bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychiatric Disorders among Patients Undergoing Hemodialysis Therapy
Authors: Fukunishi Isao , Kitaoka Tateki , Shirai Tetsuo , Kino Kyoko , Kanematsu Emiko , Sato Yoshikazu
Published: April 2003

We examined the incidence rates of psychiatric disorders in end-stage renal failure patients on hemodialysis (HD) based on 4-year long-term follow-up. Among various psychiatric disorders, the frequency of three psychiatric disorders, dementia, delirium, and major depression, was relatively high. One-year incidence rate of whole psychiatric disorders was 10.6% (7.1% in non-aged and 13.7% in aged). One-year incidence rate of dementia in aged patients was 4.2% (dementia of the Alzheimer’s disease, 0.5%; multi-infarct dementia, 3.7%). One-year incidence rate of multi-infarct dementia in aged HD patients was 7.4 times as large as that in the elderly general populations, suggesting that aged HD patients tend to exhibit multi-infarct dementia. The high incidence rate may be closely related to advanced arteriosclerosis and other medical conditions. Psychiatric management is required for ESRD patients with three major psychiatric disorders, dementia, delirium, and major depression, in particular for aged patients with multi-infarct dementia who has received long-term HD therapy.
Cerebrospinal Fluid Shunt Survival and Etiology of Failures: A Seven-Year Institutional Experience
Authors: McGirt Matthew J. , Leveque Jean-Christophe , Wellons III John C. , Villavicencio Alan T. , Hopkins John S. , Fuchs Herbert E. , George Timothy M.
Published: April 2003

Background: Innovations in shunt technology and neuroendoscopy have been increasingly applied to shunt management. However, the relative life span of shunts and the etiology of shunt failure have not been characterized recently. Methods: We reviewed the records of all shunting procedures at our institution between January 1992 and December 1998. Independent predictors of shunt failure were analyzed via multivariate Cox regression analysis in 836 shunting procedures. Independent predictors of the etiology of failure (infection, proximal obstruction, distal malfunction) were analyzed via multivariate logistic regression analysis in the 383 shunts which failed. Results: A total of 353 pediatric patients underwent 308 shunt placements and 528 revisions. The risk (hazard ratio; HR) of shunt failure decreased as a function of time in both primary placements and revised shunts. In failed shunts, the odds of infection decreased 4-fold per year of shunt function, while the odds of distal malfunction increased 1.45-fold per year. Increasing number of shunt revisions (HR 1.31, p < 0.05), decreasing patient age in years (HR 1.04, p < 0.001), gestational age <40 weeks (HR 2.15, p < 0.001) but not the etiology of hydrocephalus were associated with an increased risk of shunt failure. Revisions versus primary placements, Dandy-Walker cysts and gestational age <40 weeks were independently associated with proximal, distal and infectious causes of failure, respectively. Conclusions: The long-term shunt revision rates observed here are similar to those reported over the past 2 decades. Shunt life span remains poorer in shunt revisions and in younger patients. Patient characteristics may suggest a specific risk and mechanism of failure, aiding in the long-term management of shunted hydrocephalus.
Neodymium-YAG Laser Core through Urethrotomy in Obliterative Posttraumatic Urethral Strictures after Failed Initial Urethroplasty
Authors: Dogra P.N. , Nabi G.
Published: April 2003

Objective: To assess the feasibility, problems and results of Nd-YAG laser core through urethrotomy in the management of failed urethroplasty for posttraumatic bulbomembranous urethral strictures. Material and Methods: 61 patients with obliterative posttraumatic urethral strictures were treated by Nd-YAG laser core through urethrotomy between May 1997 to April 2000. Of these, 5 patients had failed end-to-end urethroplasty done as an initial procedure at various periods of time. The procedure was performed as day care and patients were discharged within 6 h of procedure. Results: At 24–30 months of follow-up, all patients are voiding well and are continent. Auxiliary procedures were required in 2 cases. Conclusion: Nd-YAG laser core through urethrotomy is a feasible day care option for patients of obliterative urethral strictures following failed initial urethroplasty with successful outcome.
Selective Induction of MCP-1 in Human Mesangial Cells by the IL-6/sIL-6R Complex
Authors: Coletta Isabella , Soldo Lucia , Polentarutti Nadia , Mancini Francesca , Guglielmotti Angelo , Pinza Mario , Mantovani Alberto , Milanese Claudio
Published: April 2003

