bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Cisapride on Gastric Emptying in Patients with Gastro-Oesophageal Reflux Disease
Authors: Koruk M , Yildirim M , Onuk MD , Varoğlu E
Published: February 2013

To investigate the effect of cisapride in gastro-oesophageal reflux disease (GERD), gastric emptying time, measured using scintigraphy, and reflux symptoms were compared before and after cisapride therapy in 30 patients with endoscopically proven GERD. Gastric emptying time was also measured in 20 age-matched controls. Patients with GERD were treated with 30 mg cisapride orally three times daily for 7 days. Gastric emptying time was significantly reduced following cisapride therapy in 28 of these patients (71.6 ± 18.1 min versus 57.9 ± 13.9 min), although it was still longer than the gastric emptying time of the control group (i.e. 46.2 ± 8.1 min). In addition, cisapride relieved heartburn, which is a representative symptom of GERD. These findings suggest that cisapride may be useful in treating reflux symptoms and oesophagitis in patients with GERD.
Autologous Peripheral Stem-Cell Transplantation after Intensive Chemotherapy in a Case of CD30 (Ki-1)-Positive Anaplastic Large-Cell Lymphoma
Authors: Tsuda T , Matsunami M , Nakayama K , Hara J , Sakaguchi R , Katayama N , Ota K
Published: February 2013

Simultaneous treatment with peripheral blood stem-cell (PBSC) transplantation and intensive chemotherapy was evaluated in a case of non-Hodgkin's lymphoma (NHL) with poor prognosis. A 59-year-old male diagnosed with a high-grade, anaplastic large-cell (Ki-1) NHL, involving fractures in the left hip, underwent computed tomography and gallium scintigram surveillance. The patient received chemotherapy with epirubicin hydrochloride, cyclophosphamide, vincristine and prednisolone, and the fractured hip bone was repaired following the first course of chemotherapy. After the second and third courses of chemotherapy, PBSCs were harvested and cryopreserved. The patient then received a further course of chemotherapy and PBSC transplantation was conducted using infused cells consisting of 9.63 × 106/kg CD34 cells and 2.24 × 105/kg granulocyte macrophage colony-forming units. Recovery of platelet and white blood cell counts occurred 10 and 8 days, respectively, after PBSC infusion and the patient remains well.
Efficacy of Topically Applied Glutamate-Aspartate and Pentoxifylline Solutions in Decreasing Myocardial Damage during Open-Heart Surgery in Rats
Authors: Us MH , Özkan S , Oăuş T , Acar HV , Ege T , Çakir O , Gökben M , Öztürk ÖY
Published: February 2013

During open-heart surgery, the period between cross-clamping and maintenance of homogeneous diastolic arrest is often accompanied by significant ischaemic-hypoxic injury. The topical application of glutamate-aspartate or pentoxifylline may reduce energy demands during this period and thus prevent myocardial damage. Fifty rats were divided into five groups. In group A (control) the pericardial cavity was opened, all inlet and outlet vasculature cross-clamped, and the heart excised after 60 s. In groups B — E, the pericardial cavity was opened, all inlet and outlet vasulature cross-clamped for 60 s (groups B and D) or 90 s (groups C and E), and the pericardial cavity filled with glutamate-aspartate solution (groups B and C) or pentoxifylline solution (groups D and E) for 2 min. Following clamping, blood was withdrawn from the right atrium for biochemical analysis, and the heart excised for histological analysis. Histopathological and biochemical analysis showed a significant reduction in ischaemic-hypoxic cardiac injury in rats treated with topically applied glutamate-aspartate or pentoxifylline.
Transthoracic Colour Doppler Ultrasonography in the Evaluation of Internal Thoracic Artery Bypass Graft Patency
Authors: Catalyurek H , Karabay O , Silistreli E , Acikel U
Published: February 2013

The internal thoracic artery (ITA) is the most important conduit for coronary artery bypass grafting. The quality of the anastomosis joining the ITA to the left anterior descending coronary artery has a major impact on left ventricular perfusion. The rapid detection of flow disturbances due to sub-optimal anastomosis is, therefore, of great prognostic significance. In this study, 47 coronary bypass patients were examined using colour Doppler ultrasonography peri-operatively and 4–6 months post-operatively. Findings were correlated with clinical observations and a treadmill exercise test. The pre-operative ITA flow pattern was normally triphasic, but changed post-operatively to simulate the normal biphasic flow pattern of left anterior descending coronary artery. A 35-case-control group was used to compare pre-operative ITA flow characteristics. The authors conclude that Doppler parameters, clinical findings and the treadmill test can be used in combination for the routine evaluation of graft patency, and to select cases that require more invasive coronary angiography.
Comparison of the Effects of Hypertonic Saline and Crystalloid Infusions on Haemodynamic Parameters during Haemorrhagic Shock in Dogs
Authors: Us MH , Özkan S , Oral L , Oăuş T , Acar HV , Çakir O , Keskin Ö , Top C , Gökben M
Published: February 2013

Haemorrhagic shock, a leading cause of mortality, frequently accompanies cardiac interventions. The administration of small volumes of hypertonic saline solutions and crystalloid solutions may reduce the severity and duration of shock, and result in a decrease in adverse outcomes. Under general anaesthesia, hypotension was induced in 12 healthy dogs. After 30 min, dogs received either hypertonic saline solution or lactated Ringer's solution for fluid resuscitation. In both groups, decreases in haemodynamic variables were observed during the shock period. Following resuscitation, increases in haemodynamic variables were observed. This increase lasted longer in dogs receiving hypertonic saline. In both groups, haematocrit and oxygen content values decreased after resuscitation and lactate levels increased. During resuscitation, lactate levels decreased. Sodium and osmolarity increased with resuscitation, then subsequently decreased. In conclusion, in a model of haemorrhagic shock, the administration of hypertonic saline solutions provides haemodynamic stability and tissue oxygenation more rapidly.
Potential Fertility — Defining the Window of Opportunity
Authors: Spieler JM , Collins WP
Published: February 2013

