseline variation. The NIRS concentration parameters HbO2, HbD, and HbT were less reproducible, with significant variation due to repeated sensor replacement. However, for cerebral oximetry rSO2 is likely to be more important than the other NIRS parameters, so that NIRS has the potential to become a quantitative cerebral monitoring method.
Endogenous Production of Nitric Oxide in Endotoxemic Piglets
Authors: Kaftan Harold A. , Clark Perry L. , Norberg Mike , Garg Uttam , Thibeault Donald W. , Truog William E.
Published: April 2003

We sought to assess the relation between endotoxin-induced pulmonary hypertension and the production of nitrix oxide (NO) in neonatal animals. Adult animals respond to endotoxin by increasing exhaled NO and plasma NO metabolites. The response of neonatal animals has not previously been reported. We administered 20 µg/kg of Escherichia coli lipopolysaccharide (LPS) to 12- to 18-day-old and to 5- to 7-week-old piglets. Pulmonary vascular resistance increased significantly in both age groups. Exhaled NO in the 12- to 18-day-old animals and in the 5- to 7-week-old piglets did not increase significantly. A similarly treated group of adult rats did show a significant increase in exhaled NO (2.6 ± 1.0 to 109.5 ± 54.3 ppb; p = 0.028). Plasma NO metabolite measurements followed the same pattern of no increase in both porcine groups, and a large increase in the rat group. However, immunostaining of lungs from 12- to 18-day-old piglets did reveal an increase in inducible NO synthase. These results suggest that piglets demonstrate a limited ability to modulate LPS-induced pulmonary hypertension by elevations in exhaled NO. They also demonstrate the differential response to LPS between species.
Modified Protocols for Surfactant Therapy in Experimental Meconium Aspiration Syndrome
Authors: Tashiro Katsumi , Cui Xiao-Guang , Kobayashi Tsutomu , Curstedt Tore , Robertson Bengt
Published: April 2003

In adult rats with experimental meconium aspiration syndrome, we investigated whether the therapeutic effect of exogenous surfactant was increased by addition of dextran or preceding airway lavage with diluted surfactant. Animals (n = 72) ventilated with pure oxygen were given human meconium suspension (50–75 mg kg–1) through the airways. When the PaO2 had decreased to <20 kPa (mean ± SD 12 ± 3.9 kPa), the rats were randomly allocated to ten groups (G). G 6–10 underwent lung lavage with diluted Curosurf (5 mg ml–1, 20 ml kg–1), whereas G 1–5 did not. G 1 and 6 received no additional material through the airways. G 2 and 7 received Curosurf (100 mg kg–1), and G 3 and 8 received Curosurf (100 mg kg–1) plus dextran (75 mg kg–1); G 4 and 9 received Curosurf (200 mg kg–1), and G 5 and G 10 received Curosurf (200 mg kg–1) plus dextran (75 mg kg–1). All rats in G 1 died before 180 min after randomization. In G 2, 3, 6, 7, and 8, the PaO2 transiently increased to 30–40 kPa. In G 4, 5, 9, and 10, the PaO2 remained >30 kPa for 180 min. Both airway lavage and supplementation with dextran improved the therapeutic effects of surfactant; however, a large dose (200 mg kg–1) was nevertheless required to optimize gas exchange.
Early Respiratory System Mechanics and the Prediction of Chronic Lung Disease in Ventilated Preterm Neonates Requiring Surfactant Treatment
Authors: Choukroun M.L. , Tayara N. , Fayon M. , Demarquez J.L.
Published: April 2003

The objective of this study was to evaluate the predictive value of the respiratory system compliance (Crs) and resistance (Rrs) measured before surfactant therapy to identify infants at risk for chronic lung disease (CLD). Measurements of Crs and Rrs were obtained on 44 ventilated neonates with respiratory distress syndrome (RDS) before and after surfactant therapy using the passive expiratory flow-volume method. It was found that in addition to a lower gestational age (GA) and a lower birth weight (BW), infants with CLD (n = 10) exhibited a lower Pa/AO2 [Pa/AO2 = PaO2/(PiO2 – PaCO2)] and higher Rrs before surfactant compared to the infants without CLD (n = 28). Improvement in gas exchange 18 h after surfactant was reduced in the CLD group. Finally, we concluded that a low GA (< 28 weeks), a low BW (< 942 g), a low Pa/AO2 before and 18 h after surfactant or a high Rrs before surfactant (>0.21 cm H2O/ml/s) were associated with an increased risk of CLD.
A Rare Case of Neonatal Ileo-Cecal Valve Stenosis due to Covered Iliac Perforation
Authors: Messina Mario , Ferrucci Elisabetta , Garzi Alfredo , Meucci Daniela , Buonocore Giuseppe
Published: April 2003

