bluuebunny/crossref_metadata_2025 huggingface dataset:
Vitamin D Receptor Gene Polymorphism and Bone Mineral Density in Hypercalciuric Calcium-Stone-Forming Patients
Authors: Heilberg Ita Pfeferman , Teixeira Sergio Henrique , Martini Ligia Araujo , Boim Mirian Aparecida
Published: April 2003

Reduced bone mineral density (BMD) and an increased risk of vertebral fracture have been reported in calcium-stone-forming (CSF) patients presenting with idiopathic hypercalciuria. We investigated the association between BsmI vitamin D receptor (VDR) polymorphism and BMD in 68 hypercalciuric CSF patients (35 males and 33 premenopausal females, mean age ± SD = 39 ± 10 years). BMD was measured at lumbar spine (L2–L4) and femur neck sites using dual energy X-ray absorptiometry. A 72-hour dietary record and a 24-hour urine sample were obtained from each patient to determine calcium intake and excretion. The allelic frequency found for the sample as a whole was 16% BB, 44% Bb and 40% bb. Mean BMD values did not significantly differ among BB, Bb and bb patients at L2–L4 (1.162 ± 0.10, 1.133 ± 0.11 and 1.194 ± 0.19 g/cm2, mean ± SD, respectively) or at neck sites (0.920 ± 0.11, 0.931 ± 0.15 and 0.982 ± 0.15 g/cm2, respectively). Calcium intake and excretion were also not significantly different among the three genotypes. Patients were then divided into two groups, normal BMD, T-score ≧–1 (n = 34) and low BMD, T-score <–1 (n = 34), to further evaluate the allele influence on previous bone loss. Despite a trend for a higher mean BMD at spine or neck sites for patients with one or two b alleles when compared to BB patients, the difference did not reach statistical significance. The distribution of BB, Bb and bb genotypes in the low-bone-mass group (15, 47 and 38%, respectively) was similar to that in the normal-bone-mass group (18, 41 and 14%, respectively). These data suggest that BsmI VDR polymorphism does not play an important role in the bone loss seen in hypercalciuric CSF patients.
The Effect of Renal Transplantation on Pulmonary Function
Authors: Kalender Betül , Erk Müzeyyen , Pekpak Meltem (Ayaz) , Apaydın Süheyla , Ataman Rezzan , Serdengeçti Kamil , Sarıyar Muzaffer , Erek Ekrem
Published: April 2003

In patients with chronic renal failure, mechanical and hemodynamic changes could occur in the lungs without obvious pulmonary symptoms and findings and their effects could pave the way to pulmonary functional disorders. In this study, pulmonary functional disorders and especially alveolocapillary defects, which are frequently seen in uremia, were determined in renal transplanted patients. Pulmonary functions and diffusion capacity were assessed in uremic patients (n = 20) and in successfully transplanted patients (n = 20) without any lung disease or pulmonary edema symptoms and findings. Patients were selected randomly among outpatients who were followed up in a Nephrology and Transplantation Unit. Forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and peak expiratory flow (PEF25–75) were measured. Single breath carbon monoxide diffusion test and diffusion lung capacity adjusted for hemoglobin concentration (DLAdj) were done. The means of the spirometric values such as FVC, FEV1 and FEV1/FVC were normal in the nondialyzed uremic group, but the PEF25–75 value (68.7%) and diffusion capacity (DLAdj 72.7%) were found to be slightly low. There were 2 patients with normal values and 18 patients with some functional abnormalities in this nondialyzed uremic group. The means of all spirometric parameters and diffusion capacities were found to be normal in the transplanted group. There were 7 patients with normal function and 13 patients with some functional abnormalities in this transplanted group. When the nondialyzed uremic group and the transplanted group were compared statistically, significant differences were found between their spirometric values (except for FVC) and their diffusion capacities. Even though the uremic patients did not show any symptoms, their pulmonary function tests, especially diffusion capacity, were found to be disturbed. Although the transplanted patients as a group had normal mean spirometric values and diffusion capacity there were nevertheless many individual transplanted patients with defective diffusion capacity and abnormal spirometric values.
Differences in Sacral Angulation and Lumbosacral Curvature in Black and White Young Men and Women
Authors: Hanson P. , Magnusson S.P. , Simonsen E.B.
Published: April 2003

The angle between the base of the sacrum and its pelvic surface (SA), and the lumbosacral curve (LSC) defined as the anteroposterior distance between the L1 vertebra and the sacrum were studied in 105 fresh cadavers aged 15–32 years at death. The sample is comprised of 27 black males, 20 black females, 37 white males and 21 white females. Measurements of the SA were made with an adjustable protractor with an accuracy of ±1°. A new method using a specially designed instrument was developed for taking LSC measurements. A sliding scale that could be moved in the cranialcaudal direction was fitted with a measurement stick which measured the depth of the lumbar and sacral vertebral bodies (ventral to dorsal). The measuring device was placed on the autopsy table above the supine cadaver to measure these depths from the ventral side. The LSC was calculated as the mean difference between lumbar and sacral depths. The SA is smaller in black than in white men (43.6 ± 3.4 vs. 61.7 ± 2.1°, p <0.001). Similarly, black women have a smaller SA than white women (36.0 ± 2.2 vs. 50.2 ± 1.9°, p <0.001). The LSC is also larger in black than white men (9.4 ± 1.1 vs. 5.1 ± 0.3 cm, p <0.001), and black women also have significantly larger LSC compared to white women (13.2 ± 0.5 vs. 9.2 ± 0.6 cm, p <0.001). These data are so far the largest empirical evidence of differences in the SA and the LSC in young black and white cadaver specimens.
Distribution and Cytological Properties of Macrophages in Human Fallopian Tubes
Authors: Suenaga Y. , Katabuchi H. , Fukumatsu Y. , Okamura H.
Published: April 2003