The ClearPlan Easy™ Fertility Monitor* predicts the times of high potential fertility, i.e. the times when sexual intercourse is most likely to result in conception. The test procedure identifies the times of specified changes in the concentration of urinary hormone metabolites during each ovarian cycle. The results are displayed in terms of prior knowledge about the time-specific probabilities of conception. This paper contains a summary of the scientific background that led to the development of the ClearPlan Easy™ Fertility Monitor.
Acceptability of Home Monitoring as an Aid to Conception
Authors: Severy LJ
Published: February 2013

This paper considers the concept of consumer acceptance of medical products and its importance to successful healthcare provision. The critical dimensions (‘domains’) of acceptance for a product designed to assist family planning, and the importance of using high-quality psychometric scales to assess these domains, are discussed. Qualitative and quantitative data from acceptance studies with a personal contraceptive monitor, PERSONA™*, are presented. These data indicate that the monitor is user-friendly and acceptable to couples, and underline the importance of user acceptability for home monitors designed to assist family planning — including those used for conception purposes.
A Multicentre Study of Abdominal Aorta Diameters in a Turkish Population
Authors: Sariosmanoglu N , Ugurlu B , Karacelik M , Tuzun E , Yorulmaz I , Manisali M , Oto A , Besim A , Oto O
Published: February 2013

The aim of this study was to determine the normal values for aortic diameters and the prevalence of aortic dilatation in a mixed Turkish population. Between March 1998 and May 2000, patients who were undergoing abdominal ultrasonography examination for pathologies not involving the aorta, in three different cities, were enrolled into the study prospectively. The anterior posterior aortic diameters were measured at the subdiaphragmatic and aortic bifurcation levels using ultrasonography. A total of 596 patients were included (302 females, 294 males). The mean age was 48 ± 16 years (range, 6–88 years). The mean aortic diameter in the whole group was 19.0 ± 3.9 mm (10–45 mm) at the subdiaphragmatic level and 15.7 ± 3.6 mm (9–65 mm) at the aortic bifurcation level. The mean subdiaphragmatic aortic diameter was 18 ± 3 mm in females and 19 ± 4 mm in males. The mean aortic diameters at the bifurcation level was 15 ± 3 mm in females and 16 ± 4 mm in males. An aortic bifurcation diameter < 30 mm was encountered in 0.67% of the population. This ratio increased to 1.8% in patients over 55 years of age, regardless of sex. A subdiaphragmatic aorta diameter above 30 mm was observed in 1.2% of the population. In patients over the age of 55 years, this ratio increased to 2.7% (3.6% in males and 1.9% in females). In this national study, the subdiaphragmatic aortic diameters were similar to mean values reported in the world literature. The mean aortic bifurcation diameters were generally lower when compared with the literature, which may be due to difficulties in standardization of the measurements. Aneurysmal dilatation rates in this study also conform to those reported in studies conducted in other countries. Considering the significant number of patients with aneurysmal dilatation of the aorta in the elderly population, we believe it would be prudent to evaluate the aorta in all patients undergoing abdominal ultrasonographic examination.
The Effects of Cardiopulmonary Bypass on Androgen Hormones in Coronary Artery Bypass Surgery
Authors: Canbaz S , Ege T , Sunar H , Cıkırıkcıoglu M , Acıpayam M , Duran E
Published: February 2013

The effects of testosterone on coronary vasomotor regulation have been described by several recent reports. Here we investigated changes in serum androgen levels during and after cardiopulmonary bypass (CPB) in patients who had undergone coronary artery bypass surgery. Serum luteinizing hormone, free testosterone and dihydroepiandrestenedione sulphate (DHEA sulphate) levels were evaluated in 38 male coronary artery bypass surgery patients using a chemical immunoassay technique. All hormone levels were corrected to account for haemodilution. Serum-free testosterone level decreased significantly during weaning from CPB (from 15.7 ± 4.2 nmol/l to 6.2 ± 2.8 nmol/l), and an even greater decrease was observed in the first post-operative day (5.4 ± 3.1 nmol/l). On the seventh post-operative day, free testosterone levels reached a normal value (11.8 ± 5.5 nmol/l), although they were still significantly lower compared with the pre-operative value. There were slight alterations in serum DHEA sulphate levels, although the only significant decrease occurred from the first to the seventh day post-operation (from 4.7 ± 2.2 μmol/l to 3.7 ± 1.8 μmol/l, respectively). Serum luteinizing hormone levels were decreased during weaning from CPB (from 4.8 ± 2.1 mIU/ml to 3.9 ± 1.8 mIU/ml), but increased rapidly to the pre-operative value (5.5 ± 2.5 mIU/ml) at the first post-operative day. These results show that CPB affects serum luteinizing hormone, free testosterone and dihydroepiandrestenedione sulphate levels. The free testosterone level decreases significantly both during and after CPB surgery.
Effects of the Concomitant Administration of Tamsulosin (0.8 mg/Day) on the Pharmacokinetic and Safety Profile of Theophylline (5 mg/kg): A Placebo-Controlled Evaluation
Authors: Miyazawa Y , Starkey LP , Forrest A , Schentag JJ , Kamimura H , Swarz H , Ito Y
Published: February 2013

