bluuebunny/crossref_metadata_2025 huggingface dataset:
Pituitary-Adrenal Response to Naloxone in Non-Ulcer Dyspepsia: Preliminary Evidence for a Reduction in Central Opioid Tone
Authors: Scott Lucinda V. , Rathore Omar , Dinan Timothy G. , Keeling P.W.N.
Published: April 2003

Background: Non-ulcer dyspepsia (NUD) is one of the core functional bowel disorders. There has been recent emphasis on possible abnormal brain-gut interactions as being central to its pathophysiology. In this preliminary study, we examined central opioid tone in Helicobacter pylori-negative NUD patients using naloxone, an opioid antagonist, which stimulates pituitary-adrenal activity. The opioid system is known to govern nociceptive processing and to play a role in gut motor activity. Subjects: Eight subjects with NUD and 8 age- and sex-matched healthy subjects were examined. Methods: Naloxone, 0.125 mg/kg, was administered at time 0. Adrenocorticotropin (ACTH) and cortisol responses were measured over a 120-min period. Maximum pituitary-adrenal responses in the 2 groups were compared. Results: The ACTH response was significantly attenuated in the NUD group (p < 0.05). The cortisol response did not differ between the 2 groups (p = 0.7). Conclusions: Central opioid tone may be reduced in subjects with NUD. Our preliminary findings suggest that altered opioidergic activity may contribute to NUD pathophysiology, influencing the symptom profile through altered gut motor activity or possibly by influencing visceral sensitivity.
In vitro Antiseptic Susceptibility of Clinical Isolates from Nosocomial Infections
Authors: Shimizu M. , Okuzumi K. , Yoneyama A. , Kunisada T. , Araake M. , Ogawa H. , Kimura S.
Published: April 2003

To evaluate the susceptibility of a large number of strains to various antiseptics, we elaborated a simple, qualitative broth turbidity method in which we could quickly judge the efficacy visually. For this method, we prepared a modified neutralizer broth, consisting of trypticase soy broth containing 15% Tween 80, 1% soybean lecithin and 0.5% sodium thiosulfate. The susceptibilities of Serratia marcescens No. 26 to 4 antiseptics obtained from the turbidity method showed a good agreement with those obtained from the colony-counting method; the 4 antiseptics tested were povidone-iodine (PVP-I), chlorhexidine gluconate (CHG), benzalkonium chloride (BAC) and alkyldiaminoethylglycine hydrochloride (AEG). Both PVP-I and BAC had complete efficacy in 0.5 min against all isolates tested [100 isolates of S. marcescens, 103 of Klebsiella pneumoniae, 99 of Pseudomonas aeruginosa, 19 of Alcaligenes faecalis and 30 of A. xylosoxidans subsp. xylosoxydans (A. xylosoxydans)]. In contrast, the effectiveness of CHG was weak compared with PVP-I, BAC and AEG. Strong resistance against AEG was noted even after 3-min exposure in 1 isolate each of A. faecalis and A. xylosoxydans. It is concluded that the turbidity test is a simple and accurate method to evaluate susceptibility to various antiseptics and that it is suitable for a screening of a large number of strains. Among the 4 antiseptics tested, PVP-I and BAC showed a consistently high activity against all isolates, confirming PVP-I and BAC to be clinically useful antiseptics.
Prevention of Respiratory Infections by Povidone-Iodine Gargle
Authors: Nagatake Tsuyoshi , Ahmed Kamrudolin , Oishi Kazunori
Published: April 2003

Bacterial attachment to host cells is the initial step in the pathogenesis of infection. Our studies and those of others also showed that there is a significant correlation between the attachment of bacteria to human pharyngeal epithelial cells and the occurrence of respiratory tract infections. We identified the receptor on human pharyngeal epithelial cells which mediate binding of Moraxella catarrhalis and Haemophilus influenzae. In an attempt to prevent occurrence of infections, the effects of povidone-iodine gargling on the incidence of respiratory infections were investigated. The subjects included a total of 23 adult patients, both males and females, with chronic respiratory diseases showing repeated infections. Patients were asked to gargle more than 4 times/day with povidone-iodine gargle over extended periods of time, i.e. from several months up to over 2 years. The incidence of episodes of acute exacerbation of chronic respiratory infections decreased significantly when compared with that before use of povidone-iodine gargle. Episodes of infections with Pseudomonas aeruginosa, Staphylococcus aureus (including MRSA) and H. influenzae were reduced by about 50%. Results of this study suggest that povidone-iodine gargle is effective in providing a significant reduction in the incidence of acute exacerbations of chronic respiratory disease. We assume that the colonized bacteria were destroyed and thus infection could not occur. Therefore, povidone-iodine gargle may be used in these patients as a preventive therapy. Further studies are needed to find out the mechanism of action of this drug for the prevention of respiratory tract infections.
Skin Disinfection before Epidural Catheterization: Comparative Study of Povidone-Iodine versus Chlorhexidine Ethanol
Authors: Kasuda Haruyuki , Fukuda Hirokazu , Togashi Hideaki , Hotta Kunihisa , Hirai Yoshikazu , Hayashi Mutsumu
Published: April 2003