The macrophages in human Fallopian tubes of women in the reproductive and postmenopausal periods were examined with a focus on their morphological properties by immunohistochemical staining and transmission electron microscopy. The fine structure of the smooth muscle cells in the Fallopian tubes was also investigated during the reproductive period. For immunohistochemical staining, we used two monoclonal antibodies that were specific for human macrophages, namely PM-1K and PM-2K. PM-1K recognizes human monocytes/ macrophages corresponding to CD68, and PM-2K recognizes tissue macrophages. PM-1K-positive cells were always present and their numbers increased significantly during the menstrual and early to mid-secretory phases. In contrast, relative numbers of PM-2K-positive cells were small throughout the menstrual cycle. In the postmenopausal period, few PM-1K-positive cells were detected, but PM-2K-positive cells remained. The macrophages during the secretory phase in the endosalpingeal stroma had well-developed intracytoplasmic organelles, but relatively few cytoplasmic vacuoles and granules. In the same phase, many cells of the monocyte/macrophage lineage appeared in the vascular lumen of the endosalpingeal stroma. The macrophages during the menstrual phase had well-developed intracellular organelles, with cytoplasmic vacuoles and granules of various sizes and configurations. During the late secretory phase, just prior to menstruation, the smooth muscle cells contained few cytoplasmic filaments but electron-lucent or electron-dense lysosome-like bodies were seen. These findings suggested the presence of macrophages in human Fallopian tubes. It is possible that such macrophages might be involved in the physiological functions of the tubes during the reproductive period and moreover that they might participate in the reconstruction of the muscle layer of the tubes.
Adenylyl Cyclase Type 7 Is the Predominant Isoform in the Bovine Retinal Pigment Epithelium
Authors: Beitz E. , Völkel H. , Guo Y. , Schultz J.E.
Published: April 2003

The retinal pigment epithelium (RPE) fulfills important supporting tasks to maintain the visual functions of the sensorineural retina. One major signalling mechanism by which adjacent tissues impinge on the RPE is the adenylyl cyclase (AC)/cAMP pathway. In the RPE, cAMP seems to modulate unique functions such as the phagocytosis of discs shed from the rod outer segments, transport of vitamin A or the ion and fluid control in the subretinal space. We analyzed the AC expression pattern in the retina and the RPE and found AC type 7 to be almost the only isoform expressed in the RPE. We cloned AC type 7 from a cDNA library established with fresh bovine RPE, expressed this isoform in eukaryotic cells and characterized some of its properties.
Distribution of NADPH-Diaphorase and Nitric Oxide Synthase in the Trigeminal Ganglion and Mesencephalic Trigeminal Nucleus of the Cat
Authors: Lazarov N. , Dandov A.
Published: April 2003

The trigeminal ganglion (TrG) and mesencephalic trigeminal nucleus (MTN) neurons are involved in the transmission of orofacial sensory information. The presence of nitric oxide (NO), a putative neurotransmitter substance in the nervous system, was examined in the cat TrG and MTN using nicotinamide adenine dinucleotide phosphate diaphorase (NADPH-d) histochemistry and nitric oxide synthase (NOS) immunohistochemistry. In the TrG, where the majority of the trigeminal primary afferent perikarya are located, most of the intensely NADPH-d/ NOS-stained cells were small in size and distributed randomly throughout the ganglion. The medium-sized neurons were moderately stained. A plexus of pericellular varicose arborizations around large unstained ganglion cells and densely stained fibers in-between could also be observed. In the caudal part of the MTN, both NADPH-d activity and NOS immunoreactivity was present in MTN neurons. In addition, a few scattered NADPH-d/NOS-containing neurons were found in the mesencephalic-pontine junction part of the nucleus. In contrast, only nerve fibers and their terminals were present at a more rostral level in the mid- and rostral MTN. MTN neuronal perikarya were enveloped in fine basket-like NADPH-d/ NOS-positive networks. Differential expression patterns of NOS and its marker NADPH-d suggest that trigeminal sensory information processing in the cat MTN is controlled by nitrergic input through different mechanisms. We introduce the concept that NO can act as a neurotransmitter in mediating nociceptive and proprioceptive information from periodontal mechanoreceptors but may also participate in modulating the activity of jaw-closing muscle afferent MTN neurons.
A New Manual Power Grip
Authors: Dawson N.M. , Felle P. , O’Donovan D.K.
Published: April 2003

A manual power grip for holding a cylindrical object using a relaxed index finger is described and analysed. In a group of 21 young adult students it provided greater grip strength than the conventional oblique power grip. It allowed a significant increase in the range of adduction-abduction at the wrist. In recent years it appears to have been empirically used by a number of top class racquet players and is the basis of the modern assault rifle grip. A new design of strain gauge dynamometer, in the shape of a cylinder, which permits the testing of a number of grip types and wrist positions is described. Standard grip testing protocol is used with this device which also allows the concomitant use of a goniometer for the assessment of wrist mobility.
Increased Prevalence of GSTM1 Null Genotype in Patients with Myelodysplastic Syndrome: A Case-Control Study
Authors: Tsabouri S.E. , Georgiou I. , Alamanos I. , Bourantas K.L.
Published: April 2003

