bluuebunny/crossref_metadata_2025 huggingface dataset:
Occupational Therapy and Pulmonary Rehabilitation of Disabled COPD Patients
Authors: Lorenzi Cristina M. , Cilione Carmela , Rizzardi Roberta , Furino Vittoria , Bellantone Tommasina , Lugli Daniela , Clini Enrico
Published: May 2004

Background: Occupational therapy (OT) has been defined as a task of rehabilitation for disabled patients, giving them maximal function and independence to sustain specific activities of daily living. Objectives: To evaluate the effectiveness of OT as an adjunctive measuring during pulmonary rehabilitation (PR) of hospitalized COPD patients. Methods: A prospective clinical trial with parallel groups was undertaken in severely disabled COPD patients (n = 71, age 73 ± 5 years). They were assigned to either OT+PR (n = 47, FEV1 46 ± 21%pred.) or PR (n = 24, FEV1 44 ± 12%pred.). PR consisted of eighteen 3-hour daily sessions, whilst OT (domestic activities) was added 3 times a week up to nine 1-hour sessions. Six-min walk (6MWD) with evaluation of BORG dyspnea (D) and leg fatigue (F) scores at end of effort, breathlessness sensation (B) by means of the MRC scale as well as the number of functions lost in the Basic Activity of Daily Living (BADL) categories were assessed as outcomes before (T₀) and after (T1) rehabilitation. Results: 6MWD (from 165 ± 63 to 233 ± 66 and from 187 ± 52 to 234 ± 65 m in the OT+PR and PR groups, respectively), D (from 4.9 ± 2.1 to 3.2 ± 1.6 and from 5.3 ± 2.1 to 3.4 ± 2.1), F (from 6.1 ± 0.5 to 4.5 ± 1.7 and from 5.9 ± 0.8 to 4.3 ± 0.8) and B (from 4.3 ± 0.9 to 3.0 ± 0.9 and from 4.2 ± 1.0 to 3.2 ± 0.8) had similarly improved (p < 0.01) in both groups at T1. The percentage distribution of patients across the BADL categories significantly changed (p = 0.004) in OT+PR (from 17 to 61%, from 70 to 34% and from 23 to 5% in categories A, B and C, respectively) but not in the PR group. Conclusions: The addition of OT to comprehensive PR is able to specifically improve the outcome of severely disabled COPD inpatients.
The Effect of Continuous Positive Airway Pressure Treatment on Insulin Sensitivity in Patients with Obstructive Sleep Apnoea Syndrome and Type 2 Diabetes
Authors: Harsch Igor Alexander , Schahin Simin Pour , Brückner Kerstin , Radespiel-Tröger Martin , Fuchs Florian S. , Hahn Eckhart Georg , Konturek Peter Christopher , Lohmann Tobias , Ficker Joachim Hans
Published: May 2004

Background: The obstructive sleep apnoea syndrome (OSA) is a frequent condition, as well as type 2 diabetes mellitus. Both diseases are characterized by insulin resistance. Objectives: The aim of this study was to establish whether OSA is an independent risk factor for increased insulin resistance in diabetics. For this purpose, we tested the hypothesis that the insulin sensitivity in patients with type 2 diabetes and OSA can be improved by 2 days or 3 months of continuous positive airway pressure (CPAP) treatment. Methods: In 9 obese patients with type 2 diabetes and OSA [apnoea/hypopnoea index 43.1 ± 21.3; body mass index (BMI) 37.3 ± 5.6 kg/m2] and good glycaemic control on oral antidiabetics or on diet alone (HbA1c 6.4 ± 0.7%), the insulin sensitivity index (ISI) was established by euglycaemic hyperinsulinaemic clamp tests at baseline, after 2 days and after 3 months of effective CPAP treatment. Results: ISI was unchanged after 2 days of CPAP treatment, but was significantly improved after 3 months (4.38 ± 2.94 vs. 2.74 ± 2.25 at baseline; p = 0.021), without any significant changes in BMI. Glycaemic control was unaffected after 3 months (HbA1c 6.3 ± 0.6%; not significant). Fasting leptin levels showed no significant changes. Conclusions: These results indicate that OSA itself is an independent risk factor for insulin resistance. This effect may be explained by the elevated sympathetic activity in OSA.
Usefulness of Endobronchial Ultrasonography for Transbronchial Lung Biopsies of Peripheral Lung Lesions
Authors: Shirakawa Taeko , Imamura Fumiya , Hamamoto Junji , Honda Izumi , Fukushima Kazuo , Sugimoto Mineharu , Shirkakusa Takayuki
Published: May 2004

Background: Peripheral lung lesions are increasing in numbers. Endoscopic diagnosis is essential for the prevention of unnecessary operations. Conventional diagnostic procedures have limitations in availability and results. Objectives: Endobronchial ultrasonography (EBUS) was investigated as a means to guide transbronchial lung biopsy, to reduce the discomfort during the procedure and to improve diagnostic accuracy. Methods: In 50 cases, we performed transbronchial lung biopsy combined with EBUS and fluoroscopic guidance. The results were compared to 42 controls assessed by fluoroscopy only. Results: In 38 cases (76%), EBUS could describe the peripheral lesion (33 from inside, including 9 cases with difficulties in fluoroscopic observation, and 5 from an adjacent bronchus, indicating the correct location of the lesion). If successfully placed inside, a change in the patient’s position was not required, which helped to reduce patient discomfort. Lung cancer was diagnosed in 24 patients and benign disease in 25 patients; in 1 case diagnosis remained unknown. When the EBUS probe could be introduced inside the lesion, the sensitivity for cancer diagnosis and specificity for cancer exclusion were 100%, respectively (15/15, 18/18). Compared to the controls in whom the biopsy site was determined by fluoroscopy only, the sensitivity tended to be superior by EBUS, although it did not reach statistical significance (p = 0.06). However, specificity and accuracy were statistically significant (both p = 0.02). Conclusions: When the lesion can be correctly described by EBUS from inside the lesion, EBUS is useful to guide transbronchial lung biopsy, can contribute to a reduction in patient discomfort and improves the accuracy of diagnosis. Additional navigation tools to increase correct positioning of the EBUS probe are desirable.
Virtual Reality and Written Assessments Are of Potential Value to Determine Knowledge and Skill in Flexible Bronchoscopy
Authors: Crawford Stephen W. , Colt Henri G.
Published: May 2004