We performed a single-blind, sequential-design study to investigate the effects of concomitant oral tamsulosin 0.8 mg/day on the pharmacokinetics and safety of intravenous theophylline 5 mg/kg in healthy subjects. Ten healthy volunteers aged 19–39 years received placebo on study days 0, 1, 2 and 10 and tamsulosin on days 3–9. Theophylline was administered intravenously on days 1 and 9. Theophylline and tamsulosin pharmacokinetic data were determined following administration of the drugs on days 1 and 9 and day 9, respectively. No differences were observed in theophylline pharmacokinetic parameters with and without concomitant tamsulosin, and there were no abnormalites in tamsulosin pharmacokinetic data. Some significant changes in vital signs and a number of mild adverse reactions were reported, but the overall safety profile of tamsulosin and theophylline was acceptable. The results of the study suggest that no dose adjustment in tamsulosin is necessary when it is administered concomitantly with theophylline.
Efficacy of Metadoxine in the Management of Acute Alcohol Intoxication
Authors: Martínez MCLR Díaz , Martínez A Díaz , Salcedo V Villamil , Fuentes C Cruz
Published: February 2013

This randomized, open-label study evaluated the efficacy of 300 mg metadoxine (given intravenously) added to standard treatment compared with standard treatment alone in managing the physical and psychological signs of acute alcohol intoxication. Fifty-two acutely intoxicated patients were randomly assigned to one of two groups and followed during a 2-h period. Changes in clinical symptoms, degree of intoxication, and blood alcohol level were monitored. More patients receiving metadoxine in addition to standard therapy significantly improved by at least one degree of intoxication (one clinical category) compared with those receiving standard treatment alone (76.9% versus 42.3%, respectively). Metadoxinetreated patients also exhibited a significantly greater decrease in blood alcohol concentration compared with those receiving standard treatment alone (−105.4 ± 61.5 mg/dl versus −60.1 ± 38.6 mg/dl, respectively). Metadoxine improved the clinical signs of acute alcohol intoxication and accelerated alcohol clearance from the blood, thus supporting existing data. In contrast to previous data, these effects were concurrent but independent. No adverse effects were observed with metadoxine therapy.
Hydatid Disease of the Liver in Children: Evaluation of Surgical Treatment
Authors: Çelebi F , Salman AB , Erdoğ F , Gümüş M , Oren D
Published: February 2013

The medical records of 55 paediatric patients with hepatic hydatidosis, who were treated between 1990 and 2001 at Atatürk University, Turkey, were reviewed retrospectively. The most common symptoms at presentation were abdominal mass (32.7% of cases) and pain (81.8% of cases) in the right upper quadrant of the abdomen. Cysts were found in the right lobe in 41 patients, in the left lobe in four patients and in both lobes in 10 patients. Multiple hepatic cysts were present in 12 cases and eight patients also had cysts in other organs. Surgical procedures were evacuation of the cyst and management of the cavity with tube drainage, capitonnage, omentoplasty, cystectomy or segmentectomy. Long-lasting biliary fistula (two patients) and cholangitis (two patients) developed following evacuation and tube drainage, and one patient developed cholangitis after capitonnage. This review suggests that omentoplasty and capitonnage are more effective than tube drainage in the management of the cyst cavity.
Thyroid Abnormalities in Lithium-Treated Patients with Bipolar Affective Disorder
Authors: Çayköylü A , Çapoğlu İ , Ünüvar N , Erdem F , Çetinkaya R
Published: February 2013

The thyroid functions of 42 subjects with bipolar affective disorder receiving regular lithium therapy were analysed and their thyroid glands were examined by ultrasonography. Following the receipt of lithium therapy (duration 4–156 months), three subjects displayed subclinical hypothyroidism (7.1%), three subclinical hyperthyroidism (7.1%) and one hyperthyroidism (2.4%). Moreover, goitre was detected in 16 (38.1%) subjects. An increase in the conversion of free thyroxine (T4) to free tri-iodothyrosine (T3), which is an indication of mild thyroid dysfunction, was identified in 20 (47.6%) subjects, and was mostly seen in male subjects under 40 years of age and in those having weight gain. In conclusion, some thyroid dysfunctions were observed in the patients treated with lithium.
The Influence of Smoking and Non-Insulin-Dependent Diabetes Mellitus on Periodontal Disease
Authors: Orbak R , Tezel A , Çanakçi V , Demir T
Published: February 2013

The periodontal health of smokers and non-smokers with non-insulin-dependent diabetes mellitus (NIDDM) and non-smokers with periodontitis who were not suffering from a systemic disease was assessed. The investigation was carried out on 60 adult subjects. Levels of blood glucose, glycosylated haemoglobin and immunoglobulins G, A and M were determined, together with the plaque index, gingival index, probing pocket depths and clinical attachment level. Periodontitis was more severe in smokers and non-smokers with NIDDM than non-smokers without NIDDM, and the periodontal condition (clinical attachment level, probing pocket depth and gingival bleeding) was better in non-smokers with NIDDM than smokers with NIDDM. The results suggest that diabetes and smoking are high-risk factors for periodontal disease.
Clinical Safety Profile of Sildenafil in Singaporean Men with Erectile Dysfunction: Pre-Marketing Experience (ASSESS-I Evaluation)
Authors: Lim PHC , Ng FC , Cheng CWS , Wong MYC , Chee CTY , Moorthy P , Vasan SS
Published: February 2013