Background and Objective: Myelodysplastic syndromes (MDS) are clonal disorders of bone marrow stem cells characterized by ineffective hematopoiesis leading to blood cytopenia; they often progress to acute myeloid leukemia (AML). The glutathione S-transferases (GST) detoxify various agents, including those implicated in MDS. Both GSTM1 and GSTT1 genes have ‘null’ alleles and are polymorphic. We studied the impact of GTM1 and GSTT1 null genotypes on the MDS susceptibility, disease severity and laboratory indices with prognostic value for the syndrome. Material and Methods: In a hospital-based case-control study we analyzed lymphocyte DNA samples from 54 patients with MDS and 60 cancer-free controls matched for age, sex, smoking habits and origin. A multiplex polymerase chain reaction was used to genotype both GSTM1 and GSTT1 simultaneously. The χ2 test was used for statistical evaluation of the data and the odds ratios and attributable risk and population attributable risk were also calculated. Results: A significantly increased frequency of GSTM1 null genotype was found among MDS patients (57.4%) compared to controls (33.3%) (p < 0.01), while the frequency of GSTT1 null genotype was not significantly higher in MDS patients (11.1% vs. 6.66%). Neither GSTM1 and GSTT1 null genotype was associated with a particular category of the French-American-British (FAB) classification in the patients studied. Additionally, GSTM1 null genotype was associated with a significant decrease in the absolute number of neutrophils among the MDS patients. Conclusions: Individuals with GSTM1 null genotype may have increased susceptibility to MDS. Null genotypes do not seem to have be associated with FAB classification while they may be associated with putative prognostic factors.
Nodal Gamma/Delta T Cell Lymphoma in Complete Remission following Allogeneic Bone Marrow Transplantation from an HLA-Matched Unrelated Donor
Authors: Aoyama Yasutaka , Yamane Takahisa , Hino Masayuki , Ota Kensuke , Hasegawa Taro , Sakamoto Chikahiko , Nakamae Hirohisa , Yamamura Ryousuke , Koh Ki-Ryang , Takubo Takayuki , Inoue Takeshi , Tsubaki Kazuo , Tatsumi Noriyuki
Published: April 2003

Gamma/delta T cell lymphoma is very rare, and usually occurs as an extranodal tumor. We describe the case of a 16-year-old Japanese man with an unusual nodal gamma/delta T cell lymphoma with generalized lymphadenopathy and bone marrow involvement. No tumor involvement was observed in the liver, spleen, or nasal cavity. Examination for surface antigens on lymphoma cells revealed a unique phenotype, positive for CD3 and T cell receptor (TCR) gamma/delta, but negative for CD2. Genotypic analysis revealed the tumor to be of monoclonal origin and characterized by TCR gamma-chain gene rearrangement, but there was no rearrangement of the TCR beta-chain gene. Our patient’s tumor responded to combination chemotherapy and subsequent allogeneic bone marrow transplantation from an HLA-matched unrelated donor. He has remained well and free of disease for 35 months.
Clinical Trials and Survival Curves: The Shape of Things to Come
Authors: Elfenbein Gerald J.
Published: April 2003

Clinical trials remain the standard for introducing new treatments into the medical armamentarium. There is a wealth of information contained in survival curves that are the ultimate outcomes reported in most oncology clinical trials. Survival curves report interesting information about the disease and its response to treatment. Unfortunately, and all too often, the limitations of survival curves are not adequately presented in publications and alternative interpretations for the data are not meticulously delineated by authors. The danger inherent in any publication of survival is that the data are not sufficiently ‘mature’ to support the conclusions that are drawn. This would be of little consequence if medical decisions were not based upon reading the latest publication that is acclaimed to be definitive and settle the question ‘once and for all.’ Better understanding of survival curves and how they shape the future of clinical practice may reduce the dangers of these pitfalls.
Hemophilia B in a Female
Authors: Shetty Shrimati , Ghosh Kanjaksha , Mohanty Dipika
Published: April 2003

Hemophilia B is rare in females and only a few cases have been reported. In this report, we describe a girl with a clinically severe course of hemophilia B but with a normal 46,XX karyotype. She had no signs of Turner’s syndrome or any other dysmorphic features. She was demonstrated to have moderately decreased factor IX levels (factor IX:C, 1.5 units/dl; factor IX:Ag, 2.2 units/dl). Her father and paternal uncle were also found to be deficient in factor IX and her mother seemed to carry a factor IX gene mutation with intermediate factor IX:C and factor IX:Ag levels (factor IX:C, 46 units/dl; factor IX:Ag, 39 units/dl). The maternal grandmother also showed mildly decreased factor IX:C and factor IX:Ag levels (factor IX:C 41 units/dl; factor IX:Ag 32 units/dl), further confirming the mother’s carrier status, which was indirectly confirmed by DNA segregation analysis using the polymorphic markers of the factor IX gene, as none of her other family members were found to be deficient in factor IX. However, the DdeI polymorphic marker of the factor IX gene for which the mother was informative showed the inheritance of a ‘369-bp’ allele in the mother, which was different from the ‘319-bp’ allele found in all of her 3 brothers who had normal levels of factor IX. Intermediate levels of factor IX in the mother and the maternal grandmother, severe deficiency of factor IX in the child and the polymorphic allele different from that of the normal subjects in the family are all consistent with a homozygous or double-heterozygous condition in this child.
Systemic Capillary Leak Syndrome Preceding Plasma Cell Leukaemia
Authors: Ghosh Kanjaksha , Madkaikar Manisha , Iyer Yegneshwar , Pathare Anil , Jijina Farah , Mohanty Dipika
Published: April 2003