Background: Technically challenging professions such as those of the defense and transportation industries increasingly use computer-based simulation and written self-learning instruments for education and to determine competency. A structured learning curriculum does not exist, however, for flexible bronchoscopy, a minimally invasive diagnostic procedure performed on thousands of patients by respiratory specialists, otolaryngologists, anesthesiologists, and surgeons worldwide. Objective: To explore an analogous strategy of measuring theoretical knowledge in flexible bronchoscopy and specific technical skills using written knowledge assessments and a virtual reality bronchoscopy simulator. Methods: Twelve trainees from a university pulmonary medicine training program were asked to identify and enter five specific bronchial segments on command using a virtual reality bronchoscopy skill station, and to complete a 50-question examination pertaining to bronchoscopy theory. Their performance scores and opinions pertaining to the use of these methods of assessment were then recorded. Results: Trainees correctly identified and entered 71% of the bronchial segments required on command (median 60%, range 40–100%). Fifty percent (3/6) of the trainees who had performed more than 200 flexible bronchoscopies successfully entered all segments required. None (0/6) of those who had performed less than 200 flexible bronchoscopies correctly located, identified and entered all required segments. Despite disparate performance, all trainees believed that technical skills could be improved through practice and instruction using computer-based simulation. On the written assessment, only 51% of questions were answered correctly (median 52%, range 32–60%). No relationship between technical skill and theoretical knowledge was noted. In addition, neither bronchoscopy skill nor theoretical knowledge were associated with years of training or number of bronchoscopies previously performed. Conclusions: Trainees concluded that (1) bronchoscopy simulation was realistic, (2) simulator-based practice would help improve technical skills, and (3) a written questionnaire would benefit theoretical knowledge acquisition if designed as a learning instrument. The wide variability noted in this study as well as the lack of a relationship between technical skill, knowledge of bronchoscopy theory, extent of training, and bronchoscopy experience suggest that competency should not be assumed based on years of bronchoscopy training or on an arbitrary number of procedures performed.
Pharmacological Studies of the Effect of Wheat Grain Extract
Authors: Schachter E. Neil , Zuskin Eugenija , Rienzi Nicholas , Goswami Satindra , Castranova Vincent , Siegel Paul , Whitmer Michael , Chung Eric
Published: May 2004

Background: Agricultural farm workers exposed to wheat grain dust are at risk of developing respiratory abnormalities. The pathogenesis of this injury is only partially understood. Objectives: To determine the effect of wheat grainextract on isolated guinea pig tracheal smooth muscle. Methods: In the current study, pharmacologic properties of wheat grain extract (WGE) were tested using guinea pig tracheas studied in vitro. Dose-related contractions of nonsensitized guinea pig trachea were demonstrated using these extracts. Pharmacologic studies were performed by pretreating guinea pig tracheal tissue with drugs known to modulate smooth muscle contraction: atropine 10–6M, indomethacin 10–6M, pyrilamine 10–6M, acivicin 10–5M, nordihydroguaretic acid (NDGA) 10–5M, bromophenacyl bromide (BPB) 10–5 M, 3,4,5-trimethoxybenzoic acid-8-(diethylamino)- octyl ester TMB8 10–5M, captopril 10–5M and capsaicin 5 × 10–6M. Results: WGE causes a dose-dependent constriction of guinea pig tracheal smooth muscle. Atropine, pyrilamine, TMB8 and acivicin significantly reduced the contractile effects of the WGE. Inhibition of contraction by blocking of other mediators was significant but less complete. Conclusion: We conclude that WGE causes a dose-related constriction of airway smooth muscle by nonimmunological mechanisms involving a variety of airway mediators and possibly cholinergic receptors.
Carcinoma Arising in the Pleural Cavity following Pneumonectomy for Hydatid Disease
Authors: Zapatero Gaviria J. , Garcia Franco C.E. , Jimenez Hiscock L. , Peñalver Pascual R. , Fogué Calv o L. , Muguruza Trueba I. , Lago Viguera J.
Published: May 2004

We report a case of carcinoma following 42 years of chronic empyema in a patient who underwent surgery for a hydatid cyst at the age of 3. At the time of diagnosis, an esophageal fistula was observed and treated with cyanoacrylate. We hypothesize that chronic inflammation of the pleura, caused by decades of empyema, associated with the presence of heterotopic squamous epithelium due to a long-standing esophago-pleural fistula, led to neoplastic transformation.
Rhabdomyolysis after the Administration of Itraconazole to an Asthmatic Patient with Bronchopulmonary Aspergillosis
Authors: Ferrari Marcello , Bodini Ilaria , Lo Cascio Vincenzo
Published: May 2004

It is known that the coadministration of itraconazole with cholesterol-lowering statins may induce muscle damage. We describe the case of a patient with steroid-dependent asthma, steroid-induced severe myopathy and allergic bronchopulmonary aspergillosis who developed rhabdomyolysis and acute renal failure following a ∼6-week treatment with itraconazole, even without the concomitant use of HMG-CoA reductase inhibitors.
Sarcoidosis Presenting as Metastatic Bony Disease
Authors: Mangino Debra , Stover Diane E.
Published: May 2004