Safety and tolerability of sildenafil citrate was assessed in a population subset of 60 Singaporean men with erectile dysfunction taken from the Asian Sildenafil Efficacy and Safety Study (ASSESS-I), a double-blind, placebo-controlled, flexible-dose study. The men, from two centres, with ≥ 6 months' history of erectile dysfunction, were randomized to two treatment arms for 12 weeks. One group (30 patients) received sildenafil (initial dose 50 mg taken 1 h before sexual activity for the first 2 weeks, increased to 100 mg or decreased to 25 mg, according to efficacy and/or tolerability). The remaining 30 patients received a matching placebo. Incidence and type of adverse effects were evaluated at 2, 4, 8 and 12 weeks. Nine patients (30.0%) on sildenafil (33.1% in the full ASSESS-I study) and one patient (3.3%) on placebo (22.8% in the full ASSESS-I study) experienced treatment-related adverse events, the most frequent being headache in the sildenafil group (reported by five patients [16.7%]; 11.0% in the full ASSESS-I study). Flushing, visual disturbance, dizziness, insomnia, myalgia and back pain each occurred in one patient in the sildenafil group (3.3%); in the placebo group, one patient (3.3%) had headache. Importantly, the incidence of cardiovascular and respiratory system adverse events were relatively less than in the full ASSESS-I population (cardiovascular 3.3% in the present study versus 10.2% in the full ASSESS-I population; respiratory 3.3% versus 5.5%). All adverse events were transient and mild, and did not lead to treatment withdrawal. There was no effect on sitting blood pressure, heart rate or standard laboratory parameters; more importantly, there was no incidence of myocardial infarction, stroke or priapism. These results should reassure Singaporean patients and their physicians of the safety of sildenafil for erectile dysfunction.
A 1-Year Trial of Lamivudine for Chronic Hepatitis B in Children
Authors: Zuccotti GV , Cucchi C , Gracchi V , D'Auria E , Riva E , Tagger A
Published: February 2013

We carried out a 1-year trial to evaluate the efficacy and tolerability of lamivudine, an oral nucleoside analogue, in a small group of children with vertically acquired chronic hepatitis B. Patients were assessed for serum alanine aminotransferase (ALT) and serum hepatitis B virus (HBV) DNA at baseline and every 4 weeks thereafter, and for hepatitis B s antigen, hepatitis B e antigen and their antibodies every 12 weeks. Analysis of HBV mutation was undertaken at entry and on the occasion of the last positive control of HBV DNA. Lamivudine suppressed serum HBV DNA to undetectable levels in all treated patients within 24 weeks. Serum ALT levels returned to normal values within 36 weeks. Therapy was well tolerated, and although nausea and vomiting were reported in one child, it was not necessary to stop treatment. A new observation was that, contrary to previous data, seroconversion appeared to occur earlier in children with lower ALT levels at baseline.
Terminal Restriction Fragments of Telomere are Detectable in Plasma and Their Length Correlates with Clinical Status of Ovarian Cancer Patients
Authors: Idei T , Sakamoto H , Yamamoto T
Published: February 2013

Free plasma DNA was extracted and terminal restriction fragment (TRF) sequences were amplified by polymerase chain reaction in 32 patients with stage 3 and stage 4 ovarian cancer and 45 healthy controls. Three peaks of TRF were identified and the size of the largest peak (peak 1) correlated with cancer telomere length in cancer patients. Average size of peak 1 in cancer patients was significantly shorter than in controls. When plasma TRF peak 1 was tested pre- and post-treatment, the average pre-treatment size was 8.7 ± 0.5 Kb, lengthening significantly post-treatment. In long-term survivors of ovarian cancer (10-year disease-free survival), plasma TRF length was the same as in normal controls. The results suggest that the plasma TRF in ovarian cancer patients is of tumour origin. Its determination may reflect tumour cell viability in the host.
Osteoinduction by Recombinant Human Bone Morphogenetic Protein-2 in Muscles of Non-Human Primates
Authors: Kusumoto K , Bessho K , Fujimura K , Akioka J , Okubo Y , Wang Y , Iizuka T , Ogawa Y
Published: February 2013

Heterotopic osteoinduction in a muscle of a medium-sized, non-human primate (Japanese macaque monkey; Macaca fuscata) was investigated with recombinant human bone morphogenetic protein-2 (rhBMP-2) mixed with atelopeptide type I collagen as the carrier. Nine monkeys were divided into three groups of three: groups I (1.25 mg rhBMP-2), II (250 μg rhBMP-2) and III (50 μg rhBMP-2). Four weeks after implanting into the calf muscle pouch, the implant was examined radiographically and histologically. In one specimen of three in group I, marked radio-opaque shadow, massive chondrogenesis and partial osteogenesis were observed. In the other two specimens, only microscopic calcification signs were recognized. In groups II and III, no findings of heterotopic osteoinduction were radiographically observed; however, nuclei from muscle bundles reacted to rhBMP-2 and were large and round, as in muscle bundles near the site of osteogenesis in group I. A positive control study using rats was carried out in parallel. This was a dose-finding study, with the monkeys in group III acting as a sub-effective dose (placebo) control, and rats acting as an active control, or verum, to show that the techniques are sufficiently sensitive. Bone morphogenetic protein appears to osteoinduce less bony material in soft tissue in primates than in rats.
The Effects of Combination Therapy with Niceritrol and Pravastatin on Hyperlipidaemia
Authors: Kinoshita M , Mikuni Y , Kudo M , Mori M , Horie E , Teramoto T , Matsushima T
Published: February 2013