Background: Chlorhexidine is better than povidone-iodine for skin preparation before intravascular device insertion or blood culture collection, but it is not known whether chlorhexidine is superior in reducing the colonization of continuous epidural catheters. Methods: Patients requiring an epidural catheter for postoperative analgesia were randomly assigned to receive skin preparation with 0.5% chlorhexidine ethanol (CE group) or 10% povidone-iodine (PI group) before catheter insertion. Using surgical aseptic techniques, catheters were inserted into either the lumbar or the thoracic epidural space. Gloves used at catheter insertion, swabs of insertion site skin and the catheter tip at catheter removal were qualitatively cultured. Results: Of 70 randomly assigned patients, 62 were evaluable. The clinical characteristics of the patients and the risk factors for infection were similar in the two groups. Catheters were kept in place for 49 ± 7 h (mean ± SD). Seven cultures from gloves yielded microorganisms. In 1 case, the leak test of gloves was positive. Fifteen cultures of catheter insertion sites yielded microorganisms: 7/28 (25%) in the PI group and 8/34 (24%) in the CE group. Six cultures of catheter tips yielded microorganisms: 3/28 (11%) in the PI group and 3/34 (9%) in the CE group. As for the incidence of isolation of bacteria, no difference was seen between the two groups. In none of these 62 cases was any inflammatory reaction seen in the skin locally at catheter removal. Conclusions: The effect of 0.5% chlorhexidine ethanol is not different from that of 10% povidone-iodine in reducing catheter colonization associated with short-term epidural catheter placement.
Cloning and Characterization of the Human Lung Endothelial-Cell-Specific Molecule-1 Promoter
Authors: Tsai Jo C. , Zhang Jie , Minami Takashi , Voland Carole , Zhao Shuping , Yi Xianjin , Lassalle Philippe , Oettgen Peter , Aird William C.
Published: April 2003

Endothelial-cell-specific molecule-1 (ESM-1) is a cysteine-rich protein that is expressed primarily in endothelial cells of the lung, kidney and gut. In the present study, we have cloned and sequenced 3,888 bp of the 5′ flanking region of the human ESM-1 gene. The full-length promoter directed high-level expression of the luciferase reporter gene in bovine lung microvascular endothelial cells and bovine aortic endothelial cells, but not in nonendothelial cell types. In 5′ deletion analyses, a region spanning –81 to +58 was shown to contain information for endothelial-cell-specific expression. Mutational analysis in transient transfection assays uncovered an important role for an Ets-binding motif located between –77 and –74 and a cAMP-response-element (CRE)-like motif located between –68 and –62 in mediating high-level expression in endothelial cells. A second Ets site (–63 to –60) as well as a novel 6-bp palindromic sequence (–58 to –53) were found to inhibit expression. In DNase footprint analyses, both the Ets-binding motifs were protected specifically in endothelial cells, while the CRE-like element and palindrome were protected in endothelial and nonendothelial cells alike. Taken together, these results provide an important foundation for studying endothelial-cell-subtype-specific gene regulation.
Minimal Intervention in Dental Care
Authors: Sheiham Aubrey
Published: April 2003

High-quality appropriate dental care should encompass the concepts of effectiveness and efficiency. Many dental procedures are ineffective, and some preventive measures are inefficient. Examples of criteria that are ethically essential to use before carrying out any clinical procedure are outlined based on the concepts included in ‘informed consent’. Applying the criteria rigorously will lead to minimal intervention and a more equitable distribution of appropriate dental care. Unnecessary dental care will be reduced.
Mucous Glands in the Middle Ear – What Is Known and What Is Not
Authors: Tos Mirko , Caye-Thomasen Per
Published: April 2003

A review of acquired and lacking knowledge on mucous glands in the human middle ear is presented. Investigations on whole-mount and section preparations from fetuses, prematures and infants, normal and slightly abnormal children and adults are reviewed in detail. It is concluded that mucous glands are not a normal, but a pathological component of the middle ear mucosa. Gland formation and degeneration are described. Theories on pathogenesis are discussed and new ideas for further research are indicated.
Otorhinolaryngology through the Works of Hippocrates
Authors: Manolidis L.S.
Published: April 2003

This retrospective survey referes to the philosophers and first scientists of the pre-Hippocratic era, which included the foundation of schools in Greece at the time (e.g. Ionia, South Sicily, Kyrinia). During the ensuing Hippocratic era the foundations of medicine as a science were laid. The concepts developed by Hippocrates and his school are set out in the Corpus Hippocraticum. In many sections of this work reference is made to diseases of the ear, nose, larynx, head and neck. It is difficult no to be impressed by the fact that many of the diagnoses and therapies are not very dissimilar to contemporary approaches. The notion that Hippocrates, Father of Medicine, gave meaning to otorhinolaryngology is also discussed here.
A Historical Vignette: Red-Hair Medicine
Authors: Veldman Jan E.
Published: April 2003

Since 1650 Dutch medical doctors have played a key role in teaching western medicine in Japan. Two hundred years later, Dutch naval surgeons, trainees of the College of Army Surgeons in Utrecht, The Netherlands, became together with their Japanese students the founding fathers of the University Medical Faculties of Nagasaki, Tokyo and Osaka. The Deshima settlement surgeons Engelbert Kaempfer and Philipp Franz von Siebold (of German decent) were of great importance for our knowledge of Japan in the 18th and 19th century.
Cholinergic Urticaria, a New Pathogenic Concept: Hypohidrosis due to Interference with the Delivery of Sweat to the Skin Surface
Authors: Kobayashi Hiromi , Aiba Setsuya , Yamagishi Tomoo , Tanita Muneo , Hara Masahiro , Saito Hiroshi , Tagami Hachiro
Published: April 2003