Although asymptomatic lytic bony lesions of the phalanges of the hands and feet are not uncommon in patients with sarcoidosis, involvement of the vertebral bodies is rare. Because these lesions can mimic other diseases of the bones on radionuclide scans and magnetic resonance imaging (MRI), this case emphasizes the importance of obtaining tissue and excluding malignancy and infection before the diagnosis can be established with confidence
The Role of Tec Family Kinases in Myeloid Cells
Authors: Schmidt Uwe , Boucheron Nicole , Unger Bernd , Ellmeier Wilfried
Published: May 2004

Members of the Tec kinase family (Bmx, Btk, Itk, Rlk and Tec) are primarily expressed in the hematopoietic system and form, after the Src kinase family, the second largest class of non-receptor protein tyrosine kinases. During lymphocyte development and activation Tec kinases have important functions in signaling pathways downstream of the antigen receptors. Tec family kinases are also expressed in cells of the myeloid lineage. However, with the exception of mast cells and platelets, their biological role in the myeloid system is only poorly understood. This review summarizes the current knowledge about the function of Tec family kinases in hematopoietic cells of the myeloid lineage.
Mineral and Vitamin Status in Elderly Persons from Northwest Spain Consuming an Atlantic Variant of the Mediterranean Diet
Authors: Vaquero M. Pilar , Sánchez-Muniz Francisco J. , Carbajal Angeles , García-Linares M. Carmen , García-Fernández M. Camino , García-Arias M. Trinidad
Published: May 2004

Aim: To assess dietary intake and serum mineral and vitamin levels in elderly people from Northwest Spain consuming a Mediterranean diet, rich in vegetables, fruit, meat, fish, olive oil, dairy products and moderate in wine. Methods: Cross-sectional observational study in four retirement homes. Forty-five men and 65 women participated. Dietary intake and serum calcium, magnesium, iron, retinol, α-tocopherol, albumin, cholesterol, glucose and hematological parameters were determined. Results: Mean consumption of fruit plus vegetables was 600 g/day. Men consumed significantly more legumes, fruit, meat, and alcoholic beverages, but fewer vegetables than women. Women presented higher carbohydrate and lower alcohol energy contributions. Men consumed significantly more thiamin, niacin equivalents, riboflavin, retinol equivalents and iron. Vitamin D intake was 2.2 ± 1.2 µg/day and folate intake was 204 ± 47 µg/day without gender differences. Prevalence of anemia was 6.7% and that of high ferritin, 1.8%. Serum cholesterol and retinol were higher in women. Mean serum α-tocopherol/cholesterol ratio in the whole population was 6.3 ± 2.3 mmol/mol without gender differences. Conclusion: This elderly population consumes an Atlantic-Mediterranean diet that appears, according to biochemical and hematological parameters, appropriate. However, more fatty fish and leafy green vegetables and the inclusion of fortified foods in the diet might optimize micronutrient status.
Influence of Dietary Habits on Serum Selenium Concentration
Authors: Borawska Maria Halina , Witkowska Anna Maria , Hukałowicz Katarzyna , Markiewicz Renata
Published: May 2004

Background: A serum selenium concentration of 70 µg/l is considered to be sufficient for glutathione peroxidase (GSHPx) activity, a selenium-dependent enzyme reflecting the body selenium status. The purpose of the study was to assess which foods or food groups best affect serum selenium in subjects with selenium concentrations below or above 70 µg/l. Methods: A food frequency questionnaire was employed to describe the dietary habits of 129 subjects. Serum selenium concentrations were determined using the electrothermal absorption spectrometry (ETAAS) technique following serum dilution. Results: Multiple regression analysis revealed that consumption of ham, honey and tea was positively associated with the selenium concentration in the sera of selenium-inadequate subjects. In selenium-inadequate subjects, alcohol consumption may be responsible for selenium losses. Unlike the selenium-inadequate subjects, the selenium concentrations in the sera of the selenium-adequate subjects were positively correlated with the frequencies of wholegrain bread consumption and processed fruit consumption. In all the groups tested, the serum selenium concentration was not affected by cigarette smoking. Conclusions: The serum selenium concentration is influenced by dietary habits, but not by cigarette smoking. Frequent consumption of ham, tea and honey may be effective to improve the selenium concentration in the sera of selenium-inadequate subjects.
Effects of Dietary Intake and Life Style on Bone Density in Patients with Diabetes mellitus Type 2
Authors: de Luis Román D.A. , Aller R. , Perez Castrillon J.L. , De Luis J. , Gonzalez Sagrado M. , Izaola O. , Romero E. , Martín Escudero J.C. , Herreros V.
Published: May 2004