At birth, newborn babies tend to respond to any stressful event with elective blood shunting towards the main organ systems, such as the brain and heart. Consequently, the bowel may suffer from a severe flow reduction with a high risk of hypoperfusion. The distal ileum is relatively less vascularized than other parts of intestine, due to a lack of collateral arteriolar circulation. It is therefore at higher risk of hypoxia, tissue necrosis and perforation in situations of minimal hypoperfusion or spasm. A rare case of covered perforation of the last loop of the ileum in a severely preterm baby is reported. The perforation manifested atypically as inflammatory stenosis of the loop and the ileo-cecal valve. To avoid misdiagnoses and to manage these cases correctly, the caregiver has to consider this rare eventuality in the differential diagnosis of intestinal occlusion/subocclusion in the first days of life.
Correlation between Mononuclear Infiltration and Changes in VASP Phosphorylation Patterns after Heterotopic Cardiac Transplantation in the Rat
Authors: Deuse T. , Lange V. , Schrepfer S. , Eigenthaler M. , Reichart B. , Walter U. , Elert O.
Published: April 2003

Chronic cardiac transplant vasculopathy still remains the major cause of late graft failure after the 1st postoperative year, with iNOS playing a central role in the progression of this disease. Since VASP, a recently identified microfilament-associated protein in smooth muscle cells, endothelial cells, and platelets, is phosphorylated by cyclic nucleotide dependent protein kinases, changing amounts of NO-producing mononuclear infiltration cells during cardiac rejection are supposed to change platelet VASP phosphorylation patterns. We investigated whether platelet VASP Ser157 phosphorylation (VASP shift) after coronary passage of rat cardiac allografts correlates with graft infiltration. The Lew-F344 heterotopic rat cardiac transplantation model was used. Native hearts and grafts were harvested 3–150 days after transplantation and were used for Langendorff perfusion. The platelet VASP shift after native heart and graft perfusion was identified. Additional iNOS stimulation and iNOS inhibition were achieved pharmacologically. Immunohistology revealed graft mononuclear infiltration. Platelet VASP Ser157 and Ser239 phosphorylation significantly increased after coronary passage of native hearts and grafts (p < 0.01). Though platelet VASP Ser157 phosphorylation failed to directly express graft infiltration, we showed a significant correlation between changes of platelet VASP shift and extent of grafts’ mononuclear infiltration after competitive iNOS inhibition (p < 0.01). The platelet VASP shift is modified during coronary perfusion, and this modification correlates with mononuclear infiltration in the graft. This emphasizes the influence of mononuclear infiltration cells on microfilamental structures of the cytoskeleton in adjacent cells.
On the Age-Related Prevalence of Anisometropia
Authors: Weale R.A.
Published: April 2003

Data on the prevalence of non-amblyopic anisometropia amongst adults throughout the world were tabulated and plotted as a function of age. The global picture reveals a systematic rise in the prevalence of anisometropia with age, the fitted linear regression having a significant positive slope of 1% (p < 0.0005) for every 7 years. The distribution may embrace a juvenile rise and a later, post-presbyopic one, perhaps due to neuro-senescence.
Novel Noninvasive Sensitive Determination of Tear Volume Changes in Normal Cats
Authors: Murakami Tadahiro , Fujita Hiromi , Fujihara Tsutomu , Nakamura Masatsugu , Nakata Katsuhiko
Published: April 2003