In the present study, we evaluated the effects of combination therapy with niceritrol and pravastatin in patients with hyperlipidaemia. A total of 62 patients with hyperlipidaemia, defined as total cholesterol levels above 220 mg/dl or triglyceride levels above 150 mg/dl, were recruited. Patients were divided into two groups: Group N received initial therapy with niceritrol 750–1500 mg/day, and those in Group P, pravastatin 10 mg/day. After 8 weeks, pravastatin 10 mg/day was added to the Group N treatment regimen for a further 8 weeks, while patients in Group P were given niceritrol 750–1500 mg/day in addition to pravastatin for 8 weeks. After the 8-week combination therapy study period, total cholesterol levels were 209.6 mg/dl in Group N and 220.7 mg/dl in Group P. Decreased triglyceride and lipoprotein(a) levels and increased high-density lipoprotein cholesterol levels, neither of which were achieved by pravastatin administration alone, were achieved with the combination of pravastatin and niceritrol. We conclude that when a single lipid-lowering drug fails to show therapeutic value, attempting combination therapy with a nicotinic acid preparation and a 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor (statin) is worthwhile.
A New Fixed-Dose Combination for Added Blood Pressure Control: Telmisartan Plus Hydrochlorothiazide
Authors: Lacourcière Y
Published: February 2013

Population surveys on hypertension management reveal worrying deficiencies in the awareness and treatment of high blood pressure. Many patients with hypertension will require two or more drugs with complementary mechanisms of action (which generally have additive effects, producing greater blood pressure reductions than either agent alone) to attain the blood pressure goals specified in internationally accepted guidelines. Nevertheless, physicians are often reluctant to prescribe multiple anti-hypertensive drugs due to concerns over side-effects, inconvenient dosing regimens and costs. Fixed-dose formulations combining two agents from different classes in a single tablet should help to allay these concerns. A fixed-dose combination containing telmisartan (an angiotensin II receptor blocker) and hydrochlorothiazide (a thiazide diuretic) has recently been developed. Telmisartan/hydrochlorothiazide provides additional anti-hypertensive efficacy compared with the respective monotherapies in a wide range of patients, including black patients, requires once-daily dosing, is cost-effective, well tolerated and is associated with less potassium depletion than hydrochlorothiazide administered alone.
Serum Interleukin 2 Levels in Patients with Rheumatoid Arthritis and Correlation with Insulin Sensitivity
Authors: Öncül O , Top C , Özkan S , Çavuşlu Ş , Danaci M
Published: February 2013

Interleukin 2 (IL-2), a Th1 lymphocyte-derived cytokine, is thought to play an important role in the pathogenesis of type 2 diabetes and rheumatoid arthritis (RA). The aim of our study was to evaluate changes in serum IL-2 levels and their correlation with glucose metabolism abnormalities, such as insulin resistance, in patients with RA. Thirty-six subjects with varying degrees of disease activity and 20 healthy age-, sex- and body mass index-matched control individuals were evaluated. Patients with any causes of peripheral insulin resistance were excluded. After a 12-h overnight fast, fasting insulin levels, homeostatic model assessment-insulin resistance (HOMA-IR) estimated insulin sensitivity, and serum IL-2 levels were significantly higher in all patients with RA than in the control individuals. Fasting insulin, HOMA-IR scores and IL-2 levels were correlated in the RA group. This study showed that patients with RA have altered IL-2 regulation, and that there was a significant correlation between serum IL-2 levels and insulin sensitivity.
Pharmacokinetics of Rosiglitazone in Patients with End-Stage Renal Disease
Authors: Thompson-Culkin K , Zussman B , Miller AK , Freed MI
Published: February 2013

The pharmacokinetics and tolerability of a single 8-mg oral dose of rosiglitazone, an anti-diabetic agent, were compared in 10 long-term haemodialysis patients and 10 healthy volunteers. Haemodialysis patients received rosiglitazone 4 h after haemodialysis (non-dialysis day) and 3 h before haemodialysis (dialysis day). Haemodialysis did not influence rosiglitazone pharmacokinetics, and dialytic clearance was low (0.10 l/h). The mean area under the concentration-time curve (AUC(0–∞)), the maximum observed plasma concentration ( Cmax) and the half-life for rosiglitazone were similar in haemodialysis patients (non-dialysis day) and healthy individuals (2192 ± 598 ng.h/ml versus 2388 ± 494 ng.h/ml, 338 ± 114 ng/ml versus 373 ± 95 ng/ml, and 3.70 ± 0.75 h versus 3.81 ± 0.86 h, respectively). AUC(0−∞) and Cmax were not markedly influenced by haemodialysis. Rosiglitazone dose adjustments are not warranted in patients with type 2 diabetes with end-stage renal failure on haemodialysis.
Increased Cytotoxicity of Carbon Tetrachloride in a Human Hepatoma Cell Line Overexpressing Cytochrome P450 2E1
Authors: Takahashi S , Takahashi T , Mizobuchi S , Matsumi M , Morita K , Miyazaki M , Namba M , Akagi R , Hirakawa M
Published: February 2013

Cytotoxic free radicals generated during the metabolism of carbon tetrachloride by cytochrome P450 2E1 (CYP2E1) are thought to cause hepatotoxicity. Here, the cytotoxic effects of carbon tetrachloride in a liver cell line expressing CYP2E1 (HLE/2E1) are compared with those in the mother cell line (HLE). The effects of carbon tetrachloride on the gene expression of HSP70, a potential marker of oxidative stress, were also examined. The viability of HLE/2E1 cells after exposure to carbon tetrachloride was significantly decreased compared with that of HLE cells. Northern blot analysis revealed that the HSP70 mRNA level was significantly increased after carbon tetrachloride treatment in both cell lines, while the magnitude of its increase was much greater in HLE/2E1 cells than in HLE cells. These results suggest that the oxidative stress induced by CYP2E1 plays an important role in the increase in cytotoxicity of carbon tetrachloride in CYP2E1-overexpressing cells.
Evaluation of Microcirculation in Buerger's Disease Using 201Thallium/99mTechnetium Macroaggregated Albumin Scintigraphy
Authors: Ates A , Varoglu E , Yekeler İ , Ozyazicioglu A
Published: February 2013