We report a patient with plasma cell leukaemia with systemic capillary leak syndrome, a rare disorder often associated with monoclonal gammopathy. In this patient, the manifestation of capillary leak syndrome antedated the diagnosis of plasma cell leukaemia by 5–6 months. During that time, he was repeatedly admitted to the hospital with weight gain, congestive cardiac failure, cough and anasarca in the presence of normal renal function, liver function and normal echocardiography. On presentation, a serum protein electrophoresis showed monoclonal IgG; the blood smear showed 60% plasma cells with a total count of 4.4 × 109/l. A bone marrow aspirate showed replacement of the normal marrow by sheets of immature plasma cells. His systemic capillary leak syndrome initially responded to decongestive therapy with terbutaline and aminophylline but later on he became refractory to them and responded to vincristine, doxorubicin and dexamethasone (VAD) combination therapy only transiently. Danocrine and oxypentiphylline, added during VAD chemotherapy, did not produce a durable response in capillary leak syndrome, which finally responded to autologous peripheral blood stem cell transplantation (PBSCT). After PBSCT, he remained free of capillary leak for 10 months without terbutaline, oxypentiphylline corticosteroids, aminophylline or danocrine. His disease relapsed without recurrence of the capillary leak. He died 15 months after PBSCT and 20 months after the diagnosis of plasma cell leukaemia.
Cytogenetic and Molecular Monitoring of Residual Disease in Chronic Myeloid Leukaemia
Authors: Kaeda Jaspal , Chase Andrew , Goldman John M.
Published: April 2003

For patients with chronic myeloid leukaemia, methods for monitoring response to treatment have changed considerably in recent years. In the 1980s, the principal approach was repeated examination of bone marrow metaphases for the presence of the Ph chromosome in patients treated by interferon-α (IFN-α) or allogeneic stem cell transplantation. The use of fluorescence in situ hybridisation (FISH) techniques to detect the BCR-ABL fusion gene in Ph-positive leukaemia cells increased the sensitivity of cytogenetic studies to some degree. In the last 10 years, the reverse-transcriptase polymerase chain reaction (RT-PCR) has proved extremely valuable for assessing and monitoring minimal residual disease in patients who achieve Ph negativity after treatment with IFN-α or with the new Abl tyrosine kinase inhibitor imatinib mesylate or after allogeneic stem cell transplantation (SCT). Results are consistent with the notion that the majority of long-term survivors after allogeneic SCT are probably ‘cured’; for other patients monitored serially in complete cytogenetic remission, rising numbers of BCR-ABL transcripts detected by RT-PCR can indicate the need for further therapy.
A Fourth Case of 8p11 Myeloproliferative Disorder Transforming to B-Lineage Acute Lymphoblastic Leukaemia
Authors: JabbarAl-Obaidi Magda , Rymes Nichola , White Paula , Pomfret Mark , Smith Hilary , Starczynski Jane , Johnson Rod
Published: April 2003

A 56-year-old male presented with inguinal lymphadenopathy and leucocytosis (WBC 98 × 109/l). Bone marrow morphology showed myeloid hyperplasia, with eosinophilia. Cytogenetic analysis showed no evidence of the Philadelphia chromosome, and fluorescence in situ hybridisation studies for the BCR/ABL fusion were negative. All cells examined showed the t(8;13)(p11;q12) translocation. Six weeks after presentation, the disease progressed to an acute lymphoblastic leukaemia (ALL). The lymphoblasts were CD19/CD10 dual positive. Cytogenetic analysis again showed the t(8;13) translocation, with no additional abnormalities. There have been at least 14 reported cases of the t(8;13) myeloproliferative disorder to date, of which only 3 transformed to B-lineage ALL: our case is the 4th.
Bone Mineral Density in Patients Beginning Hemodialysis Treatment
Authors: Pečovnik Balon Breda , Hojs Radovan , Zavratnik Andrej , Kos Martina
Published: April 2003

Background: Our study was designed to determine bone mineral density (BMD) in patients beginning hemodialysis (HD) treatment, a possible correlation with the duration of renal failure prior to treatment, a possible correlation with the basic disease and the association with the concentration of intact parathormone (iPTH). Methods: Our prospective clinical trial included 50 patients beginning HD treatment. Cortical bone mineral density (BMDc) was measured at the left femoral neck and trabecular bone mineral density (BMDt) in the region of the lumbosacral spine. Bone mineral density (BMD) was measured by quantitative digital radiography using a Hologic 2000 plus device belonging to the third generation of densitometers based on dual-energy X-ray absorptiometry. Results: In patients (PTS) beginning HD, the average BMDc was 82 ± 15% of BMDc in a healthy population of corresponding age and sex. The average BMDt was 91 ± 16% of BMDt in a healthy population of corresponding age and sex. The difference was statistically significant (p < 0.05). There is a negative correlation between iPTH and BMDc r = –0.34 (p < 0.02). Patients with chronic glomerulonephritis (GN) had a statistically significantly higher BMDc (g/cm2) (p < 0.01) than those with analgetic nephropathy (AN). PTS with AN have lower BMDc (g/cm2, %) (p < 0.02) and BMDt (p < 0.005) than the rest of the PTS, iPTH in PTS with AN is higher than in the rest of the PTS (p < 0.05). Conclusions: In PTS at the beginning of HD, BMD is lower than in healthy people of corresponding age and sex. This means that BMD already decreases prior to HD. BMDc was statistically significantly lower than BMDt (p < 0.00005). PTS with AN have lower BMD than those with GN and all remaining PTS. A negative correlation between iPTH and BMDc was found.
Comparison of Body Composition Analysis Methods in Clinical Routine
Authors: Erselcan Taner , Candan Ferhan , Saruhan Sabriye , Ayca Tulay
Published: April 2003