Interleukin (IL) 6, an autocrine growth factor for mesangial cells, and chemokines, which are released from activated mesangial cells and induce leukocyte infiltration, play a critical role in the progression of immune system mediated renal diseases. Since the reciprocal relationship between IL-6 and chemokines in renal inflammation has been barely investigated, we have analyzed whether IL-6 (500 ng/ml), alone or in combination with the soluble form of its receptor (sIL-6R, 200 ng/ml), can induce normal human mesangial cells (NHMC) to release alpha and/or beta chemokines: MCP-1 (monocyte chemoattractant protein 1), IL-8, Rantes (regulated on activation, normal T cell expressed and secreted), and MIP-1α (macrophage inflammatory protein 1α). Whereas IL-6 or sIL-6R alone were ineffective in inducing significant chemokine release from NHMC, the simultaneous treatment with IL-6 and sIL-6R showed a significant interaction, leading to a strong synergic effect on MCP-1 synthesis and release without exerting any relevant activity on IL-8, Rantes, or MIP-1α. Consistently with the unresponsiveness to IL-6, mRNA and protein expression analysis of the two subunits which form the functional IL-6 receptor showed that NHMC express only the gp130 signal-transducing chain and not the subunit-specific IL-6R (gp80). These findings support an unexpected role of the IL-6 system in kidney inflammatory reactions through the selective regulation of monocyte recruitment.
Non-Invasive Fetal Sex Determination on Fetal Erythroblasts from the Maternal Circulation Using Fluorescence in situ Hybridisation
Authors: Hromadníková Ilona , Karamanov Sultan , Houbová Bela , Hridelova Dana , Kofer Josef , Mrstinova Miluse
Published: April 2003

Objective: The main purpose of this study was to evaluate the potential of a non-invasive method for fetal sex determination in clinical practice using dual-colour fluorescence in situ hybridisation (FISH) analysis. We evaluated the differences in nucleated red blood cell (NRBC) recovery from the maternal circulation using various slide preparation procedures following high-gradient magnetic cell separation (double MACS). Methods: NRBCs were enriched from peripheral blood mononuclear cells of 63 pregnant women between 12 and 37 weeks of gestation by double MACS involving simultaneous CD14+ and CD45+ maternal cell depletion and CD71+ fetal cell enrichment. Isolated cells were analysed by dual-colour FISH with X- and Y-specific probes. Before applying the FISH technique, cells were treated using three different protocols. Cells were either fixed in methanol:acetic acid (3:1) and dropped immediately onto glass slides (protocol 1) or treated with 75 mM KCl before resuspension in fixative (protocol 2). Alternatively, isolated cells were transferred onto glass slides and then treated using a method described in the literature (protocol 3). Results: Using various slide preparation procedures, fixed cell numbers as well as the quality of slides differed significantly. Using protocol 1, fetal sex was well determined in 30 cases, in 15 out of 17 male fetuses (1–13, mean 3 fetal cells were found among 5–164, mean 50 maternal cells) and in 15 female fetuses (7–178, mean 56 fixed cells). On the other hand, interpretation difficulties occurred in 7 out of 8 studied cases using protocol 2 due to a lack of cells or damage to the isolated cells. The highest recovery of fixed cells was achieved using protocol 3 (27–411, mean 186); fetal cells positive for the Y signal (2–12, mean 6) were detectable in all studied cases (n = 16). In 7 of the samples from women carrying female fetuses, we could only detect cells with two X signals (51–182, mean 103). All of the experiments were interpretable due to the presence of compact cells with well-visible red and green signals. Conclusion: Our study revealed that using protocol 3 as the post-MACS treatment results in improved NRBC recovery and enables a reliable prospective non-invasive fetal sex determination.
Effects of Antibiotic Treatment on the Concentrations of Interleukin-6 and Interleukin-8 in Cervicovaginal Fluid
Authors: Matsuda Yoshio , Kouno Satoshi , Nakano Hitoo
Published: April 2003