In the current study, 10 patients with Buerger's disease (thromboangiitis obliterans) and seven control patients with atherosclerosis obliterans (ASO) were evaluated for microvascular disturbance. After exercising for 1 min, patients were injected with 37 MBq 201thallium (201Tl) intra-arterially, and anterior planar images of the feet and whole body images of the lower extremities were taken. The same procedure was repeated after 1 week using 185 MBq 99mtechnetium macroaggregated albumin (99mTc-MAA). Rectangular regions of interest were drawn on the 201Tl and 99mTc-MAA images, and 201Tl/99mTc-MAA uptake ratios were calculated. 201Tl/99mTc-MAA ratios of the toes of those with Buerger's disease were significantly lower than those of ASO cases, whereas no significant difference was found for the lower limbs and feet. These findings may be explained by disturbances of microvascular regulation observed in Buerger's disease.
Dose-Dependent Effect of an Oral Adsorbent, AST-120, in Patients with Early Chronic Renal Failure
Authors: Yorioka N , Ito T , Masaki T , Ogata S , Asakimori Y , Tanji C , Kyuden Y , Komiya Y , Kumagai J , Taniguchi Y , Kohno N
Published: February 2013

We evaluated the dose dependence of an oral adsorbent, AST-120, in 31 patients with early chronic renal failure (baseline serum creatinine: 1.2–3.0 mg/dl). Twenty-three patients were given AST-120 and eight patients were not. AST-120 was administered at three different maintenance doses, < 3.0 g, 3.0 g and 6.0 g/day, according to patients' ability to tolerate treatment. The treatment period was 12 months. The slope of the reciprocal of serum-creatinine concentration versus time was calculated to assess the progression of renal failure. This slope became significantly less steep after AST-120 treatment at 6.0 g/day, but did not change significantly at the other doses. These findings suggest that 6.0 g/day of AST-120 may delay the initiation of dialysis in patients with early chronic renal failure.
Measurement of Plasma Glutathione S-Transferase in Hepatocellular Damage in Pre-Eclampsia
Authors: Kumtepe Y , Börekçi B , Aksoy H , Altinkaynak K , Ingeç M , Özdiller O
Published: February 2013

Glutathione S-transferase (GST) is a cytosolic enzyme found in high concentrations in the liver. We investigated the value of plasma GST measurements in pre-eclamptic patients. A total of 80 patients (40 in the pre-eclampsia group and 40 in the control group) were recruited. All patients were evaluated for GST, alanine aminotransferase (ALT), aspartate aminotransferase and lactate dehydrogenase. Pre-eclampsia was defined as the occurrence, after 20 weeks' gestation, of a diastolic blood pressure greater than 90 mmHg on two or more occasions at least 4 h apart, and concomitant proteinuria greater than 0.3 g/l over a 24-h urine collection period. There was no statistical difference between the pre-eclampsia and control groups in terms of ALT, gestational age, maternal age or number of previous pregnancies; a significant difference was found between the pre-eclampsia and control groups in terms of GST. Pre-eclampsia represents a significant cause of maternal and perinatal morbidity and mortality. Accurate assessment of hepatocellular damage is essential in the clinical management of these patients. GST levels in pre-eclamptic patients were found to be much higher (131.98 IU/l) than in control patients (68.67 IU/l), and this high level suggests hepatocellular damage. We concluded that measurement of plasma GST might provide an earlier and much more sensitive indicator of hepatocellular damage than other liver-function tests.
Thrombocytopenia Complicating the Clinical Course of Leptospiral Infection
Authors: Turgut M , Sünbül M , Bayirli D , Bilge A , Leblebicioğlu H , Haznedaroğlu İ
Published: February 2013

Leptospirosis can present with a wide clinical spectrum, and haematological manifestations are often apparent. We retrospectively analysed platelet counts in 49 patients with leptospirosis. Forty-three patients (87.8%) had thrombocytopenia. Mean baseline platelet counts rose from 69 × 109/l to 151 × 109/l following treatment. Haemorrhagic episodes were observed in 11 patients. Platelet nadir was 29 × 109/l in the group experiencing bleeding and 64 × 109/l in the remainder. Six patients died due to bleeding and one due to sepsis. Thirty-six patients (73.5%) had acute renal failure; their mean platelet count was 46 × 109/l. Liver enzyme levels were elevated in all patients. Thrombocyte count, liver enzyme levels and bilirubin levels were significantly correlated. Forty-three (87.8%) patients showed signs of sepsis; mean thrombocyte count was 46 × 109/l in these patients, and 133 × 109/l in those without sepsis. Multiple organ involvement and fulminant disease is usually associated with renal failure and/or thrombocytopenia in leptospirosis.
Pharmacodynamics of Menatetrenone and Effects on Bone Metabolism in Continuous Ambulatory Peritoneal Dialysis Patients
Authors: Sugimoto T , Yamakado M , Matsushita K , Iwamoto T , Tagawa H
Published: February 2013

Prevention of osteoporosis and renal osteodystrophy are important for the long-term quality of life in dialysis patients. We examined whether administration of menatetrenone (vitamin K2) improves bone metabolism in continuous ambulatory peritoneal dialysis (CAPD) patients. Administration of a single dose of menatetrenone (15 mg) revealed that the 24-h pharmacodynamics in CAPD patients were comparable to those in control individuals. In a 12-month period of oral menatetrenone administration (45 mg/day), eight stable CAPD patients were studied for blood-bone metabolism parameters and for bone mineral content. Blood concentration of menatetrenone was detectable during the experiment period. Only at 12 months did active vitamin D3 and bone-type alkaline phosphatase (ALP) fall significantly, while total ALP rose significantly. Bone mineral density measured by dual-energy X-ray absorptiometry remained at the same level throughout the study period, suggesting that menatetrenone may protect against bone mineral loss in CAPD patients. These results show that the same dose of oral menatetrenone can be given to CAPD patients as to control individuals, and that menatetrenone can be used safely for 1 year in CAPD patients.
Plasma Concentrations of C-Reactive Protein and Fibrinogen in Ischaemic Stroke
Authors: İyigün İ , Bakirci Y
Published: February 2013