Background: Skinfold thickness (SFT) and bioelectrical impedance (BIA) are readily available and commonly used techniques in patient monitoring for body composition analysis (BCA) in clinical practise. Another one, dual-energy X-ray absorptiometry (DEXA) method became popular in body composition analysis (BCA) in recent years. Its results have been reported to be quite accurate and precise, in comparison with in vivo or in vitro multiple component reference methods. The aim of the present study was to assess the degree of agreement between SFT and DEXA, and BIA and DEXA methods, in obese and nonobese patients. Methods: Body fat mass (FM) was measured in 16 nonobese (mean body mass index; BMI = 22.2 ± 2.2 kg/m2) and in 21 obese (BMI = 34.5 ± 6.1 kg/m2) women with DEXA, SFT, and BIA in the same morning. Results: Mean (± SD) FM (kg) was 16.3 ± 5.5, 15.0 ± 5.1, 14.7 ± 4.9 in nonobese subjects and 38.8 ± 10.1, 36.3 ± 10.0, 37.1 ± 12.0 in obese patients, by DEXA, SFT and BIA, respectively. Comparison of the DEXA-BIA and DEXA-STF methods showed high correlation in regression line analysis in nonobese subjects as, r2 = 0.93 and 0.89, respectively. Regression coefficents were 0.84 and 0.75 in obese patients. However, reanalysis of the data by the Bland and Altman method revealed an obvious lack of agreement between the DEXA-BIA and DEXA-SFT methods in obese patients. In addition, FM was underestimated by BIA and SFT as compared to DEXA in both of the study groups. Besides, better precision was obtained by DEXA method among the others. Conclusion: The SFT or BIA method would be preferred to monitor BCA in non-obese subjects in clinical routine. However, DEXA should be considered as the method of choice in obese patient monitoring, since reproducibility gains special importance, other than the accuracy in the context.
Relationship between Plasma Retinol and Infectious Diseases in the Elderly
Authors: Chau Nearkasèn , Tébi Ambroise , Créton Christine , Belbraouet Slimane , Debry Gérard
Published: April 2003

This study assessed the relationship between plasma retinol deficiency and infectious diseases. The plasma retinol, anthropometric (Body Mass Index, triceps skinfold thickness, mid-arm muscle circumference) and biological indices (proteins, albumin, transferrin, prealbumin, retinol binding protein) of protein-energy malnutrition of 63 patients with infectious diseases (ID) were compared to those of two control groups of similar age: 527 patients with other diseases (C1) and 92 healthy people (C2). Plasma retinol, albumin, transferrin and prealbumin were significantly lower in the ID group than in the C1 group. A lower body mass index was noted in men only. The ID and C1 groups had lower values for all indices (except for mid-arm muscle circumference). The ID group had lower albumin, transferrin, and prealbumin than the C1 group. The percentage of patients with plasma retinol below 300 µg/l was higher in the ID group (48.0% in men, 39% in women) than in the C1 group (25.0 and 21.5%); the odds ratio adjusted on age and sex equaled 2.46, 95% CI (1.39–4.37). It was lower than 2% in the C2 group. The results obtained with multiple regression analysis showed that, in the patients, the association between plasma retinol and infectious diseases remained significant when age, sex, anthropometric and biological indices were taken into account. Consequently, it is useful to check up the food intake habits of the elderly.
Casein and Soy Protein Isolate in Experimental Atherosclerosis: Influence on Hyperlipidemia and Lipoprotein Oxidation
Authors: Damasceno Nágila R.T. , Gidlund Magnus A. , Goto Hiro , Dias Carlos T.S. , Okawabata Fábio S. , Abdalla Dulcineia S.P.
Published: April 2003

Background/Aims: Nutrients able to modify the susceptibility of lipoproteins to oxidation and/or reduce the cholesterol levels of blood plasma are important for prevention and/or treatment of atherosclerosis. The influence of animal and vegetable proteins on hypercholesterolemia and atherogenesis has been studied, concerning the mechanisms able to modify the digestion, absorption and bioavailability of lipids. In this study, the influence of casein and soy protein isolate on lipoprotein oxidation and atherosclerosis progression was investigated in cholesterol-fed rabbits. Methods: During 2 months, 20 New Zealand rabbits were fed with diets containing 1% cholesterol and 27% casein or 27% soy protein isolate. Blood samples were collected at baseline, 15, 30, 45 and 60 days of feeding. Results: Casein feeding contributed to increasing cholesterol and triglyceride concentrations, lipoprotein oxidation and the area of aorta atherosclerotic lesions. In contrast, the soy protein isolate reduced, when compared to casein, the concentrations of cholesterol and lipid peroxides of β-VLDL and LDL fractions during the experimental time course, as well as the area of atherosclerotic lesions at the end of the study. Conclusion: Soy protein isolate, in comparison with casein, promoted a decrease of lipid peroxides, cholesterol and triglyceride content of atherogenic lipoproteins (β-VLDL and LDL), which had beneficial effects over atherosclerosis progression in cholesterol-fed rabbits.
Contralateral Masking in Cochlear Implant Users with Residual Hearing in the Non-Implanted Ear
Authors: James Chris , Blamey Peter , Shallop Jon K. , Incerti Paula V. , Nicholas Anstee M.
Published: April 2003

Contralateral masking was investigated in cochlear implant users with residual hearing in the non-implanted ear. Threshold elevations for acoustic probes were observed when electrical maskers were presented in the opposite ear. Also, threshold elevations for electrical probes were observed when acoustic contralateral maskers were presented. The amount of threshold shift expressed in decibels charge or decibels sound pressure level produced by either contralateral acoustic or electric maskers was within the range found in normal listeners for similar stimuli (i.e. 4–8 dB). There was a correlation between the sensation level of acoustic maskers and the maximum amount of masking observed which is consistent with data for normally hearing subjects. The width of the masking patterns was similar to that expected from forward masking patterns in severely sensorineurally impaired ears and implanted ears. The maximum amount of acoustic masking tended to occur for electrode positions that were more basal than expected from characteristic frequency positions. However, where a relatively high-frequency 4-kHz masker could be used, there was a good match between the characteristic frequency position of the maximum threshold elevation and that of the masker.
Directional Sensitivity of the Human Macula utriculi Based on Morphological Characteristics
Authors: Tribukait Arne , Rosenhall Ulf
Published: April 2003