Background: Acetylcholine has been suspected to be a pathogenetic factor for cholinergic urticaria (CU), without definite evidence. In contrast, there are scattered reports of CU associated with acquired generalized hypohidrosis. We have recently examined 2 patients with CU in both of whom we noticed the presence of extensive hypohidrosis that occurred only in winter. Objective: In these 2 patients, acquired hypohidrosis due to superficial obstruction of the acrosyringium was suspected as the cause. Both case 1, a 22-year-old Japanese man, and case 2, a 21-year-old Japanese man, began to have anhidrosis and numerous red macules on their body whenever they felt hot in winter. These symptoms ceased to appear in summer. Methods: We studied histologically their lesional skin in addition to provocation tests for CU. Results: The diagnosis of CU was confirmed by the provocation of typical wheals after physical exercise in both cases. Histological study revealed findings suggestive of the presence of occlusion of the superficial acrosyringium. Conclusion: We think that such a hypohidrosis due to occlusion of superficial sweat ducts may also play a role in many other patients with CU of unknown etiology that becomes exacerbated in winter when sweating is not a frequent event.
A Proposed Set of New Guidelines for Routine Blood Tests during Isotretinoin Therapy for Acne vulgaris
Authors: Altman Rachel S. , Altman Lawrence J. , Altman Jeffrey S.
Published: April 2003

Background: Isotretinoin has been proven to be an effective treatment for acne vulgaris. The enclosed package insert with isotretinoin suggests weekly/biweekly laboratory testing (hepatic functions and lipid analysis) but fails to recommend the needed action levels for abnormalities. Methods: We provide a statistical analysis of a retrospective study of 141 individuals’ course of therapy on isotretinoin and their laboratory blood analysis results. Results: Very few statistically significant elevations in liver enzymes or lipid profiles occurred. More importantly, in only 1 case did these elevations warrant the discontinuation of therapy. Conclusion: The data presented here support the conclusion that limited blood testing should be performed for most patients and that more complete blood testing be done only for those patients with a significant response in liver enzymes, cholesterol or triglycerides. A set of guidelines is proposed for the practicing physician to interpret blood test results.
Autoantibodies to Amphiphysin I and Amphiphysin II in a Patient with Sensory-Motor Neuropathy
Authors: Perego L. , Previtali S.C. , Nemni R. , Longhi R. , Carandente O. , Saibene A. , Sciolla R. , Villa A. , Gai P. , Panzeri C. , Dell’Antonio G. , Quattrini A. , Folli F.
Published: April 2003

A proportion of patients with peripheral neuropathies has circulating autoantibodies directed against neural antigens. In some cases, autoantibodies may play a pathogenic role. We studied a patient with a progressive sensory-motor axonal neuropathy of unknown etiology, looking for circulating autoantibodies against neural antigens and we showed that the patient’s serum contained anti-amphiphysin I (AMP I) and amphiphysin II (AMP II) autoantibodies. A sural nerve biopsy revealed an axonal neuropathy. Indirect immunofluorescence experiments with the patient’s serum showed a staining of rat axons due to α-AMP I autoantibodies and a specific labelling of cytoplasm and Schmidt-Lanterman incisures of Schwann cells due to α-AMP II autoantibodies. In conclusion we identified a patient affected by a sensory-motor neuropathy with autoantibodies against both AMP I and AMP II.
Emerging Issues in Speech Therapy in Iran
Authors: Nilipour Reza
Published: April 2003

This report is a short review of the form and content of speech and language therapy services and the trend of their institutionalization in Iran. A summary of formal education in speech and language therapy in Iran as originated by establishing a 4-year BS rehabilitation program in the College of Rehabilitation Sciences in Tehran is given. Since then, speech and language rehabilitation programs have been expanding both in size and quality, resulting in about 1,000 speech therapists practicing in hospitals and rehabilitation centers throughout the country. The expansion of graduate programs at MS level in three different institutions and a prospective PhD program are also adding to the quality of these services. The content of the theory courses and clinical practice courses as well as research on specific speech and language disorders and cross-linguistic studies are briefly described.
Fluticasone Propionate Downregulates Nasal Fibroblast Functions Involved in Airway Inflammation and Remodeling
Authors: Silvestri M. , Sabatini F. , Scarso L. , Cordone A. , Dasic G. , Rossi G.A.
Published: April 2003

Background: Besides being highly effective in the treatment of allergic and nonallergic rhinitis with eosinophilia, intranasal corticosteroids appear to be useful in reducing nasal polypoid lesions and the likelihood of polyp recurrence after surgery. We evaluated the ability of fluticasone propionate to downregulate fibroblast functions related to nasal inflammation and remodeling. Methods: Primary nasal polyp tissue-derived fibroblasts were stimulated with tumor necrosis factor (TNF)-α or interleukin (IL)-4 or basic fibroblast growth factor (bFGF) in the presence of fluticasone propionate (0.1–100 nM). Fibroblast proliferation, intercellular adhesion molecule (ICAM)-1 and vascular cell adhesion molecule (VCAM)-1 expression and eotaxin release were then evaluated. Results: As compared with unstimulated cultures, a significant increase in fibroblast proliferation was observed when the cells were stimulated with bFGF (p < 0.05), but not with TNF-α or IL-4 (p > 0.05). TNF-α induced an upregulation of ICAM-1 expression (p < 0.05), which was not seen in fibroblasts cultured in the presence of IL-4 or bFGF. No changes in VCAM-1 expression were induced by TNF-α, IL-4 or bFGF, whereas both TNF-α and IL-4 increased eotaxin release (p < 0.05). Both bFGF-induced fibroblast proliferation and TNF-α-induced ICAM-1 expression were significantly reduced by fluticasone, starting at the dose of 1 and 10 nM, respectively (p < 0.05). Fluticasone at concentrations of 1–100 nM effectively inhibited eotaxin release by TNF-α- or IL-4-stimulated fibroblasts (p < 0.05). Conclusions: The pharmacologic activity of fluticasone in patients with chronic upper airway inflammatory disease may include inhibition of resident fibroblast functions involved in airway inflammation and remodeling.
Postural Control Measured by Visual Feedback Posturography
Authors: Hirvonen Timo Petteri , Hirvonen Meeli , Aalto Heikki
Published: April 2003