Objective: We investigated to see the effect of antibiotics on interleukin (IL)-6 and IL-8 in cervicovaginal fluid in patients with premature rupture of the membranes. Study Design: Cervicovaginal fluid was sampled on admission and before delivery for measurement of IL-6 and IL-8 from 31 patients with less than 35 weeks of gestation. Concentrations of IL-6 and IL-8 were measured by ELISA. Results: The concentrations of IL-6 in cervicovaginal fluid in patients who were delivered because of clinical chorioamnionitis with antibiotics (n = 6) were significantly higher than in patients who were delivered because of active labor with (n = 14, p = 0.0133) and without antibiotics (n = 11, p = 0.0067). A significant change in the concentrations of IL-6 and IL-8 in cervicovaginal fluid was not observed in patients with and without antibiotics who were delivered because of active labor. Conclusions: The concentrations of IL-6 and IL-8 in cervicovaginal fluid might be influenced by the presence of clinical chorioamnionitis, but not by antibiotic administration.
Umbilical Cord Cyst in a Monochorionic Twin Pregnancy: An Experiment of Nature for the Treatment of Twin-Twin Transfusion Syndrome
Authors: Jacquemyn Y. , Markov D. , Beckstedde I.
Published: April 2003

A patient with a monochorionic twin pregnancy developed signs of twin-twin transfusion syndrome from 18 weeks of gestational age. At 23 weeks, an umbilical cord cyst and absent diastolic umbilical artery flow were noted in the donor twin. The pregnancy progressed uncomplicated until term and resulted in vaginal delivery of 2 healthy male babies at 38 weeks of gestational age. We hypothesize that the compression on the umbilical arteries of the donor twin by the umbilical cord cyst has resulted in a partial ‘compensation’ of the twin-twin transfusion phenomenon.
Maternal-Fetal Factors That Affected Doppler Waveform Analysis in a Patient Undergoing Hemodialysis
Authors: Lembet Arda , Eroğlu Derya , Ergin Tolga , Haberal Ali
Published: April 2003

Pregnancy in women having chronic renal insufficiency and undergoing hemodialysis is a rare event with a poor outcome. This is the 1st case in whom pre- and posthemodialysis fetal renal artery Doppler flow velocimetry was used in conjunction with fetal blood sampling which was performed to assess fetal karyotype and blood chemistry. Uteroplacental Doppler measurements were also performed, and a close correlation between maternal-fetal blood creatinine and urea nitrogen levels and fetal renal, umbilical, and uterine artery resistance indexes was observed.
Ecstasy-Induced Psychotic Disorder: Six-Month Follow-Up Study
Authors: Landabaso M.A. , Iraurgi I. , Jiménez-Lerma J.M. , Calle R. , Sanz J. , Gutiérrez-Fraile M.
Published: April 2003