Objective: The aim of our study was to investigate the relation among glycemic control, lifestyle and dietary intake with bone mineral density in patients with diabetes mellitus type 2. Design: Cross-sectional study. Setting: Tertiary care hospital. Participants: A cross-sectional study in a tertiary care hospital was performed. Ninety-two patients attending our diabetes service (56 females/36 males) with diabetes mellitus type 2 were enrolled in a consecutive way. The inclusion criteria were diabetes diagnosed >40 years of age, with type 2 diabetes defined in accordance with the criteria of the American Diabetes Association and no use of dietary supplements. Body mass index, waist-to-hip ratio, glucose level, and HbA1c levels were assessed in all patients. X-ray densitometry of the calcaneal region and a 3-days written food record keeping, and a qualitative questionnaire of lifestyle were also performed. Results: A total of 21.7% of patients had osteoporosis (T score <2.5 SD). Patients were overweight with a high BMI and a medium glucose control. Patients with osteoporosis were older than those without osteoporosis (67.8 ± 6.9 vs. 62.1 ± 9.2 years; p < 0.05). Significant differences were detected between patients without and with osteoporosis in calcium intake (1,219.37 ± 387 vs. 839 ± 251 mg/day; p < 0.05) and zinc intake (9.23 ± 3.5 vs. 13.3 ± 6.9 mg/day; p < 0.05), respectively. No differences were detected in other dietary dairy intakes. In correlation analysis age (r = –0.23; p < 0.05) and BMI (r = 0.48; p < 0.05) was correlated with BMD. In univariate analysis with dicotomic variables, only exercise was positive associated with osteoporotic status (87.5% exercise habit in patients without osteoporosis and 25% exercise habit in patients with osteoporosis; p < 0.05). In a logistic model with the dependent variable (osteoporosis), remained in the final model dietary dairy intake of calcium and zinc, BMI, age and exercise. Exercise, calcium intake and BMI were protective factors. Zinc intake, and age were risk factors. Conclusions: Exercise, calcium intake, body mass index had a protective role in bone mineral density in patients with diabetes mellitus type 2. Zinc intake and age were risk factors in our population.
Relationship between Alpha-Tocopherol Content in the Different Lipoprotein Fractions in Term Pregnant Women and in Umbilical Cord Blood
Authors: Sánchez-Vera Isabel , Bonet Bartolomé , Viana Marta , Sanz Concepción
Published: May 2004

Aims: To determine the concentration of vitamin E in normal maternal and umbilical cord blood pairs, and to study the relationship between vitamin E content in maternal lipoprotein fractions and umbilical cord blood. Methods: Fifty healthy pregnant women were recruited randomly at term and blood samples were drawn from the mothers at delivery and cord blood was obtained immediately postpartum. Vitamin E was determined by HPLC in plasma, in the different lipoprotein fractions and in the placenta. Plasma levels of triglycerides and cholesterol were also measured. Results: The concentration of vitamin E in umbilical cord plasma was 250 µg/dl, lower than in maternal plasma (1,460 µg/dl) (p < 0.001). A positive correlation was found between the vitamin E concentration in maternal plasma, LDL and VLDL and in the umbilical cord plasma. In contrast, no correlation was found between maternal HDL concentration and umbilical cord blood. Conclusion: These results show that the concentration of vitamin E in umbilical cord blood is lower than in maternal plasma. LDL and VLDL seem to be the main source of vitamin E for the fetus.
Effects of Green Tea Catechin on Polymorphonuclear Leukocyte 5′-Lipoxygenase Activity, Leukotriene B4 Synthesis, and Renal Damage in Diabetic Rats
Authors: Choi Jeong-Hwa , Chai Young-Mi , Joo Gil-Jae , Rhee In-Koo , Lee In-Seon , Kim Kwan-Ryu , Choi Myung-Sook , Rhee Soon-Jae
Published: May 2004

The purpose of this study was to investigate the effects of green tea catechin on polymorphonuclear leukocyte 5′-lipoxygenase activity, leukotriene B4 synthesis, and renal damage in diabetic rats. Male Sprague-Dawley rats weighing 100 ± 10 g were randomly assigned to 1 normal group and 3 diabetic groups given a catechin-free diet (DM-0C group), 0.25% catechin diet (DM-0.25C group), or 0.5% catechin diet (DM-0.5C group), respectively. 5′-Lipoxygenase activity in the polymorphonuclear leukocytes significantly increased by 54% in the DM-0C group compared to the normal group, while the level in the DM-0.5C group remained the same as in the normal group. The leukotriene B4 content in the polymorphonuclear leukocytes increased 55% in the DM-0C group compared to the normal group, whereas the DM-0.25C and DM-0.5C groups exhibited the same level as the normal group. The superoxide radical content in the kidney microsomes increased 116% in the DM-0C group when compared to the normal group, yet decreased 29% in the DM-0.25C group and 50% in the DM-0.5C group compared to DM-0C group. The lipofuscin content was 197 and 136% higher in the DM-0C and DM-025C groups, respectively, than in the normal group, whereas the DM-0.5C group exhibited the same content as in the normal group. The carbonyl value increased 118% in the DM-0C group compared to the normal group, and the DM-0.25C and DM-0.5C groups were not significantly different from the DM-0C group. Accordingly, these results indicate that dietary catechin inhibited the generation of superoxide radicals, oxidized protein, and lipid peroxide in the kidney of streptozotocin-induced diabetic rats. Furthermore, green tea catechin supplementation in diabetic rats also appeared to inhibit the production of leukotriene B4 based on regulating the activity of 5′-lipoxygenase, thereby potentially reducing renal oxidative damage and inflammatory reactions.
Serum Carotenoid and Retinol Levels during Childhood Infections
Authors: Cser M.A. , Majchrzak D. , Rust P. , Sziklai-László I. , Kovács I. , Bocskai E. , Elmadfa I.
Published: May 2004