The objective was to study the applicability and repeatability of visual feedback posturography (VFP) in assessing postural control of 23 healthy subjects. The subjects had to move their center of gravity (COG) marker on a computer screen to chosen targets by leaning their body on the platform, and the accuracy, velocity, and side difference of these movements were measured. The intraclass correlation coefficients for all parameters during repeated tests were significant (r = 0.93–0.96; p < 0.01). Hold percentage within the targets and COG marker velocity to the targets did not change significantly during repeated tests. Balance index and hit delay were significantly smaller during the 4th and 5th than during the 1st test session (p < 0.05), but they did not change significantly between the other test sessions. The normative limit for side difference in postural control was 22%. VFP can be used to follow active postural control due to its high test-retest repeatability. However, learning effects in some parameters must be taken into account when applying VFP repeatedly in different patient populations to assess the progress in postural control.
Neurofibroma in the Mastoid Segment of the Facial Canal
Authors: Klingebiel Randolf , Djamchidi Cyrus , Harder Anja , Lehmann Rüdiger , Jahnke Volker
Published: April 2003

Neural tissue-derived facial nerve tumours usually present as neurinomas. We describe the extremely rare occurrence of a histologically verified neurofibroma primarily arising in the mastoid segment of the facial canal in a patient not fulfilling diagnostic criteria for neurofibromatosis. The tumour showed evidence of perineural growth into the jugular foramen, as suggested by cross-sectional imaging and intraoperative findings.
Follicular Dendritic Cell Tumor of the Cervical Lymph Node
Authors: Hangai Kimihiko , Nonaka Satoshi , Iwakiri Hiromasa , Kobayashi Yoshifumi , Hayashi Tatsuya , Harabuchi Yasuaki , Miyokawa Naoyuki
Published: April 2003

Follicular dendritic cell (FDC) tumor is an uncommon sarcoma, which occurs in lymph nodes or in extranodal sites. A 61-year-old female was referred to our hospital because of a nontender mass on her neck. The mass was surgically removed and initially diagnosed as a metastasis of malignant fibrous histiocytoma (MFH). Because the subsequent progress was inconsistent with the common prognosis of a patient with MFH, the possibility of FDC tumor was taken into consideration. Immunohistological studies for FDC antigens, such as CD21 and CD35, led to final diagnosis. It is suggested that FDC tumor should be included in the diagnostic considerations when a spindle cell tumor is present in a lymph node.
Rhabdomyosarcoma of the Adult Nasopharynx
Authors: Kanagalingam J. , Medcalf M. , Courtauld E. , Clarke P.M.
Published: April 2003

Rhabdomyosarcoma of the adult head and neck is rare, particularly beyond 40 years of age. In this region, the nasopharynx is an unusual site. Most nasopharyngeal rhabdomyosarcomas are of an alveolar variety. We report a case of embryonal or spindle cell rhabdomyosarcoma in the nasopharynx of a 47-year-old man. The histology of this tumour revealed clear cells that have not been described in embryonal rhabdomyosarcomas occurring in the head and neck. The pathology is discussed and current literature reviewed.
Involvement of Phenotypes and Serum Levels of Haptoglobin in the Outcome of in vitro Fertilization and Embryo Transfer
Authors: Ueda Kayoko , Yamamasu Seiichi , Nakamura Yoshihiro , Honda Ken-ichi , Ozaki Koji , Fujino Yuji , Ishiko Osamu , Ogita Sachio
Published: April 2003

Haptoglobin (Hp) possesses many functions in the immune system and angiogenesis as well as scavenging released hemoglobin, and thus it is speculated that Hp may also play a critical role in the reproductive process. To investigate the possible involvement of Hp in the outcome of in vitro fertilization and embryo transfer (IVF-ET), the serum Hp of 50 patients who underwent IVF-ET was analyzed by the Western blot method. The results showed a higher pregnancy rate in the patients with the Hp2-2 phenotype (38%) than in those with the Hp2-1 phenotype (16%) (p = 0.08), and the serum α2 subunit levels in the patients who achieved pregnancy within four attempts at IVF-ET were higher than in the others (p < 0.05). The results of this study suggest that Hp is involved in the outcome of IVF-ET.
Long-Term Results of Burch Colposuspension
Authors: Demirci Fuat , Yucel Oguz , Eren Sadiye , Alkan Akif , Demirci Elif , Yildirim Uzay
Published: April 2003

The study included 220 women who had undergone Burch colposuspension. Group I (65 women) was studied prospectively and the mean follow-up was 1.5 years. Group II (155 women) was studied retrospectively and the mean follow-up was 4.5 years. The cure rate was 87.7% in group I and 77.4% in group II. The cure rate was significantly higher following the primary procedure than the secondary procedure. At follow-up, late complications in 220 women were: cystocele in 18; rectocele in 32; enterocele in 35; dyspareunia in 6, and groin or suprapubic pain in 15. In group I, of the 11 women with detrusor instability preoperatively, 10 were cured and in 1 detrusor instability persisted postoperatively. Two women had de novo detrusor instability. In conclusion, the cure rate of Burch colposuspension is satisfactory, although it declines a little with time. Women who had previous anti-incontinence surgery have a greater probability of recurrence. The procedure elevates the bladder neck into the abdominal cavity and stabilizes it. Surgical failure is related to inadequate elevation and stabilization of the bladder neck.
Potential Role of β1 Integrin and Collagen Biosynthesis in Estrogen-Dependent Reduction of Apoptosis in Tamoxifen-Treated Breast Cancer Cells
Authors: Dabrowska Milena , Palka Jerzy , Wolczynski Slawomir , Pietruczuk Miroslawa , Osada Joanna
Published: April 2003