We describe a novel, high-resolution and noninvasive method for measuring tear volume changes in cats. The method entails photographing at the lid margin the tear meniscus area defined by instillation of 0.1% fluorescein solution into the cul-de-sac. The inferior tear meniscus area was obtained from the digitized images with computer-assisted software. The tear meniscus area increased in proportion to the saline volume applied into the conjunctival sac, which validates the technique. Furthermore, this technique detected with high sensitivity previously described increases in tear fluid secretion induced by the P2Y2 agonist. We demonstrate in cats that changes in conjunctival sac tear volume can be evaluated by measurement of its inferior tear meniscus area.
A Feasible Tool to Detect mRNA Expression of Matrix Metalloproteinases and Their Tissue Inhibitors in Human Tenon’s Capsule
Authors: Huang Yu-Lun , Liu Catherine J. , Chiu Allen W. , Wang Yu-Chun , Huan Steven K. , Lee Fenq-Lih , Chen Shih-Jen , Hsu Wen-Ming , Hsieh Shie-Liang
Published: April 2003

Purpose: To determine the mRNA expression of matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) in human specimens of Tenon’s capsule. Methods: Reverse transcription-polymerase chain reaction (RT-PCR) with specific primers for MMP-1, MMP-2, MMP-9, TIMP-1 and TIMP-2 was performed on tissue specimens obtained from patients with cataract, rhegmatogenous retinal detachment, glaucoma, or diabetes mellitus. Results: Glyceraldehyde phosphate dehydrogenase (GAPDH) mRNA transcripts were detected in 26 (76.5%) of 34 specimens, with almost the same amount of expression in each of these samples. Messenger RNA expression of one or more of the MMPs/TIMPs could also be detected in all of these 26 samples, but not in any sample without GAPDH expression. MMP-2, TIMP-1 and TIMP-2 were detected in 25 (96.2%) of the 26 samples with GAPDH expression, while MMP-1 and MMP-9 were detected with a lower percentage (34.6 and 19.2%, respectively). Conclusions: The feasibility of RT- PCR with GAPDH as an internal standard to determine mRNA transcripts of the MMPs and TIMPs in the subconjunctival Tenon’s capsule was demonstrated.
Clinicocytological Correlation in Establishing the Aetiology of Chronic Rhinitis
Authors: Gulati S.P. , Goyal Neeraj , Sen Rajeev , Sachdeva Ashok , Gera Ravinder
Published: April 2003

Two hundred patients clinically diagnosed as having chronic rhinitis were provisionally grouped into allergic and non-allergic types of rhinitis on the basis of history, clinical examination, X-ray of the paranasal sinuses using the occipitomental view and other relevant investigations like differential and total leucocyte count. Whereas 158 cases were categorized into allergic rhinitis, 13 were diagnosed as suffering from vasomotor rhinitis, 25 from infective rhinitis and 4 patients from atrophic rhinitis. A nasal cytogram performed in all these cases showed allergic rhinitis in 107 cases, vasomotor rhinitis in 30 cases, infective on top of allergic rhinitis in 32 cases, common cold over allergic rhinitis in 3 cases, infective rhinitis in 20 cases, a non-infective non-allergic type in 4 cases and atrophic rhinitis in 4 cases. There was a good clinicocytological correlation; however, 30 patients clinically suspected to be having allergic rhinitis had an infective episode alone or on top of allergic rhinitis. Nasal cytology was thus found useful in modifying the treatment. It is a simple, easy and reliable investigation that can be done routinely in the out-patient department.
Somatoform Symptoms, Anxiety, and Depression in the Context of Traumatic Life Experiences by Comparing Participants with and without Psychiatric Diagnoses
Authors: Hexel Martina , Sonneck Gernot
Published: April 2003