Background: In recent years, new physiological functions of vitamin A have been identified, including its role in immune defense. The antioxidant potential of carotenoids is thought to account for their health benefits. The aim of this study was to investigate the concentration changes in the provitamin-A (α- and-β-carotene, β-cryptoxanthin) and of the non-provitamin-A carotenoids (lutein, zeaxanthin and lycopene) in children with acute infections. Methods: Serum retinol and carotenoid concentrations were measured by HPLC in 45 children suffering from acute infections and in 29 healthy controls. In addition 15 healthy children collected food samples over 2 days. C-reactive protein (CRP) levels were measured by turbidimetry. Results: Serum levels of β-carotene, α-carotene, β-cryptoxanthin and retinol and non-provitamin-A carotenoid lutein and zeaxanthin concentrations were significantly lower in children with infections compared to healthy controls. There were significant negative correlations between CRP levels and serum β-carotene and retinol concentrations. The average intake of retinol equivalents was 1.1 ± 0.6 mg/day. Conclusion: Serum retinol and provitamin-A as well as non-provitamin-A carotenoid concentrations were lower in children with acute phase infections compared to healthy controls. The inverse correlations between CRP and β-carotene or retinol indicate either decreased synthesis or increased utilization of these antioxidants.
LDL Susceptibility to Copper-Induced Oxidation after Administration of a Single Dose of Free or Esterified Beta-Cryptoxanthin
Authors: Wolters Maike , Hahn Andreas
Published: May 2004

Background: The oxidative modification of LDL is believed to be an initial step in atherosclerosis. Thus, antioxidative substances such as carotenoids may have a role in the prevention of coronary heart disease. We examined the susceptibility of LDL to Cu2+ oxidation in young adults before and after a single dose of β-cryptoxanthin. Methods: 1.3 mg of β-cryptoxanthin was administered to 12 apparently healthy young volunteers. Six of the volunteers received esters, the other six free β-cryptoxanthin. The plasma concentration of β-cryptoxanthin and the susceptibility of LDL to copper-induced oxidation ex vivo in terms of the duration of lag time were measured before and 12 h after β-cryptoxanthin ingestion. Results: A single dose of β-cryptoxanthin significantly increased the mean plasma β-cryptoxanthin concentration and the mean cholesterol adjusted β-cryptoxanthin concentration by 117 and 133%, respectively. No effect on the length of lag time was assessed. However, in LDL isolated from plasma 12 h after β-cryptoxanthin administration the lengths of lag time correlated significantly with the plasma β-cryptoxanthin concentration and with the cholesterol adjusted β-cryptoxanthin levels. The lag time did not differ significantly between volunteers who received esters and those who received the same dosage as free β-cryptoxanthin. At both measuring points, smokers, male volunteers and women using oral contraceptives tended to exhibit lower β-cryptoxanthin concentrations and lower cholesterol adjusted β-cryptoxanthin concentrations as well as increased LDL oxidizability compared to nonsmokers and women not using oral contraceptives. Conclusion: A single dose of β-cryptoxanthin does not enhance the duration of LDL lag time ex vivo in healthy young subjects.
Weakness of Anastomotic Site in Diabetic Rats Is Caused by Changes in the Integrity of Newly Formed Collagen
Authors: Onodera Hisashi , Ikeuchi Daisuke , Nagayama Satoshi , Imamura Masayuki
Published: May 2004

Aims: Diabetes mellitus often causes anastomotic leakage leading to severe complications after surgery. The purpose of this study was to determine whether collagen synthesis is correlated with the anastomotic strength in diabetic animals in special reference to collagen type differences. Methods: Thirty Lewis rats weighing approximately 250 g were made diabetic by tail vein injection of streptozotocin (STZ). Laparotomy was performed through a midline incision under ether anesthesia. A colonic segment 5 cm distal to the ileocecal junction was transected then anastomosed with absorbable suture. Anastomotic strength was measured on days 3, 5, 7 and 14 postoperatively, and compared with normal rats. Collagen type I and type III mRNA together with the total collagen concentration were measured in anastomotic sites. Results: Anastomotic strength in diabetic rats was significantly lower on day 7, but gradually recovered up to day 14. There was no statistical significance between the two groups in hydroxyproline concentrations. Although the expressions of mRNA of collagen type III in both groups were statistically not different, that of collagen type I in the diabetes group merely increased and was clearly less than that of the control group. Conclusions: Anastomotic integrity in diabetic rats was significantly damaged on day 7 after surgery but recovered by day 14. This is caused not by the total contents of collagen accumulation but by the decrease of newly formed collagen type I contents.
Coenzyme Q10 Levels in Maternal Plasma and Cord Blood:Correlations with Mode of Delivery
Authors: Compagnoni G. , Lista G. , Giuffrè B. , Mosca F. , Marini A.
Published: May 2004

Background: Oxygen (O2) plays a critical role in the O2-reduction reactions indispensable for life, but can produce free radicals that are involved in many diseases. Coenzyme Q10 (CoQ10), acting as a redox carrier in the respiratory chain, occupies a central position in the energy metabolism and oxidative defence. Neonates seem to be very subjected to oxidative stress because of their deficient antioxidant systems. Design/Methods: The aim of the study was to verify whether the mode of delivery may affect CoQ10 levels in the mother and neonate, and thus influence the risk of oxidative damage in the newborn. We measured CoQ10 levels in maternal plasma and cord blood at birth after three different modes of delivery (45 term healthy pregnancies): (1) vaginal in room air (VD) (n = 15); (2) elective caesarean section with general anaesthesia (50% O2 and 50% N2O) (CSg) (n = 15), and (3) elective caesarean section with spinal anaesthesia without O2 (CSs) (n = 15). Our results showed higher levels of Q10 in mothers and neonates with VD (1.29 ± 0.43 and 0.15 ± 0.06 µg/ml, respectively) or CSs (1.15 ± 0.28 and 0.24 ± 0.06 µg/ml, respectively) when compared to CSg (0.74 ± 0.28 and 0.07 ± 0.03 µg/ml, respectively) (p < 0.01). Conclusions: These data demonstrate that the mode of delivery may affect CoQ10 levels in mothers and neonates, and thus influence the risk of oxidative damage in the newborn.
Combined Adrenal Myelolipoma and Medullary Hyperplasia
Authors: Ishay Avraham , Ishay Avraham , Dharan Muralee , Dharan Muralee , Luboshitzky Rafael , Luboshitzky Rafael
Published: May 2004