Objective: To describe the psychiatric symptoms manifested by persons diagnosed for the first time as having ecstasy-induced psychotic disorder and to explore the evolution of their symptoms over a 6-month period. Design: Observational study with a 6-month follow-up. Method: The subjects studied were 32 ecstasy consumers who were treated at two drug-dependency outpatient centers for hallucinatory-delusive manifestations and who were diagnosed as having ecstasy-induced psychotic disorder according to DSM-IV criteria. For the assessment of the intensity of the syndrome and its follow-up, the Brief Psychiatric Rating Scale (BPRS), the Hamilton Depression Rating Scale (HDRS) and the Clinical Global Impression (CGI) were used at the outset and after 1, 3 and 6 months. All subjects received treatment with olanzapine. Results: The treatment program was completed by 96.9% of the patients. At the baseline assessment, a high incidence of symptoms of a severe psychiatric disorder was observed. From the first month the psychotic symptoms (BPRS) were considerably reduced with treatment, with the most severe positive symptoms remitting in the first 3 months. The three assessment indicators (BPRS, HDRS and CGI) showed a statistically significant clinical reduction over the 6 months of the assessment period. Furthermore, no relevant side effects were noted. Conclusions: In its initial manifestations, a drug-induced psychotic syndrome includes marked symptoms meeting the criteria of a severe psychotic disorder, with the presence of considerable positive and negative symptoms. Olanzapine has been shown to be very effective in these situations and its use is suggested as first-choice therapy.
Restraint Stress-Induced Elevation of Endogenous Glucocorticoids Decreases Peyer’s Patch Cell Numbers via Mechanisms That Are either Dependent or Independent on Apoptotic Cell Death
Authors: Sudo Nobuyuki , Oyama Naomi , Yu Xiao-Nian , Kubo Chiharu
Published: April 2003

In this study, we investigated whether restraint stress induces either apoptotic cell death or lymphocyte migration in Peyer’s patches. Exposure to stress induced a striking decrease in the number of CD3+CD4+, CD3+CD8+ and B220+ cells. Such decreases were accompanied by the enhanced induction of apoptosis in Peyer’s patches. The apoptosis of Peyer’s patch cells was completely reversed by pretreatment with either high or low doses of RU-486, a glucocorticoid receptor antagonist. In contrast, the stress-induced lymphopenia was little affected by administration of low doses of RU-486, although such lymphopenia was perfectly inhibited by treatment with high doses of RU-486. Taken together, these results suggest that the stress-induced lymphopenia in Peyer’s patches is partly due to apoptotic cell death, although other systems such as lymphocyte migration, may contribute to such a reduction in the number of Peyer’s patch cells.
Patterns of Reactivity to Lipid Transfer Proteins of Plant Foods and Artemisia Pollen: An in vivo Study
Authors: García-Sellés Francisco Javier , Díaz-Perales Araceli , Sánchez-Monge Rosa , Alcántara Manuel , Lombardero Manuel , Barber Domingo , Salcedo Gabriel , Fernández-Rivas Montserrat
Published: April 2003

Background: Lipid transfer proteins (LTPs) are major allergens of Rosaceae fruits in the Mediterranean area. IgE-cross-reactivity has been demonstrated in vitro among LTPs from peach, apple, chestnut and Artemisia pollen. The aim of this study was to evaluate the reactivity to LTPs from peach, apple, chestnut and Artemisia pollen by means of skin prick tests (SPTs). Methods: Forty-seven patients allergic to peach (peach group), 20 patients sensitized to Artemisia pollen with no food allergies (Artemisia group), and 12 control subjects were skin tested with fresh peach, as well as with whole extracts and purified LTPs of peach, apple, chestnut and Artemisia pollen. Results: The rates of positive SPTs for peach, apple, chestnut and Artemisia LTPs were, respectively, 91, 77, 23, and 36% in the peach group, and 30, 5, 15 and 40% in the Artemisia group. No response was observed in the control subjects. SPTs with peach LTP strongly correlated with SPTs conducted with fresh peach. In the peach group, the most frequent pattern of reactivity to LTPs was the combination peach-apple (45%), followed by peach-apple-Artemisia-chestnut (21%). Significant correlations were found between peach and apple LTPs, and between Artemisia and chestnut LTPs. Positive SPTs to chestnut LTP were only observed in patients with positive SPTs to Artemisia LTP. All the patients with positive case histories to chestnut reacted to chestnut LTP. Conclusions: LTPs are plant panallergens with different patterns of cross-reactivity. They are major allergens of Rosaceae fruits and seem to be involved in allergic reactions to unrelated foodstuffs such as chestnut, probably through sensitization to the cross-reactive Artemisia LTP. Rosaceae LTPs could be useful tools for in vivo diagnosis of Rosaceae fruit allergy.
Prevalence of Japanese Cedar Pollinosis among Schoolchildren in Japan
Authors: Ozasa Kotaro , Dejima Kenji , Takenaka Hiroshi
Published: April 2003