The present study examines somatoform symptoms, anxiety and depression in connection with traumatic life experiences by comparing participants with and without psychiatric diagnoses. Significant group differences in the quantity of somatoform symptoms and the degrees of anxiety and depression could be found between participants with and without psychiatric diagnoses. Experience of sexual abuse leads to significantly more somatoform symptoms. Experience of repeated physical abuse as an additional factor significantly increased the depression score in all groups. This study reveals that the type of somatic complaint allows a prediction of the kind of traumatic life experience suffered. Physical abuse may be predicted by discomfort in and around the precodium, loss of appetite and stomach discomfort or a churning feeling in the stomach. Sexually abused participants reported significantly more anal pain, bad taste in the mouth or an excessively coated tongue, sexual indifference, and urinary retention. The findings of this study also revealed an association between depression, anxiety and somatoform symptoms and the type of traumatic life experience. The experience of physical and sexual abuse was found to be the most highly discriminative function.
Early Detection of Psychotic Disorders in Adolescents: Specificity of Basic Symptoms in Psychiatric Patient Samples
Authors: Resch F. , Koch E. , Möhler E. , Parzer P. , Brunner R.
Published: April 2003

Based on the results of adult studies that have shown a subgroup of basic symptoms to have a predictive value for later schizophrenic disorder, a cross-sectional study on 36 schizophrenic and 75 nonschizophrenic adolescent psychiatric inpatients was performed to elucidate the specificity of prodromal signs in early age groups. The occurrence of any single basic symptom does not show schizophrenic specificity in adolescents, but the number of basic symptoms in the categories of the Bonn Scale for the Assessment of Basic Symptoms is increased in schizophrenic patients compared with subjects with other diagnoses. The interrelation between minus symptoms and cognitive symptoms exerts a higher amount of cognitive disturbances given a certain level of irritation in schizophrenic adolescents. With the help of odds ratios, the seven most discriminating cognitive items could be elucidated including perception, information processing and action tendency.
Risk Factors for Dementia in the Cardiovascular Health Cognition Study
Authors: Kuller Lewis H. , Lopez Oscar L. , Newman Anne , Beauchamp Norman J. , Burke Greg , Dulberg Corinne , Fitzpatrick Annette , Fried Linda , Haan Mary N.
Published: April 2003

Background: The Cardiovascular Health Cognition Study has evaluated the determinants of dementia among 3,608 participants that had a magnetic resonance imaging (MRI) of the brain in 1991 and were followed to 1998–1999. Methods: There were 480 incident dementia cases, 330 (69%) were classified as Alzheimer’s disease (AD). Results: In univariate analysis, low scores on the Modified Mini-Mental State Examination (3MSE) and on the Digit Symbol Substitution Test as well as declines in scores over time prior to the development of dementia were significant predictors of dementia. A high ventricular grade on the MRI (atrophy) as well as high white matter grade, a number of brain infarcts on the MRI were all determinants of dementia. Apolipoprotein E Ε4 (ApoE-4) was also a powerful predictor of dementia. In a multivariate Cox proportional hazards model controlling for race, gender and grade, the hazard ratios for age (1.1), 3MSE score (0.9), ventricular size (1.4), white matter grade (1.8), presence of large infarcts >3 mm (1.3) and ApoE-4 (2.1) were significant predictors of dementia. The combination of an ApoE-4 genotype, 3MSE score <90, ≧5 ventricular grade, ≧3 white matter grade at the time of the MRI were associated with a 17-fold increased risk (95% CI: 8.6–34.9) of dementia as compared to individuals with none of the above attributes. Conclusions: Measures of cognition, ApoE-4 and MRI of the brain are strong predictors of both dementia and of AD.
Management Patterns and Health Care Use after Intracerebral Hemorrhage
Authors: Weimar Christian , Weber Carsten , Wagner Markus , Busse Otto , Haberl Roman Ludwig , Lauterbach Karl W. , Diener Hans Christoph
Published: April 2003

Background: The German cost-of-illness study of stroke is a multicenter study in 6 departments of internal medicine, 9 departments of general neurology and 15 departments of neurology with an acute stroke unit. The aims of this study are to describe the management patterns, cost of treatment and overall resource utilization after intracerebral hemorrhage (ICH) as well as the major differences to ischemic stroke (IS). Methods: During a 12-month period, 30 participating centers with a special interest in stroke prospectively included 586 patients with ICH which were collected in a joint data bank. About 75% of all patients could be centrally followed up via structured telephone interviews after 3 and 12 months to assess further acute hospital and rehabilitation stays, outpatient resource utilization, functional outcome and quality of life. Results: Mortality after 3 months (33.5%) was markedly higher than in patients with IS from the same hospitals. Accordingly, only 30.9% of patients had regained independent functional status after 3 months. Cumulative cost of treatment amounted to 5,301 EUR for inpatient stay in the documenting hospital and 8,920 EUR for the overall hospital stay including rehabilitation. Mean direct cost after discharge during the first year amounted to 4,598 EUR and the loss of work force was equivalent to 5,537 EUR in all surviving patients. Conclusion: This study provides a comprehensive overview of patient characteristics, treatment strategies and health care cost of ICH from a societal perspective in Germany.
Seizures in Cerebral Vein and Dural Sinus Thrombosis
Authors: Ferro J.M. , Correia M. , Rosas M.J. , Pinto A.N. , Neves G.
Published: April 2003