This study investigated how fibrinogen and C-reactive protein (CRP) levels change in response to neural damage occurring after ischaemia, and the relationship between the distribution of the arterial lesion, the disease prognosis and the levels of these substances. Fibrinogen and CRP levels were measured in blood samples obtained from 83 patients admitted to hospital within 72 h of a first ischaemic stroke. The patients were evaluated clinically with the Glasgow Outcome Scale (GOS), and results were compared with 43 age-matched controls. The fibrinogen and CRP levels in unconscious patients with hemiparesis or hemiplegia were higher than those in conscious hemiplegic patients. Also, the difference in GOS values between the unconscious patients with hemiparesis or hemiplegia and conscious patients with hemiparesis or hemiplegia was statistically significant. Patients with large infarcts in the median cerebral artery and anterior cerebral artery had higher fibrinogen and CRP concentrations than the control group. In conclusion, fibrinogen and CRP may be important measures for determining the prognosis and outcome in patients following ischaemic stroke.
Beta-Lactam/Beta-Lactamase Inhibitor Combinations in Empiric Management of Pediatric Infections
Authors: Adam D
Published: February 2013

Beta-lactam antibiotics have long played a central role in the management of pediatric infections. However, widespread beta-lactam resistance among community- and hospital-acquired pathogens, mainly due to beta-lactamase production, has reduced the usefulness of these trusted and well-tolerated agents. Many regions have reported an increase in beta-lactamase-mediated resistance to cephalosporins and carbapenems as well as penicillins among clinically important Gram-positive and Gram-negative aerobes and anaerobes. For some pathogens such as Moraxella catarrhalis, Klebsiella species and Pseudomonas aeruginosa, virtually all strains worldwide are beta-lactamase producers. The development of beta-lactamase inhibitors for co-administration with a number of established beta-lactam agents has restored their usefulness in pediatric patients. The combination of ampicillin plus sulbactam has broad anti-aerobic and anti-anaerobic activity in vitro and achieves high concentrations in many body tissues and fluids. The availability of a mutual oral prodrug, sultamicillin, has enabled the development of an oral formulation. Excellent clinical response and bacterial eradication rates with ampicillin/sulbactam and sultamicillin have been demonstrated for upper and lower respiratory tract infections, urinary tract infections, osteomyelitis, and meningitis in pediatric patients and neonates. Furthermore, many studies have demonstrated an excellent tolerability profile. Thus, ampicillin/sulbactam has an important role in the management of pediatric infections.
Apoptosis in Normal Tissues Induced by Anti-Cancer Drugs
Authors: Tamaki T , Naomoto Y , Kimura S , Kawashima R , Shirakawa Y , Shigemitsu K , Yamatsuji T , Haisa M , Gunduz M , Tanaka N
Published: February 2013

To investigate the damage mediated by anti-cancer drugs in normal cells, we examined the effect of such drugs on apoptosis of normal cells of the small intestinal epithelium and the bone marrow by in situ DNA end-labelling and transmission electron microscopy. Mice received a single dose of 5-fluorouracil (5-FU) or cisplatin, or repeated daily doses of 5-FU for 7 days. In mice treated with a single dose of 5-FU 50 mg/kg or cisplatin 5 mg/kg, the number of apoptotic cells appearing in the small intestine 12 h after injection was relatively small, but increased steadily reaching a peak after 36 h and then decreasing to close to that in the control group by 48 h. In bone marrow cells, results were similar in mice treated with single doses of 5-FU 50 mg/kg but apoptosis increased much less in those treated with cisplatin 5 mg/kg. The proportion of apoptotic cells reached peak values earlier at higher concentrations of 5-FU or cisplatin both in small intestine and in bone marrow. In the mice treated repeatedly with 5-FU 50 mg/kg, the proportion of apoptotic small intestinal epithelial cells reached a succession of peaks at 48-h intervals. Mice treated repeatedly with 5-FU 50 mg/kg also showed a rapid increase in diarrhoea symptoms and a steady decrease in the height of villi. Our results suggest it may be possible to prevent the side-effects of anti-cancer drugs by inhibiting apoptosis in the gastrointestinal tract.
Sedation for Outpatient Endometrial Biopsy: Comparison of Remifentanil-Propofol and Alfentanil-Propofol
Authors: Dogru K , Madenoglu H , Yildiz K , Boyaci A
Published: February 2013

The purpose of the study was to compare the clinical activity of remifentanil or alfentanil under propofol sedation with regard to respiratory rate, sedation and recovery rate when used for outpatient endometrial biopsy. Patients were randomized to receive intravenously either bolus remifentanil 0.4 μg/kg and propofol 1 mg/kg in the remifentanil group ( n = 30), or bolus alfentanil 20 μg/kg and propofol 1 mg/kg in the alfentanil group ( n = 30). Patients were monitored for heart rate, systolic and diastolic arterial pressure, peripheral O2 saturation (SpO2), respiration rate, and Aldrete sedation score. Pulse oximetry was used to monitor heart rate and SpO2 during endometrial biopsy. Apnoea was observed in five patients from the remifentanil group, and in three patients from the alfentanil group. The groups did not differ with regard to apnoea incidences. Times were recorded for orientation and Aldrete score > 8, and were similar between the two groups (13.20 ± 3.64 min and 14.0 ± 3.87 min in the remifentanil group, 14.7 ± 3.64 min and 15.9 ± 3.15 min in the alfentanil group, respectively). The sedative and analgesic combination of remifentanil-propofol does not offer any advantages compared with a combination of alfentanil-propofol with regards to respiration and recovery during sedation for outpatient endometrial biopsy.
The Diagnostic Value of Troponin T and Myoglobin Levels in Acute Myocardial Infarction: A Study in Turkish Patients
Authors: Vatansever S , Akkaya V , Erk O , Öztürk Ş , Karan MA , Salmayenli N , Taşçioğlu C , Güler K
Published: February 2013