Objective: A patient is reported with hypertension due to combined medullary adrenal hyperplasia and myelolipoma. Methods: A 52-year-old woman with long-standing hypertension was evaluated for an incidentally discoveredlargetumor of the left adrenal. Left adrenalectomy was performed for a presumptive clinical diagnosis of pheochromocytoma. Results: Histopathologic examination revealed a mixed tumor consisting of a large myelolipoma with infiltrating foci of adrenal medulla. Conclusions: A patient is described with hypertension, myelolipoma and adrenal medullary hyperplasia; following adrenalectomy, however, blood pressure and biochemical abnormalities normalized.
IL-9 in Allergic Inflammation
Authors: Hauber Hans-Peter , Bergeron Celine , Hamid Qutayba
Published: May 2004

Th2 type cytokines such as interleukin (IL)-4, IL-5, IL-9, and IL-13 are important mediators in allergic inflammation. The present review will focus on the role of IL-9 in allergic inflammation. The structure and genomic architecture of IL-9 and its receptor, the source of IL-9 and its regulation as well as its effects on different cell types will be reviewed. Furthermore, the specific role of IL-9 in allergic diseases and the potential therapeutic approach of blocking IL-9 will be discussed.
Effect of Concomitant Administration of Cyclosporine and Ketoconazole in Children with Focal Segmental Glomerulosclerosis
Authors: El-Husseini Amr , El-Basuony Fathy , Mahmoud Ihab , Donia Ahmed , Hassan Nabil , Sayed-Ahmed Nagy , Sobh Mohamed
Published: May 2004

Background: Focal segmental glomerulonephritis (FSGS) is now the most common primary glomerulonephritis that leads to end-stage renal disease in both adults and children. Cyclosporine (CsA) is a well-known and effective immunosuppressive agent that has become a cornerstone of immunotherapy in solid organ transplantation and it has been used in the treatment of FSGS for over 15 years. The deliberate use of ketoconazole (keto) to reduce the need for CsA is not new, but it is particularly relevant because of the high cost of CsA. Many studies have documented this benefit in renal and cardiac transplants, but this co-administration has not been reported in children with nephrotic syndrome (NS). Methods: This study included 116 children (below 18 years of age) with primary FSGS who were steroid resistant or dependent and received CsA therapy. Among them, 88 received daily keto therapy (keto group) in a dose of 50 mg with concomitant decrease of CsA dose by one third, while 28 patients received CsA alone (non-keto group). Mean (±SD) age was 6.17 ± 4.68 years and male to female ratio was 1.9:1. The great majority of the study population received the drugs for 1–2 years. The characteristics of both groups were comparable. Results: Co-administration of keto significantly reduced mean doses of CsA by 46% at 1 year with overall net cost savings of 36%. It also significantly improved the response to CsA therapy and decreased the frequency of renal impairment. No significant side effects for keto were observed. Conclusion: Co-administration of keto and CsA in idiopathic FSGS children is safe. This combination not only reduces the costs but also may improve the response to CsA and stabilize the renal function.
Evolution of Plasma D-Dimer and Fibrinogen in Witnessed Onset of Paroxysmal Atrial Fibrillation
Authors: Wang Tzong-Luen , Hung Chi-Ren , Chang Hang
Published: May 2004

Background: Although increased D-dimer and fibrinogen have been proved to be related with atrial fibrillation (AF), their evolution in the course of time remains unclear. Methods: To elucidate the evolution of plasma D-dimer and fibrinogen in AF of different duration. 56 patients (group A) of 3,524 patients in whom the onset of AF had been witnessed in a chest pain clinic were enrolled for study. Plasma D-dimer and fibrinogen concentrations were checked within 30 min after the onset of AF and followed up as scheduled. Another 50 patients (group B) with chronic AF underwent the same protocol and served as controls. Results: In group A, the D-dimer levels reached a plateau at the 18th hour (382 ± 52 vs. 840 ± 280 ng/ml, p < 0.001 by ANOVA) and the fibrinogen level increased gradually from 4.1 ± 0.6 g/ml at baseline to 6.1 ± 0.9 g/ml at the 48th hour (p < 0.001). No subjects had evidence of intra-cardiac thrombi by transesophageal echocardiography. There were significant differences in plasma D-dimer and fibrinogen levels between the two groups at each measurement. At the cut- off value of 500 ng/ml, plasma D-dimer had a sensitivity of 100%, a specificity of 93% in defining AF lasting for less than 12 h. The positive and negative predictive values were 52% and 100%, respectively. Plasma D-dimer increased above the normal range prior to the 12th hour after the onset of AF. Conclusion: The observations support its use as a screening tool for identifying patients with short duration AF capable of being safely converted.
Spiral Computed Tomography for Acute Pulmonary Embolism
Authors: Schoepf U. Joseph , Goldhaber Samuel Z. , Costello Philip
Published: May 2004