A morphometric analysis of 43 human maculae utriculi is presented. Individual data on the shape, total area and relative area of the pars interna are given. In addition, the sensitivity of the entire macula to shear stimuli in different directions was estimated. The mean area of 39 maculae from adults and children was 4.30 ± 0.30 (SD) mm2. The pars interna was slightly but significantly smaller than the pars externa. The interindividual variability was larger for the shape of the macula than for the total area and the percentage of the pars interna. The estimated responsiveness of the macula was largest for shear directed anteromedially and smallest for shear directed posteriorly. The data are discussed taking into consideration clinical findings on patients with unilateral loss of otolith function.
Spectral Features Control Temporal Plasticity in Auditory Cortex
Authors: Kilgard Michael P. , Pandya Pritesh K. , Vazquez Jessica L. , Rathbun Daniel L. , Engineer Navzer D. , Moucha Raluca
Published: April 2003

Cortical responses are adjusted and optimized throughout life to meet changing behavioral demands and to compensate for peripheral damage. The cholinergic nucleus basalis (NB) gates cortical plasticity and focuses learning on behaviorally meaningful stimuli. By systematically varying the acoustic parameters of the sound paired with NB activation, we have previously shown that tone frequency and amplitude modulation rate alter the topography and selectivity of frequency tuning in primary auditory cortex. This result suggests that network-level rules operate in the cortex to guide reorganization based on specific features of the sensory input associated with NB activity. This report summarizes recent evidence that temporal response properties of cortical neurons are influenced by the spectral characteristics of sounds associated with cholinergic modulation. For example, repeated pairing of a spectrally complex (ripple) stimulus decreased the minimum response latency for the ripple, but lengthened the minimum latency for tones. Pairing a rapid train of tones with NB activation only increased the maximum following rate of cortical neurons when the carrier frequency of each train was randomly varied. These results suggest that spectral and temporal parameters of acoustic experiences interact to shape spectrotemporal selectivity in the cortex. Additional experiments with more complex stimuli are needed to clarify how the cortex learns natural sounds such as speech.
Auditory Evoked Potentials as Measures of Plasticity in Humans
Authors: Purdy Suzanne C. , Kelly Andrea S. , Thorne Peter R.
Published: April 2003

There is increasing evidence from animal studies for plasticity of auditory function. This has prompted research to determine whether such plastic changes occur in adults and children with hearing disorders. Behavioural measures such as speech perception scores do show improvements after hearing aid fitting and cochlear implantation. Several studies have also shown changes in cortical auditory evoked potentials after cochlear implantation and after auditory training. These studies indicate that improvements in speech perception ability are associated with changes in the central auditory system, particularly at the cortical level.
Correlates of Urea Kinetic Modeling during Hemodialysis in Patients with Acute Renal Failure
Authors: Jaber Bertrand L. , King Andrew J. , Cendoroglo Miguel , Cunniff-Jaber Paula J. , Balakrishnan V.S. , Ruthazer Robin , Pereira Brian J.G.
Published: April 2003

The current guidelines on dialysis adequacy in acute renal failure (ARF) are loosely defined and have been extrapolated from patients with end-stage renal disease. The objectives of this study were (1) to compare three methods of urea kinetic modeling measurement in patients with ARF receiving intermittent hemodialysis, (2) to compare prescribed to delivered dose of dialysis, and (3) to explore the factors that are associated with dialysis delivery. ‘Single-pool’ urea kinetic modeling was assessed by the Ureakin® software and the second-generation equation which uses a logarithmic estimate of spKt/V. ‘Equilibrated’ Kt/V (eKt/V) was calculated using the rate adjustment equation. The prescribed dose was derived using the manufacturer’s specifications of the dialyzer clearance, prescribed time, actual delivered blood and dialysate flow, and estimates of volume of urea distribution. A total of 78 consecutive spKt/V measurements were obtained in 24 patients. The mean urea reduction ratio was 51 ± 1%. The delivered spKt/V was significantly lower than that prescribed (0.87 ± 0.03 or 0.83 ± 0.03 vs. 1.28 ± 0.05; p = 0.0001). The equilibrated Kt/V was markedly lower than the delivered spKt/V (0.73 ± 0.03 vs. 0.83 ± 0.03; p = 0.0001). Univariate analyses demonstrated that female gender, low body mass index, low predialysis weight, use of cellulose acetate dialyzers, and increased prescribed time were associated with increased odds of prescribed spKt/V ≧1.2. Similarly, old age, increased delivered time, and high cytokine production were associated with increased odds of delivered spKt/V ≧1.2. In summary, while the impact of delivered intermittent hemodialysis on the survival of patients with ARF remains to be determined, these results indicate that dialysis delivery is suboptimal in ARF, and empiric dosing should strongly consider factors related to lean body mass, including age and gender.
Respiratory Failure
Authors: Zimmerman Janice L.
Published: April 2003

Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are common causes of hypoxemic respiratory failure. Multiple etiologies lead to direct and indirect pulmonary injury that progresses through an acute exudative phase, fibroproliferative phase, and recovery phase. Inflammatory mechanisms are thought to play a predominant role in the pathophysiology of ALI/ARDS. Mechanical ventilation with a lower tidal volume and an inspiratory plateau pressure of ≤30 cm H2O is one intervention that has demonstrated a reduction in mortality. A clinical trial to determine the role of restrictive versus liberal fluid management is underway. Inhaled nitric oxide has been used to improve oxygenation but has not resulted in any outcome benefit. Glucocorticoids may be beneficial in the fibroproliferative phase of lung injury by suppressing chronic inflammation. Rigorous clinical trials of new and established interventions are required to determine optimum therapy and reduce mortality in ALI/ARDS.
Early Nasal Continuous Positive Airway Pressure and Minimal Handling in the Treatment of Very-Low-Birth-Weight Infants
Authors: Kamper Jens
Published: April 2003

Continuous positive airway pressure (CPAP) was introduced in 1971 and at that time welcomed as ‘the missing link’ between oxygen and ventilator treatment of premature infants. Originally CPAP was administered by tracheal tube (or head box) which because of the inherent risk of complications necessitated a cautious approach. New, more simple and less risky methods of application, such as nasal CPAP (N-CPAP), permitted earlier treatment which in randomized trials showed a reduction in inspired oxygen concentration, reduced need for mechanical ventilation and a reduction in the rate of death. Early N-CPAP/minimal handling today is an established first-line treatment in a number of centers in Denmark and Sweden, while N-CPAP outside Scandinavia apparently is used less often. However, recently the method has gained new interest as more publications have demonstrated that N-CPAP/minimal handling is both feasible and effective in most very-low-birth-weight infants. Early rescue treatment with fast-acting surfactant, given during a brief intubation, has increased the effectiveness of N-CPAP further. Descriptive studies on N-CPAP suggest that the risk of bronchopulmonary dysplasia may be lower than in conventional intensive treatment because of the relatively low need for mechanical ventilation. This question is at the present time being addressed in a randomized controlled trial in England.
Treatment of Acute (Adult) Respiratory Distress Syndrome
Authors: Taeusch H. William
Published: April 2003

The treatment of neonatal respiratory distress syndrome with surfactant represents a successful culmination of decades of basic and clinical research. In many babies, respiratory distress syndrome is a relatively pure expression of surfactant deficiency. Acute respiratory distress syndrome (ARDS) is a more common disease that is most frequently seen in adults, but the processes are common to lung injuries in newborns and children as well. While some impairment of production and secretion of surfactant constituents may be present in ARDS, surfactant inactivation is probably a more important factor in this disease. Until recently, surfactants available for human use have been easily susceptible to inactivation and this may explain why they have been less successful for treatment of ARDS than for neonatal respiratory distress syndrome. This review outlines recent information on surfactant inactivation and describes initiatives that may result in ‘inactivation-proof’ surfactants that may be of increased benefit in ARDS.
High-Frequency Oscillatory Ventilation in the Management of Respiratory Distress Syndrome
Authors: Moriette Guy , Brunhes Anne , Jarreau Pierre-Henri
Published: April 2003

Early use of high-frequency oscillatory ventilation with a high volume strategy (HFOV-HVS) has been proposed to decrease the incidence of chronic lung disease following respiratory distress syndrome (RDS) in extremely immature infants. Despite encouraging results of animal experiments, clinical trials have provided discordant results. Our own multicenter trial showed that using HFOV-HVS, compared with conventional ventilation, decreased exogenous surfactant requirements, but did not modify pulmonary outcome, and increased the risk of severe intraventricular hemorrhage. This prompted us to change our management of RDS, by switching from elective use of HFOV to an ‘early rescue’ approach.
Mild Dilatation of Renal Pelvis in Term Neonates with Urinary Tract Infection
Authors: Dellagrammaticas H.D. , Iacovidou N. , Papadimitriou M. , Daskalaki A. , Papadoyannis M.
Published: April 2003

The purpose of this study was to assess the incidence and evolution of mild dilatation confined to the renal pelvis in term neonates with urinary tract infection developing within 2 weeks from birth. Twenty-two neonates with mild dilatation of the renal pelvis out of 180 neonates with urinary tract infection were identified giving an incidence of 12.2% for this finding. Male to female ratio was 6.3:1. The left kidney was twice as frequently involved (68 vs. 32%). At follow-up, the dilatation had disappeared in 20 neonates (90.9%) by a mean age of 2.7 years with only one neonate developing two further episodes of urinary tract infection in the infantile period. No other morbidity was noted.
Promoting Effect of Colostrum on the Phagocytic Activity of Bovine Polymorphonuclear Leukocytes in vitro
Authors: Sugisawa H. , Itou T. , Sakai T.
Published: April 2003

Bovine colostrum contains a variety of essential nutrients, antibodies, cytokines, hormones, and growth factors that are important for nutrient supply, host defense, growth and for general neonatal adaptation. We have investigated the effect of bovine colostrum on the phagocytic activity for latex particles by normal peripheral blood polymorphonuclear leukocytes using flow cytometric analysis. The phagocytosis promoting effect was observed in colostrum. The promoting activity showed dose-dependent increase up to 25% at a concentration of colostrum. This activity was maximum in the colostrum obtained at parturition and gradually decreased with the time course of lactation as well as IgG level. Colostrum possessed the higher promoting activity than milk and normal serum. These results indicate that bovine colostrum strongly activates polymorphonuclear leukocyte phagocytosis, suggesting the concernment with development of nonspecific immune system in newborns.
7-Nitroindazole, but Not Aminoguanidine, Attenuates the Acute Inflammatory Responses and Brain Injury during the Early Phase of Escherichia coli Meningitis in the Newborn Piglet
Authors: Park Won Soon , Chang Yun Sil , Lee Munhyang
Published: April 2003