It was found that 10 µM tamoxifen induced apoptosis and a significant (approximately 50%) depletion of β1 integrin levels in human breast cancer cells. Estradiol-treated MCF-7 cells exhibited exceptional viability and adherence, high levels of β1 integrin and increased (by 100%) collagen biosynthesis. Pretreatment of MCF-7 cells with 1 nM estradiol prevented tamoxifen-induced cell death, loss of cell adherence and decrease in β1 integrin level. Tamoxifen and estradiol had an opposite effect on the β1 integrin level and adherence in breast cancer cells, suggesting that the decrease in the β1 integrin level may be an early event during tamoxifen-induced apoptosis in breast cancer cells.
Connexins and Gap Junctions in the Inner Ear
Authors: Forge Andrew , Becker David , Casalotti Stefano , Edwards Jill , Marziano Nerissa , Nickel Regina
Published: April 2003

Mutations in the genes for three different isotypes of the gap junction channel protein connexin are associated with deafness. This indicates an important role for gap junctions in auditory function and provides an opportunity to explore structure-function relationships in the connexin molecule. We have been examining the distribution of gap junctions and the pattern of connexin expression in the mature inner ear and during development, and the effect of specific mutations on the processing and functionality of the expressed connexin proteins in an in vitro system.
From Gene Identification to Gene Therapy
Authors: Kanzaki Sho , Kawamoto Kohei , Oh Seung-Ha , Stöver Timo , Suzuki Mitsuya , Ishimoto Shinichi , Yagi Masao , Miller Josef M. , Lomax Margaret I. , Raphael Yehoash
Published: April 2003

Inner ear disease due to hair cell loss is common, and no restorative treatments for the balance and hearing impairment are currently available. To develop clinical means for enhancing protection and regeneration in the inner ear, it is necessary to understand the molecular basis for hereditary and acquired deafness and vestibular disorders. One approach is to identify and characterize genes that regulate protection or repair in other systems. For that purpose, we have used the differential display assay and compared gene expression between normal and acoustically traumatized inner ears of chicks. Several chick cDNAs that were identified are considered as candidates for roles in the reparative process that follows trauma in the basilar papilla. The mammalian vestibular epithelium has a limited regenerative capability. To identify genes that may participate in the regenerative response, we have used gene arrays profiling, comparing normal to drug-traumatized vestibular epithelia. We identified several genes that are differentially expressed in traumatized vestibular epithelium, including several insulin-like growth factor-I binding proteins. To use this molecular knowledge for enhancing protection and repair in the organ of Corti, it is necessary to overexpress the genes of choice in the inner ear. Using viral-mediated gene transfer, we overexpressed transgenic glial cell line-derived neurotrophic factor and demonstrated a robust protective effect against acoustic and ototoxic inner ear trauma. Future identification of the genes that are important for protection and regeneration, along with improved gene transfer technology, will allow the use of gene therapy for treating hereditary and environmental inner ear disease.
Increased Blood-Brain Barrier Permeability in White Matter Lesions of Binswanger’s Disease Evaluated by Contrast-Enhanced MRI
Authors: Hanyu Haruo , Asano Tetsuichi , Tanaka Yuriko , Iwamoto Toshihiko , Takasaki Masaru , Abe Kimihiko
Published: April 2003

We investigated blood-brain barrier (BBB) permeability in white matter lesions of Binswanger’s disease (BD) with contrast-enhanced MRI. Three subject groups were studied: 17 patients with BD and periventricular hyperintensities (PVH) on MRI, 10 patients with ischemic cerebrovascular events and with PVH but no dementia, and 14 age-matched control subjects without PVH. BBB permeability was quantified by calculation of T1 change defined as [(T1post – T1pre)/T1pre] ×100, where T1pre and T1post represent the T1 relaxation times before and after Gd-DTPA administration. T1 change in PVH of BD patients significantly decreased in comparison with that observed in PVH of the nondemented patients and in normal white matter of the control subjects, but no significant T1 change was observed between the PVH of the nondemented patients and normal white matter of the controls. There was a significant correlation between the Mini-Mental State Examination score and T1 change for areas of PVH in BD. These results suggest that BBB permeability increases in areas of PVH in BD and that a BBB dysfunction is related to a progression of cognitive impairment.
Corticosteroids of Clinical Value in Lipid-Soluble-Chemical-Induced Irritation in Man?
Authors: Levin Cheryl , Zhai Hongbo , Maibach Howard I.
Published: April 2003