There is still considerable debate about the optimal diagnostic imaging modality for acute pulmonary embolism. If imaging is deemed necessary from an initial clinical evaluation such as
d
-dimer testing, options include nuclear medicine scanning, catheter pulmonary angiography, and spiral CT. In many institutions, spiral CT is becoming established as the first-line imaging test in daily clinical practice. With spiral CT, thrombus is directly visualized, and both mediastinal and parenchymal structures are evaluated, which may provide important alternative or additional diagnoses. However, limitations for the accurate diagnosis of small peripheral emboli, with a reported miss rate of up to 30% with single-slice spiral CT so far, have prevented the unanimous embrace of spiral CT as the new standard of reference for imaging pulmonary embolism. The clinical significance of the detection and treatment of isolated peripheral pulmonary emboli is uncertain. Evidence is accumulating that it is safe practice to withhold anticoagulation in patients with suspected pulmonary embolism on the basis of a negative spiral CT study. Remaining concerns about the accuracy of spiral CT for pulmonary embolism detection may be overcome by the introduction of multidetector-row spiral CT. This widely available technology has improved visualization of peripheral pulmonary arteries and detection of small emboli. The most recent generation of multidetector-row spiral CT scanners appears to outperform competing imaging modalities for the accurate detection of central and peripheral pulmonary embolism. In this review, we assess the current role and future potential of CT in the diagnostic algorithm of acute pulmonary embolism.
The Voice in the Mask
Authors: Alström Torbjörn
Published: May 2004

In the classical Greek theatre, masks were in fact used not only for visual effect but also as vocal resonance instruments. Can similar masks be constructed today? Singing and speaking through a mask focuses the attention of the audience not only on the posture and breathing movements of the singer or speaker, but equally on her voice.
Don't Want to Be This: The Elusive Sarah Kane
Authors: Singer Annabelle
Published: May 2004

Sarah Kane's plays are part of the outrage, conviction, and sorrow that was her life and death. Kane was a moral hard-ass who aimed to force others to think through the ethical paradoxes of their lives. She struggled to balance her mortal terror and moral vision. As Kane wrote: “Liverpool's [soccer player] Paul Ince publicly admits that he finds tackling more enjoyable than sex. Performance is visceral. It puts you in direct physical contact with thought and feeling.”
Combating Coevolutionary Disengagement by Reducing Parasite Virulence
Authors: Cartlidge John , Bullock Seth
Published: May 2004

While standard evolutionary algorithms employ a static, absolute fitness metric, co-evolutionary algorithms assess individuals by their performance relative to populations of opponents that are themselves evolving. Although this arrangement offers the possibility of avoiding long-standing difficulties such as premature convergence, it suffers from its own unique problems, cycling, over-focusing and disengagement.

Here, we introduce a novel technique for dealing with the third and least explored of these problems. Inspired by studies of natural host-parasite systems, we show that disengagement can be avoided by selecting for individuals that exhibit reduced levels of “virulence”, rather than maximum ability to defeat coevolutionary adversaries. Experiments in both simple and complex domains are used to explain how this counterintuitive approach may be used to improve the success of coevolutionary algorithms.
Dynamic Subset Selection Based on a Fitness Case Topology
Authors: Lasarczyk Christian W.G. , Dittrich Peter , Banzhaf Wolfgang
Published: May 2004

A large training set of fitness cases can critically slow down genetic programming, if no appropriate subset selection method is applied. Such a method allows an individual to be evaluated on a smaller subset of fitness cases. In this paper we suggest a new subset selection method that takes the problem structure into account, while being problem independent at the same time. In order to achieve this, information about the problem structure is acquired during evolutionary search by creating a topology (relationship) on the set of fitness cases. The topology is induced by individuals of the evolving population. This is done by increasing the strength of the relation between two fitness cases, if an individual of the population is able to solve both of them. Our new topology—based subset selection method chooses a subset, such that fitness cases in this subset are as distantly related as is possible with respect to the induced topology. We compare topology—based selection of fitness cases with dynamic subset selection and stochastic subset sampling on four different problems. On average, runs with topology—based selection show faster progress than the others.
A Reconsideration of the Aphrodite-Ashtart Syncretism
Authors: Budin Stephanie
Published: May 2004

Scholars have long recognized a one-to-one correspondence, or interpretatio syncretism, between the Greek goddess Aphrodite and the Phoenician goddess Ashtart (Astarte). The origin of this syncretism is usually attributed to the eastern origins of Aphrodite herself, whereby the Greek goddess evolved out of the Phoenician, as is suggested as early as the writings of Herodotos. In contrast to this understanding, I argue here that the perceived syncretism actually emerged differently on the island of Cyprus than throughout the rest of the Mediterranean. On Cyprus, the syncretism emerged out of an identification between the two queen goddesses of Cyprus - Aphrodite and Ashtart. In Greece, by contrast, it evolved out of a slow "Orientalizing" of Aphrodite combined with a Greek tendency to equate almost all eastern goddesses. As a result, the identification between Aphrodite and Ashtart was quite general, and both goddesses were syncretized not only with each other, but with a full range of Mediterranean goddesses.
The Buddhist Dimension of John
Authors: Derrett J. Duncan
Published: May 2004

Many features of the Fourth Gospel have hitherto found no source and commentators are confined to imagination. Meanwhile Buddhists' use of Greek, Roman and Jewish materials is established. It turns out, from a close examination of twelve instances, that Buddhist traditions, found in Hīnayāna and Mahāyāna sources, contemporary in essence with St John, offered the latter an opportunity to make his gospel attractive to contemporary targets of Buddhist missions, groups for whom Moses was not a commanding figure. Buddhists would recognise Jesus, already known from "synoptic" or para-synoptic materials, as a Bodhisattva, now a Buddha, who like Gautama promised a Paraclete, strongly resembling Maitreya in character and function.
Electrochemical Behaviour of Conducting Polymer/Polyimide Composite
Authors: Iroh J.O. , Levine K. , Shah K. , Zhu Y. , Donley M. , Mantz R. , Johnson J. , Voevodin N.N. , Balbyshev V.N. , Khramov A.N.
Published: May 2004