Background: Japanese cedar pollinosis is an important allergic rhinoconjunctivitis in Japan in spring. We investigated the relationship between the amount of pollen in the air and the prevalence of the disease and sensitization to Japanese cedar pollen in this ecological study. Methods: The IgE antibody to Japanese cedar pollen (JCP-IgE) was determined in human serum and rhinoconjunctival symptoms were surveyed in 407–510 children in May or June every year from 1995 to 2001. Japanese cedar pollinosis was defined as being JCP-IgE ≧1.5 IU/ml and having any rhinoconjunctival symptom lasting 3 weeks or longer in March or April. Results: Prevalence rates of Japanese cedar pollinosis were 13.8–22.9%. Prevalence rates of being JCP-IgE ≧1.5 IU/ml were 39.0–50.1%, and those of being JCP-IgE ≧15.01 IU/ml were 11.4–23.2%. All prevalence rates were significantly related to the amount of pollen in the air. The proportion of subjects with rhinoconjunctival symptoms was relatively constant in each stratum of low JCP-IgE levels (<0.35, 1.50–2.99, 3.0–14.9 IU/ml). Conclusion: High exposure to Japanese cedar pollen was associated with higher levels of JCP-IgE antibody and a high prevalence of Japanese cedar pollinosis. The relationship between the level of JCP-IgE and the proportion of subjects with symptoms was relatively constant.
Return to Work after Ischemic Stroke: A Methodological Review
Authors: Wozniak Marcella A. , Kittner Steven J.
Published: April 2003

Despite the economic cost of lost employment, return to work after ischemic stroke has received little study. The percentages of patients working after stroke vary widely from 11 to 85%. Comparisons of these studies are difficult because they report return to work in different populations after diverse follow-up periods using variable definitions of stroke and work. Stroke severity as measured by activities of daily living was the most robust predictor of return to work. However, many factors known to influence vocational outcome after other illness (e.g., social and job characteristics) have not been examined. Directions for future studies of return to work are suggested.
Distribution of Multiple Sclerosis in Sweden Based on Mortality and Disability Compensation Statistics
Authors: Landtblom Anne-Marie , Riise Trond , Boiko Alexei , Söderfeldt Birgitta
Published: April 2003

Previous studies have shown the Fennoscandian region to be a high-risk area for multiple sclerosis (MS). In order to investigate the distribution of MS in Sweden, mortality (1952–1992) and disability pensioning statistics (1971–1994) were studied. A total of 11,414 cases with a disability pension and 5,421 cases with MS on their death certificate were analysed according to county and time period and the results were compared with the mortality figures for amyotrophic lateral sclerosis (ALS) and disability pensioning statistics for Parkinson’s disease. We found increasing rates of both MS mortality and disability pensioning. Disability pensioning correlated well with mortality 10 years later (r = 0.42, p = 0.04). We also found a marked geographical variation. Värmland county had the highest mortality, with 14 out of its 16 municipalities having higher rates than the national mean. Unexpectedly, we found a high correlation between mortality due to MS and ALS (r = 0.60, p = 0.002).
A Phase II Study of Irinotecan Alternated with a Weekly Schedule of High-Dose Leucovorin and 48-Hour 5-Fluorouracil Infusion in Patients with Metastatic Colorectal Cancer
Authors: Rosati Gerardo , Rossi Antonio , Reggiardo Giorgio , Manzione Luigi
Published: April 2003