We evaluated the anti-inflammatory and neuroprotective effects of the selective neuronal nitric oxide synthase inhibitor 7-nitroindazole and aminoguanidine, which predominantly inhibits inducible nitric oxide synthase, during the early phase of experimental bacterial meningitis in the newborn piglet. Meningitis was induced by intracisternal injection of 108 colony-forming units of Escherichia coli in 100 µl of saline. 7-Nitroindazole significantly attenuated the meningitis-induced acute inflammatory responses such as increased intracranial pressure, decreased cerebrospinal fluid (CSF) glucose concentration, and CSF leukocytosis at 2 h. However, meningitis-induced CSF leukocytosis at 4 h and increased CSF lactate and tumor necrosis factor alpha levels were not significantly attenuated. Reduced cerebral cortical cell membrane Na+,K+-ATPase activity and increased lipid peroxidation products, indicative of meningitis-induced brain cell membrane dysfunction, were also significantly improved with 7-nitroindazole treatment. In contrast, although aminoguanidine significantly attenuated the increase in the CSF tumor necrosis factor alpha level, it failed to attenuate the acute inflammation and the ensuing brain injury in bacterial meningitis. In summary, 7-nitroindazole, but not aminoguanidine, significantly attenuated the acute inflammatory responses and brain injury during the early phase of neonatal bacterial meningitis.
Hemodynamic Effects of Levcromakalim in Neonatal Porcine Pulmonary Hypertension
Authors: Ambalavanan Namasivayam , Bulger Arlene , Ware Janice , Philips Joseph B.
Published: April 2003

Levcromakalim (LKM; a KATP channel opener) reverses hypoxic pulmonary vasoconstriction in isolated pulmonary arteries and perfused lungs. This vasorelaxation is blocked by glibenclamide (GLB; a KATP channel blocker). We evaluated the hemodynamic effect of LKM followed by GLB in a chronically instrumented neonatal porcine model of pulmonary hypertension, created by exposing piglets to hypoxia (n = 7) or heat-killed group B streptococci (GBS) (n = 6). Hypoxia increased pulmonary arterial pressure (PAP), which LKM decreased, and GLB subsequently increased in a dose-dependent manner. Systemic arterial pressure (SAP) did not change with hypoxia but was also decreased by LKM and increased by GLB. GBS also led to increased PAP, but LKM significantly reduced only SAP, which was then increased by GLB. We conclude LKM is capable of reversing hypoxic, but not GBS-induced, pulmonary hypertension but lacks specificity for the neonatal pulmonary vasculature.
Plasma Cyclic Guanosine Monophosphate Reflecting the Severity of Persistent Pulmonary Hypertension of the Newborn
Authors: Turanlahti M. , Pesonen E. , Pohjavuori M. , Lassus P. , Fyhrquist F. , Andersson S.
Published: April 2003

The aim of the study was to examine the relationship between the plasma concentration of cyclic guanosine monophosphate (cGMP) and pulmonary pressure and hypoxia defined by oxygenation index (OI) in newborn infants with severe persistent pulmonary hypertension (PPHN) on inhaled nitric oxide (NO). In this prospective study, 18 newborn infants having Doppler ultrasound-diagnosed PPHN and treated with NO were investigated. The ratio of pulmonary artery to systemic artery pressure (PAP/SAP) and OI was assessed before treatment and at 0.5, 1, 12, and 24 h from the beginning of NO. At these time points, plasma concentrations of cGMP could be determined in 11 patients. The association of birth asphyxia as assessed by Apgar 1 min and 5 min and plasma cGMP before the NO treatment was examined. The initial median plasma concentration of cGMP was 37.3 pmol/ml (IQR 13.3–79.6). After the start of NO, cGMP increased significantly within 60 min (p = 0.003) and peaked at 12 h. Initial plasma cGMP was associated with Apgar score (1 and 5 min). OI decreased within 30 min of NO and PAP/SAP within 60 min. Persistent high PAP/SAP after 1 h of NO was associated with low cGMP concentration (r = 0.70, p = 0.02). We conclude that a significant increase in plasma cGMP is already evident after 60 min of NO therapy. This effect is accompanied by changes in oxygenation index and in pulmonary artery pressure. Initial plasma concentrations of cGMP were associated with hypoxia assessed as Apgar score.
Inhibition of Macrophage Proinflammatory Cytokine Expression by Steroids and Recombinant IL-10
Authors: Li Ying-Hua , Brauner Annelie , Jonsson Baldvin , van der Ploeg Ingeborg , Söder Olle , Holst Mikael , Jensen Jørgen Skov , Lagercrantz Hugo , Tullus Kjell
Published: April 2003

Chronic lung disease (CLD) of prematurity is a prolonged respiratory failure in very-low-birth-weight neonates. Proinflammatory cytokines have been implicated in the development of CLD. Steroids have been shown to produce some improvement in neonates with this disease. The purpose of this study was to evaluate the downregulation of these proinflammatory cytokines by dexamethasone, budesonide and recombinant IL-10 (rIL-10) in order to elucidate the mechanism of the clinical benefit of steroids in babies. Our results showed that dexamethasone, budesonide and rIL-10 significantly inhibited both IL-6 and TNF-α production in the THP-1 cell line stimulated by lipopolysaccharide and Ureaplasma urealyticum antigen. Similar effects were found in macrophages from tracheobronchial aspirate fluid from newborn infants. In the rat alveolar macrophage cell line, steroids inhibited IL-6 and TNF-α production, while rat rIL-10 did not significantly decrease production. In conclusion, steroids and human rIL-10 were able to downregulate proinflammatory cytokine production, which may explain the beneficial effect of steroids and suggests that rIL-10 could be tried as an anti-inflammatory agent in neonates with a high risk of CLD.