Two types of conducting polymer composites comprising polypyrrole (PPy) (filler) dispersed in a polyimide (PI) (matrix) and bilayered conducting polymer/PI composites, were successfully formulated. Electrochemical deposition of the PPy/PI composite was accomplished by initially depositing PPy onto the working electrode, and then casting a layer of PI onto the modified electrode. The PPy/PI composite was also formulated by first casting a PI film onto the bare electrode followed by electrochemical deposition of PPy. Poly(N-ethylaniline)/PI composites were prepared by initially depositing a thin layer of poly(N-ethylaniline) onto the substrate (AA 2024-T3) and then casting a layer of PI resin onto the modified substrate. The composite coatings were characterised by advanced analytical techniques, such as reflection absorption infrared spectroscopy (RAIR), SEM, dc polarisation studies and electrochemical impedance spectroscopy. SE/S275
Environmental Protection of Titanium Alloys in Centrifugal Compressors at 500°C in Saline Atmosphere
Authors: Beguin J.D. , Faure P. , Adrian D. , Alexis J. , Petit J.A. , Belaygue P. , Fournier D.
Published: May 2004

The use of the titanium alloy Ti-6246 (Ti–6Al–2Sn–4Zr–6Mo, wt-%) for gas turbine compressors allows an increase in working temperature and stress level. Under severe service conditions, the material experiences combined high temperature and high mechanical stress and, in saline atmospheres, stress corrosion cracking (SCC) can occur, leading to catastrophic mechanical failure. The present study was performed to evaluate the potential of several surface treatments to protect Ti-6246 alloy, after salt deposit, from hot salt SCC at temperatures ≤500°C and 500 MPa static mechanical stress conditions. Shot peening, thermal oxidation and metal–ceramic coatings were investigated. Experimental results confirm the existence of brittle stress corrosion phenomena marked by a low residual elongation of test samples and the presence of oxides on the fracture surfaces. Both shot peening and metal–ceramic coatings increase the hot salt SCC resistance of the alloy. Times to rupture were improved by a factor of 3 for shot peening and by a factor of 10 for metal–ceramic coatings. Inversely, the time to rupture of preoxidised alloys has been halved compared with uncoated alloys. As well as these interesting quantitative results, structural studies of metal–ceramic coatings showed that they are mechanically and chemically compatible with the titanium alloy substructure and should work under severe thermomechanical stresses and aggressive atmospheres. SE/504
Adherence of Electrodeposited Zn–Ni Coatings on EN AW2024 T3 Aluminium Alloy
Authors: Alexis J. , Adrian D. , Masri T. , Petit J.A.
Published: May 2004

The use of hexavalent chromium in surface treatments will be reduced in the future, as it is suspected to be carcinogenic. Electrodeposition of Zn–Ni, which is currently used on steel, represents a non-chromate alternative surface treatment for the corrosion protection of aluminium alloys. Zn–Ni coatings were electrodeposited onto an EN AW2024 T3 aluminium alloy sheet in a laboratory flow cell. To obtain several percentages of Ni in the coatings, solutions with different Ni2+ concentrations were used. The influence of a specific pretreatment to promote adherence, such as zincate immersion (109 g L–1 ZnO, 525 g L–1 NaOH) or phosphoric anodisation (36 wt-%H3PO4, 20°C) prior to electrodeposition was also investigated. The smoothness of the coating, measured on a three-dimensional roughness tester, increased when the percentage of Ni increased. This can be explained by a microstructural refinement observed using SEM and AFM. These microstructural changes are due to the evolution of the crystal structure of the coatings and can be observed by X-ray diffraction. The mechanical properties of the coatings (hardness and Young's modulus) were measured by microindentation and nanoindentation. The adherence of the coatings was tested by a scratch test and a three point bending test dedicated to coatings. The scratch behaviour of the coatings was a function of the percentage of Ni. The scratches observed indicate a ductile fracture for coatings with a low percentage of Ni and a brittle fracture for a high percentage of Ni. Bending tests demonstrated the favourable effect of pretreatments such as zincate immersion or phosphoric anodisation as well as adhesion enhancement as a function of increasing percentage of Ni. SE/503
Mathematical Model of Shock Hardening of Weld Zones in Aluminium Alloys by High Energy Electron Beams
Authors: Farnush M.
Published: May 2004

The possibility of shock hardening the weld heat affected zones of 5010 and 6063 aluminium alloys was studied using high energy electron beams (HEEB). The welded samples were irradiated for 5 s, at 6 mA current beam and 10 MeV beam energy with different doses statically by a Rudotron non-linear accelerator. A mathematical model to find the ratio between measured variables, the hardness before irradiation hb, the hardness after irradiation ha, and the distance from the centre of the weld D, is discussed in the framework of the least squares method. The ratio between the three variables is ha=Ahb + CD, therefore (dha/dhb)d=Cte and (dha/dD)d=Cte. SE/506
Effects of Treatment Parameters on Microstructure of Diffusion Alloyed Coatings on Pure Magnesium
Authors: Youping M. , Weixin W. , Pengfei L. , Kewei X.
Published: May 2004

In the present study, the effect of various solid state diffusion times (8 h, 16 h, 24 h) on the microstructure of diffusion alloyed samples and its corresponding composition and microhardness changes were investigated at 480°C. Optical microscopy, SEM, EDX and microhardness techniques were used to examine the treated samples cross-sectional morphology, microstructure and the corresponding composition and microhardness changes. The results show that, with increasing time, the alloy layer zone changes from one subzone (the transition subzone) to two subzones (white phase subzone and the transition subzone). At a diffusion alloying time of 24 h, two distinct subzones were observed in the alloying layer, continuous white phases (WP zone) consisting of the Al5Mg11Zn4 phase was present in the outermost layer of diffusion alloying zone, and the microhardness value for Al5Mg11Zn4 phase (WP zone) was ≤332 HV, which is beneficial from the point of view of wear resistance. SE/507