This study compares the diagnostic value of troponin T (TnT) and myoglobin with creatinine kinase (CK) for myocardial infarction (MI) in a tertiary care centre in a developing nation. The study group comprised 33 acute myocardial infarction patients and 27 healthy controls. Receiver operating characteristic curves for TnT, myoglobin and CK were drawn and areas under the curve calculated. At admission, myoglobin levels had greater diagnostic sensitivity than TnT or CK levels. After 2 h, myoglobin and TnT had equal sensitivity and specificity, whereas CK still had lower sensitivity than myoglobin and TnT. After 4 h there was no difference between the tests. It was concluded that myoglobin levels on admission and TnT at 2 h had the greatest diagnostic rate, whereas all the tests were similar after 4 h for MI.
A Single Ascending Dose Study of Epigallocatechin Gallate in Healthy Volunteers
Authors: Ullmann U , Haller J , Decourt JP , Girault N , Girault J , Richard-Caudron AS , Pineau B , Weber P
Published: February 2013

This randomized, double-blind, placebo-controlled study assessed the safety, tolerability and plasma kinetic behaviour of single oral doses of 94% pure crystalline bulk epigallocatechin gallate (EGCG) under fasting conditions in 60 healthy male volunteers. In each group of 10 subjects, eight received oral EGCG in single doses of 50 mg, 100 mg, 200 mg, 400 mg, 800 mg or 1600 mg, and two received placebo. Blood samples were taken at intervals until 26 h later. The area under the concentration-time curve from 0 h to infinity (AUC(0–∞)), the maximum plasma concentration ( Cmax) of EGCG, the time taken to reach the maximum concentration ( Tmax), and the terminal elimination half-life ( t1/2z) of EGCG were determined. Safety and tolerability were assessed. In each dosage group, the kinetic profile revealed rapid absorption with a one-peak plasma concentration versus time course, followed by a multiphasic decrease consisting of a distribution phase and an elimination phase. The mean AUC(0– ∞) of total EGCG varied between 442 and 10368 ng·h/ml. The according mean Cmax values ranged from 130 to 3392 ng/ml and were observed after 1.3–2.2 h. The mean t1/2z values were seen between 1.9 and 4.6 h. Single oral doses of EGCG up to 1600 mg were safe and very well tolerated.
Relationship between Mandibular Nutrient Canals and Hypertension
Authors: Yilmaz AB , Akgül N , Akgül HM , Dagistanli S , Çakur B
Published: February 2013

This study was undertaken to investigate the correlation between the presence of nutrient canals in the mandibular anterior region and hypertension. Periapical radiographs taken from the mandibular anterior region of 139 normotensive and 76 hypertensive edentulous patients were examined. There was no statistical difference in the incidence of nutrient canals between normotensive and hypertensive patients, suggesting that the presence of nutrient canals is not indicative of the existence of hypertension.
Effect of Galanin on Plasma Glucose, Insulin and Pancreatic Glucagon in Dogs
Authors: Manabe T , Okada Y , Sawai H , Funahashi H , Yamamoto M , Hayakawa T , Yoshimura T
Published: February 2013

The effect of synthetic galanin on plasma glucose, insulin and pancreatic glucagon levels in dogs was studied. Infusion of galanin caused a rapid, reversible and dose-dependent reduction in basal insulin level. A maximal increase in blood glucose level accompanying the insulin decrease was observed when galanin was administered at a dose of 4 μg/kg per h. Pancreatic glucagon levels showed little change compared with basal secretion. These results indicate that galanin is involved in the regulation of glucose through control of insulin secretion.
Activated T Cells and Soluble Molecules in the Portal Venous Blood of Patients with Cholestatic and Hepatitis C Virus-Positive Liver Cirrhosis. Possible Promotion of Fas/FasL-Mediated Apoptosis in the Bile-Duct Cells and Hepatocyte Injury
Authors: Ariki N , Morimoto Y , Yagi T , Oyama T , Cyouda Y , Sadamori H , Inagaki M , Urushihara N , Iwagaki H , Tanaka N
Published: February 2013

We investigated the immune responses of patients with cholestatic and hepatitis C virus-positive (HCV-positive) liver cirrhosis by analysing T-cell subsets and cytokine levels in the portal and peripheral veins, using flow cytometry and enzyme-linked immunosorbent assay. In cholestatic liver cirrhosis, the proportion of natural-killer (NK) T cells and interleukin (IL) 6 and IL-18 levels in the portal venous blood were significantly higher than those in the peripheral venous blood. In HCV-positive liver cirrhosis, the proportions of NK T cells and Fas+ T cells and IL-6 and soluble Fas levels in the portal venous blood were significantly higher than those in the peripheral venous blood. These results suggest that in these diseases, activated T cells and soluble molecules in portal venous blood may promote Fas/FasL-mediated apoptosis of the bile-duct cells and hepatocytes, and contribute to the deterioration in liver function as an inevitable result of positive feedback.