Background: Topical corticoids are used to treat irritant contact dermatitis (ICD) in man. However, their clinical efficacy remains sub judice. Objective: The effects of corticosteroids on lipid-soluble-chemical-induced ICD in man were studied. Methods: ICD was induced by 24-h patch application of nonanoic acid (NAA) onto volunteers’ forearms. Betamethasone-17-valerate, hydrocortisone and petrolatum control were applied twice daily. Visual grading, transepidermal water loss (TEWL), laser Doppler flowmetry (LDF) and chromametry quantified responses on days 1–5 and 8. Results: On day 8, with 90% NAA, a slight, yet significant improvement in TEWL was observed with betamethasone when compared to untreated control. Betamethasone also significantly decreased chromametric values on day 8 with 90% NAA when compared to hydrocortisone. Petrolatum reduced LDF values when compared to untreated control at 60% NAA on day 3. Conclusion: The results suggest a slight improvement with betamethasone and petrolatum though their benefit in typical clinical use remains unclear.
Colonic Transit Time in Diabetic and Nondiabetic Long-Term Care Patients
Authors: Ron Yishai , Leibovitz Arthur , Monastirski Nechama , Habot Beni , Segal Rephael
Published: April 2003

Background: Constipation is a frequent health concern for elderly people. The increased incidence of constipation with age is mainly based on self-reported data. Only a few studies have examined this problem objectively and even fewer have carried this out in the special subpopulation of frail elderly patients. Objective: The aim of this study was to examine colonic transit time (CTT) in frail elderly patients. We also attempted to compare CTT in diabetics and nondiabetics within this population. Methods: 45 frail elderly patients, all immobile with and without diabetes mellitus, residing permanently in long-term geriatric departments were recruited for the study. All patients underwent segmental and total CTT studies using radiopaque markers. The segmental CTT was calculated separately for the four segments of the colon (ascending, transverse, descending, and rectosigmoid) and for the total transit time which was the sum of all four segments. Results: The average CTT was extremely prolonged in all patients included in this study. In the diabetics the CTT was even longer with a mean total transit time of 200 ± 144 h as compared with 143 ± 95 h in the controls. The difference was not statistically significant. For each segment tested, the CTT was shorter in the control group, but these differences did not reach statistical significance. Conclusions: The CTT is prolonged in immobile frail elderly patients. No significant differences were noted between diabetic and nondiabetic patients.
Timed Instrumental Activities of Daily Living Tasks: Relationship to Cognitive Function and Everyday Performance Assessments in Older Adults
Authors: Owsley Cynthia , Sloane Michael , McGwin Jr. Gerald , Ball Karlene
Published: April 2003

Background: We live in a world where information is presented in a time-limited fashion and successful adaptation is dependent on time-limited responses. Slowed visual-processing speed is common among older adults. Its impact on everyday task performance is not clearly understood. Objective: The goal was to determine whether visual-processing speed, as well as memory and inductive reasoning, are independently associated with the time required by older adults to complete instrumental activities of daily living typical of everyday life. Methods: Five timed instrumental activities of daily (TIADL) tasks were administered to 173 older adults (ages 65–90 years) along with assessments of visual-processing speed, memory, and inductive reasoning. The dependent variable was the time required to perform the task (e.g., finding a telephone number, making change, finding and reading the ingredients on a can of food, finding food items on a shelf, reading instructions on medicine container). Medical and functional comorbidities known to affect task performance were measured in order to adjust for their impact on the dependent variable. Other measures of everyday task competence (Everyday Problems Test, Observed Tasks of Daily Living, questionnaire on IADL difficulties) were also administered in order to determine to what extent existing measures of everyday performance are associated with TIADL performance. Test-retest reliability of the TIADL score was assessed in a separate sample. Results: Although memory and reasoning were crudely related to the time needed to perform the TIADL tasks, only processing speed was independently associated with TIADL scores. Those older adults with slow processing speed were more likely to require longer times to complete everyday tasks. Previously developed measures of everyday task competence (e.g., Everyday Problems Test, Observed Tasks of Daily Living) based on accuracy scoring did not strongly predict TIADL performance. Conclusion: These results suggest a unique role for an everyday competence test that focuses on the timely completion of everyday tasks, rather than on an assessment of accuracy alone. TIADL measures may prove useful in evaluating the everyday effectiveness of cognitive interventions targeted at increasing information-processing speed.
Gestational Diabetes mellitus and Neonatal Hyperthyrotropinemia
Authors: Lao Terence T. , Lee Chin-Peng
Published: April 2003

Objective: To determine whether gestational diabetes mellitus (GDM) is associated with increased incidence of neonatal hyperthyrotropinemia. Study Design: In a retrospective study, maternal characteristics, infant outcome and cord blood thyrotropin (TSH) concentration were compared between 469 diet-treated GDM pregnancies diagnosed by the World Health Organization 75 g oral glucose tolerance test (OGTT) with 474 non-diabetic pregnancies with normal OGTT results. Results: Hyperthyrotropinemia (TSH >16 mIU/l) was found in 7.2% of the GDM pregnancies and 2.1% of the controls (p < 0.001), but there was no difference in the birth weight or gestational age. The TSH concentration was correlated with the OGTT 2-hour glucose value (ρ = 0.0948, p = 0.029) and Apgar score at the fifth minute (ρ = –0.1197, p = 0.009). There was no difference in the TSH or free thyroxine concentrations between the hyperthyrotropinemic newborns of the GDM and control groups. In the GDM group, the hyperthyrotropinemic newborns had a higher incidence (p = 0.017) of neonatal jaundice. Conclusions: Neonatal hyperthyrotropinemia is more frequently found in pregnancies with GDM, and this could have reflected increased fetal in-utero hypoxic stress in these pregnancies.
Sexual Activity, Orgasm and Tampon Use Are Associated with a Decreased Risk for Endometriosis
Authors: Meaddough Erika L. , Olive David L. , Gallup Peggy , Perlin Michael , Kliman Harvey J.
Published: April 2003