Purpose: To evaluate the activity and safety of an alternating schedule of irinotecan (CPT-11) with high-dose 5-fluorouracil (5-FU) given as a weekly 48-hour infusion in combination with leucovorin (LV) in the first-line treatment of metastatic colorectal cancer (MCRC) patients. Patients and Methods: We tested the activity of a regimen consisting of a four times per week schedule of high-dose LV (150 mg/m2) followed by a 48-hour 5-FU infusion (2,600 mg/m2) alternated with CPT-11 (350 mg/m2). An alternating cycle was to be performed every 8 weeks. Treatment was administered until disease progression, unacceptable toxicity or patient refusal occurred. Thirty-five consecutive patients with measurable MCRC, aged 18–80, with a performance status ≤2, were entered into our study from May 1998 to January 2000. Results: Four complete and 9 partial responses were observed (objective response rate was 37%; 95% confidence interval, CI: 21.5–55.1%); an additional 46% of the patients had stable disease. The median duration of response was 6.2 months, median time to progression 8 months (95% CI: 5.9–10.1%), and overall survival was 18.5 months (95% CI: 15.1–21.9%). The 1-year survival was 68%. No toxic deaths occurred. The incidence of grade 3–4 toxicity per patient in any cycle was: mucositis 9% and diarrhea 11% for the infusional 5-FU part, nausea/vomiting 3%, diarrhea 14%, and neutropenia 43% for the CPT-11 part of regimen. Conclusions: Our alternating schedule of 5-FU/LV and CPT-11 is a well-tolerated outpatient treatment as front-line therapy for MCRC with comparable efficacy to regimens with both drugs given together.
Cerebrospinal Fluid Rhinorrhea and Recurrent Pneumococcal Meningitis after Submucous Resection of the Nasal Septum
Authors: Erol Serpil , Ozkurt Zulal , Tasyaran Mehmet A.
Published: April 2003

In an immunologically competent individual, recurrent bacterial meningitis is usually the consequence of a transdural communication between the subarachnoid space and the base of the skull. Cerebrospinal fluid (CSF) rhinorrhea is the most common sign of a CSF fistula. This condition is most commonly caused by trauma, either accidental or iatrogenic. CSF rhinorrhea following a nasal surgical procedure is an unusual condition. We report here the case of CSF rhinorrhea and recurrent bacterial meningitis in a 24-year-old female patient following submucous resection of the nasal septum. We discuss the etiology, diagnosis and clinical course.
Care of Patients with Obstructive Sleep Apnea Syndrome in Switzerland
Authors: Schoch Otto D. , Bloch Konrad E.
Published: April 2003

Background: The obstructive sleep apnea syndrome (OSAS) is the most prevalent sleep-related breathing disorder. In Switzerland, the Swiss Respiratory Society together with the Swiss and the Cantonal Lung Associations have formed a Task Force to survey the current diagnostic and therapeutic state of the art. The present practice guidelines summarize the conclusions and recommendations based on scientific evidence and on the specific setting of the Swiss health care system. Methods: Review of the scientific literature, health care policy and practice, and expert panel discussions. Results: OSAS is diagnosed by typical symptoms together with findings during polysomnography. Pulse oximetry or limited respiratory polygraphy are not appropriate to exclude OSAS. Nasal continuous positive airway pressure (CPAP) is the most effective treatment for OSAS. In Switzerland, OSAS is diagnosed by pulmonary physicians in private practice and in sleep disorder centers. The pulmonologists work closely together with the local lung associations which play an essential role in the long-term care of OSAS patients on CPAP therapy. In particular, the associations provide counseling services, home care and technical support. With this approach, a high compliance with CPAP therapy has been achieved. The costs for CPAP therapy are reimbursed by the health insurance. Weight reduction in obese patients, sleep positional training and avoidance of alcohol and sedatives are adjunctive measures. In habitual snorers and in patients with OSAS unable to tolerate CPAP, removable oral appliances have provided favorable results. Conclusions: OSAS is suggested by a typical history and evaluated by a sleep study as a basis for treatment by nocturnal CPAP. Close cooperation of pulmonary physicians and lung associations provides excellent results in the long-term care of OSAS patients on CPAP.
The Lateral Rhinopexy
Authors: Hommerich C.P.
Published: April 2003