To describe early symptomatic and late seizures in a cohort of patients with acute cerebral vein and dural sinus thrombosis (CVDST) and to identify their determinants, we performed a prospective registry and follow-up study of CVDST patients admitted to 20 Portuguese hospitals, from June 1995 to June 1998. Of 91 registered patients, 31 (34%) had early symptomatic seizures; 29 (31.9%) as a presenting feature and 2 (2.1%) after admission. Early symptomatic seizures were more frequent in patients with motor and sensory deficits and in those with focal oedema/ischaemic infarcts or haemorrhages on admission CT/MR. On multivariate logistic regression analysis, sensory defects (OR = 7.8; 95% CI = 0.8–74.8) and a parenchymal lesion on admission CT/MR (OR = 3.7, 95% CI = 1.4–9.4) were found to be significant predictors of early symptomatic seizures. Seizures were directly related to acute death in 2 patients. Eight (9.5%) patients had late seizures, which were multiple in 4 (4.8%). Late seizures were more frequent in patients with early symptomatic seizures and with haemorrhage on admission CT/MR. Neither early symptomatic seizures nor late seizures were related to functional prognosis at the last follow-up (median = 1 year). There is a moderate risk of seizure recurrence early in the course and during the first year after CVDST. Seizures can be a cause of acute death, but might not have an independent influence on functional outcome. Pharmacological prevention of seizures after CVDST should probably be limited to patients with early symptomatic seizures and cerebral lesions on admission CT/MR.
Early Outcome of Carotid Angioplasty and Stenting versus Carotid Endarterectomy in a Single Academic Center
Authors: Kastrup Andreas , Skalej Martin , Krapf Hilmar , Nägele Thomas , Dichgans Johannes , Schulz Jörg B.
Published: April 2003

Background: Evidence is accumulating that carotid angioplasty and stenting (CAS) might become an alternative to carotid endarterectomy (CEA) for the treatment of high-grade carotid artery disease (CAD). Evaluating the efficacy of this novel technique in single institutions in addition to performing further large trials can help to guide optimal patient management in everyday practice. Methods: In this study we compared the early outcome of 100 prospectively followed patients who underwent CAS with a retrospectively reviewed group of 142 patients that underwent CEA over the same time period. Only patients who had received pre- and postsurgical evaluations by a neurologist were included. According to the criteria set forth by the large trials the occurrence of minor or major strokes, myocardial infarction and death within 30 days was analysed. Results: Both groups had similar age and sex distributions, as well as cerebrovascular risk factors. In the group of CAS patients 63 (63%) and in the group of CEA patients 92 (65%) had a symptomatic carotid stenosis, respectively. For symptomatic patients the overall complication rate (any stroke or death) was 6.5% (3 minor and 3 major strokes) in the surgical and 8% (2 minor strokes, 2 major strokes, and 1 death) in the non-surgical group (n.s.). For asymptomatic patients there was one minor stroke (2%) in the surgical and no stroke or death in the non-surgical group. As a frequent non-neurological complication the post-procedural course was complicated by groin hematoma requiring surgery in 3 CAS patients, and neck hematoma requiring additional surgery in 3 CEA patients. Conclusions: Within our academic institution we found comparable complication rates for CAS and CEA in patients with symptomatic or asymptomatic high-grade CAD. Although these early results are promising and support the notion that CAS may become an alternative treatment option for CAD in everyday practice, the long-term efficacy of CAS has to be evaluated critically by means of further prospective studies.