Objective: The purpose of the study was to determine if sexual behaviors, orgasm, tampon use, and douching during menstruation modify the risk of endometriosis. Methods: A case-control study was conducted. Subjects (n = 2,012) consisted of members of the Endometriosis Association and friends not affiliated with the organization who completed mailed surveys. Data were analyzed using χ2, Fisher’s exact test, t test, and regression analyses. Results: There was no difference between study groups concerning douching practices. However, cases were less likely than controls to report sometimes or often engaging in sexual behaviors during menstruation (p = 0.002, OR = 1.5), and sexual behaviors during menstruation that included orgasm (p = 0.001, OR = 1.5). Cases were also less likely than controls to report using only tampons (p < 0.0001, OR = 2.6). Conclusion: Sexual activity, orgasm, and tampon use during menstruation may confer protection against endometriosis.
Urinary Albumin as an Indicator of Diabetic Nephropathy Lesions in Japanese Type 2 Diabetic Patients
Authors: Moriya Tatsumi , Moriya Rika , Yajima Yoshitada , Steffes Michael W. , Mauer Michael
Published: April 2003

Caucasian type 2 diabetic patients with microalbuminuria (MA) or overt nephropathy (ON) show greater heterogeneity of renal lesions than type 1 diabetic patients. We examined whether a similar situation exists in 30 Japanese type 2 diabetic patients [21 male, age 48 ± (SD) 8 years, known duration 11 ± (SD) 8 years] without definable renal disease other than diabetic nephropathy. Six patients were normoalbuminuric (NA), 11 MA, and 13 had ON. Normal controls were 9 age-matched Japanese living-related renal transplant donors. Electron microscopic morphometry was performed on renal biopsy specimens and related to renal function. Glomerular basement membrane width and mesangial fractional volume [Vv(Mes/glom)] were increased in all type 2 diabetic patients groups (NA, MA, ON) as compared with normal controls. The Vv(Mes/glom) correlated directly with urinary albumin/creatinine. However, Vv(Mes/glom) as well as glomerular basement membrane width overlapped among the three functional categories (NA, MA, ON) and normal controls. In conclusion: (1) similar to Caucasian type 2 diabetic patients, Japanese type 2 diabetic patients have greater heterogeneity of renal structure than Caucasian type 1 diabetic patients, and (2) urinary albumin is not a reliable indicator of underlying renal structure in Japanese type 2 diabetic patients.
Ninth Cranial Nerve Stimulation for Epilepsy Control
Authors: Tubbs R. Shane , Patwardhan Ravish V. , Oakes W. Jerry
Published: April 2003

Objective: To determine the anatomical and surgical feasibility of placement of a stimulator around the nerve of Hering (HN; a branch of cranial nerve nine). We previously determined the success of HN stimulation in controlling epileptiform activity in a canine model study. The present study assessed the ability to extrapolate the ease of surgical dissection and surrounding anatomy to humans. Methods: Fifteen human cadavers (8 male, 7 female) were studied. The HN on each side was specifically evaluated in each specimen with respect to its presence, size, surgically accessible length below the mandibular angle, relationship to the internal carotid artery (ICA) and carotid bifurcation and relation to the common facial vein (CFV), thyroid cartilage (superior edge) and superior cervical ganglion (SCG). Results: All 15 cadavers exhibited specimens of HN bilaterally, with the nerve diameter ranging from 0.5 to 1.5 mm (mean 1.0 mm); in relation to the ICA, the HN coursed anteromedially in 60%, anteriorly in 33% and anterolaterally in 7% of cases, and appeared to distinctly emerge at the level of the carotid bifurcation in all specimens. The surgically accessible length below the mandibular angle ranged from 6 to 30 mm (mean 15 mm). Relative to the carotid bifurcation, the superior edge of the thyroid cartilage was –35 to 33 mm (mean –5.4 mm) above; the CFV, which was clearly identifiable in only two thirds of the specimens, was –10 to 15 mm (mean 3.0 mm) above; and the inferiormost portion of the SCG was 6–30 mm (mean 16.6 mm) above. Conclusion: This study indicates that the HN was clearly present and surgically accessible in all human specimens. Based on the present study and our previous canine study, HN stimulation could be an important therapy for medically intractable epilepsy.
Oncocytic Paraganglioma of the Cauda Equina in a Child
Authors: Park Dong Hyuk , Park Youn Kwan , Oh Jae In , Kwon Taek Hyun , Chung Hung Seob , Cho Hyun Deuk , Suh Yeon Lim
Published: April 2003

The authors report a case of oncocytic paraganglioma of the cauda equina in a 12-year-old girl who presented with lower back and leg pain on the right side of 6 months’ duration. Magnetic resonance imaging revealed an ellipsoidal, intradural, extramedullary mass causing cord compression at the level of L1. Total laminectomy was performed on T12 and L1, and the tumor was excised completely without difficulty despite adherence of the tumor to the spinal cord. Postoperatively, the leg pain and motor weakness were much improved. The use of electron microscopy, and the immunohistochemical demonstration of synaptophysin in this tumor, allowed a confident diagnosis of an oncocytic paraganglioma to be made. To the authors’ knowledge, this patient represents the first definite case of an oncocytic paraganglioma of the cauda equina in a child.
Estrogens, Testosterone and Sex Hormone Binding Globulin in Relation to Liver Cancer in Men
Authors: Kuper Hannah , Mantzoros Christos , Lagiou Pagona , Tzonou Anastasia , Tamimi Rulla , Mucci Lorelei , Benetou Vassiliki , Spanos Evangelos , Stuver Sherri O. , Trichopoulos Dimitrios
Published: April 2003

Objective: Liver disease in men has been associated with an imbalance of serum estradiol and testosterone. We have evaluated whether serum estradiol and testosterone levels are altered in male liver cancer patients as a result of a specific effect of the disease or because of the associated liver damage. Methods: We have performed a hospital-based case-control study in Greece. The study subjects were all men; 73 patients with hepatocellular carcinoma (HCC), 25 with metastatic liver cancer (MLC) patients and 111 control subjects. Serum estradiol, testosterone and sex hormone binding globulin (SHBG) levels were measured for each subject. Data were analyzed by multiple linear regression. Results: Mean serum estradiol levels were significantly higher among HCC patients as well as among patients with MLC compared to controls. Mean serum testosterone levels were significantly lower among HCC patients as well as among patients with MLC compared to controls. The mean SHBG levels did not differ significantly between the groups. After controlling for the degree of liver damage, the elevated serum estradiol and reduced serum testosterone levels among HCC and MLC patients were no longer significant. Conclusions: Changes in sex steroid levels among patients with liver damage are due to the liver damage per se and not to specific disease processes.
A Role for Hypothalamic Astrocytes in Dehydroepiandrosterone and Estradiol Regulation of Gonadotropin-Releasing Hormone (GnRH) Release by GnRH Neurons
Authors: Zwain Ismail H. , Arroyo Armando , Amato Paula , Yen Samuel S.C.
Published: April 2003

Molecules of astrocyte origin influence gonadotropin-releasing hormone (GnRH) release and GnRH neuronal growth and differentiation. Furthermore, type 1 astrocytes express steroid receptors, presenting the possibility that steroid actions on GnRH neurons might occur via astrocytes. Utilizing GT1–7 cells, a GnRH-secreting cell line, the present study demonstrates that astrocytes mediate dehydroepiandrosterone (DHEA) or estradiol (E2) stimulated GnRH secretion. Conditioned media (CM) from astrocytes cultured for 48 h alone, with DHEA (DHEA-CM), or with E2 (E2-CM) were collected, treated with charcoal to remove steroids, and added to GT1–7 cells in culture for 12 h to test the effect on GnRH secretion. DHEA-CM and E2-CM stimulated GnRH secretion by GT1–7 cells by 4- and 3-fold, respectively. The effect of DHEA-CM on GnRH secretion by GT1–7 cells appears to be related to both DHEA and its metabolite, E2, since blocking the metabolism of DHEA into estrogen in the DHEA-treated astrocytes partially reversed the stimulatory effect of DHEA-CM. Addition of transforming growth factor (TGF)-β1-neutralizing antibody to the astrocyte cultures reversed the stimulatory effects of both DHEA-CM and E2-CM on GnRH secretion by GT1–7 cells, suggesting that TGF-β1 derived from astrocytes may be the principle mediator of E2 and DHEA effects. These data provide evidence for a novel mechanism by which circulating steroids and/or neurosteroids may modulate GnRH secretion.
Prognostic Evaluation of Preoperative Thermochemoradiotherapy for N3 Cervical Lymph Node Metastases of Oral Cancer
Authors: Tohnai Iwai , Hayashi Yasushi , Mitsudo Kenji , Shigetomi Toshio , Ueda Minoru , Ishigaki Takeo
Published: April 2003

Objective: The purpose of this study was to evaluate the clinical efficacy, histopathological efficacy, and response to preoperative thermochemoradiotherapy for N3 cervical lymph node metastases of oral cancer. Methods: Preoperative thermochemoradiotherapy was performed in 8 patients with oral cancer and N3 cervical lymph node metastasis. These patients underwent four-weekly sessions of hyperthermia, combined with radiotherapy (40 Gy) as well as chemotherapy with cisplatin (CDDP; 100 mg/m2), all prior to surgery. Radical neck dissection was performed 4 weeks after completion of preoperative thermochemoradiotherapy. Results: The preoperative treatment of cervical lymph node metastases yielded a partial response in 6 patients, while 2 patients demonstrated no change. Histopathologically, grade III was detected in 1, grade IIb in 4 and grade IIa in 3 patients after surgery, according to the criteria of Shimosato. The follow-up period ranged from 13 to 64 months (mean 34). Of the 8 patients, 2 died (1 of lymph node metastasis and 1 had metastasis to a distant site), and 6 patients were alive at the last follow-up, with the longest postoperative disease-free survival being 63 months. The 5-year cumulative survival rate was 70.0%. Conclusion: These results indicate that preoperative thermochemoradiotherapy is a promising modality for patients with N3 cervical lymph node metastasis of oral cancer.
Pattern Visual Evoked Cortical Potentials Predict Postoperative Visual Acuity after Cataract Surgery in Patients with Glaucoma
Authors: Hanawa Tadao , Fujimoto Naoya , Miyauchi Osamu , Adachi-Usami Emiko
Published: April 2003

Visual acuity after cataract surgery in patients with glaucoma cannot be predicted accurately. We studied preoperative recordings of pattern visual evoked cortical potentials (PVECPs) to evaluate postoperative vision in patients with glaucoma and cataract. Fifty patients with glaucoma and no cataract and 31 patients with glaucoma and cataract who underwent phacoemulsification were included in this study. Age and P100 component significantly correlated with postoperative visual acuity with multiple linear regression analysis. A significantly greater number of patients with glaucoma, cataract, and a P100 component preoperatively showed a visual acuity of 0.7 or better postoperatively, as compared to those without a P100 component. PVECP before cataract surgery was able to predict postoperative good visual acuity in patients with glaucoma and cataract.