Correction of the collapsing nasal valve is often a surgical challenge. The surgical procedures suggested so far do not always show satisfactory results. In a nonrandomized pilot study, 8 patients were operated with a new technique. The technique uses a permanent fixation of the nasal valve at the piriform aperture (lateral rhinopexy) with simultaneous lateralization of the triangular complex. This was performed through a sublabial (external) approach (lateral rhinopexy). On average, patients had had 3.2 times previous nose surgery, including procedures at the nasal valve. The surgical technique is introduced. Follow-up periods ranged from 14 to 34 months. Functional results were verified by rhinomanometry 1 year after surgery. At that time, the nasal flow was on average more than doubled. Besides the functional improvement, the cosmetic results were satisfactory. Lateral rhinopexy proved to be a safe and effective procedure for the treatment of nasal valve collapse.
Association between Chromosome Instability and Histological Grading in Laryngeal Cancer
Authors: Dąbrowski Piotr , Szyfter Witold , Szmeja Zygmunt , Szyfter Krzysztof
Published: April 2003

An analysis of chromosome instability in peripheral blood lymphocytes provides information on the genetic risk of cancer. The study was attempted to find a relationship between chromosome instability and the histological grading of laryngeal cancer using bleomycin as a model agent inducing chromatid breaks. Indices of chromatid breaks were calculated separately for subjects with grade G1 (n = 19), G2 (n = 39) and G3 (n = 12). A considerable increase (close but not significant) in chromosome instability was found for G3 subjects. The results coincide with a high number of bleomycin-oversensitive cases in the G3 group and an almost bimodal distribution of chromatid breaks in the whole study group. The biological results seem to indicate that chromosome instability is at least partly connected with the nature of the tumour. However, the hypothesis of an association between increased chromosome instability and poor prognosis was not confirmed in the follow-up study on the patients’ clinical outcome.
Comment explorer l’ototoxicité des solvants dans le cadre d’études épidémiologiques
Authors: Chouanière Dominique , Demange Valérie , Loquet Gérard , Perrin Philippe , Johnson Ann-Christin , Planeau Vincent , Baudin Vincent , Toamain Jean-Paul , Morata Thaïs
Published: April 2003

Pour étudier les effets ototoxiques des solvants industriels dans le cadre d’études épidémiologiques, il faut disposer de tests audiologiques adaptés. Cette adaptation doit tenir compte de plusieurs contraintes: les tests doivent pouvoir déterminer les niveaux lésionnels liés au processus ototoxique incriminé, ils doivent répondre à des critères de qualité nécessaires aux études épidémiologiques en général (reproductibilité et sensibilité), et tenir compte de l’environnement dans lequel ils seront effectués, en entreprise, auprès de salariés a priori asymptomatiques. Deux batteries audiologiques font référence, ce sont celles mises au point par les équipes suédoises d’Odkvist et de Johnson. Elles utilisent un matériel vocal adéquat qui n’est pas disponible en français. Les auteurs ont donc choisi de développer une batterie en langue française, comparable aux batteries de référence existantes tout en respectant les contraintes de pertinence et de qualité des tests, de faisabilité en entreprises et en utilisant le matériel vocal français disponible. La batterie en langue française proposée ici comprend l’audiométrie tonale liminaire selon la technique d’Hughson Westlake, l’audiométrie vocale dans le bruit selon la méthode d’interpolation d’Hagerman, l’audiométrie vocale à interruptions périodiques adaptée avec listes de Fournier, la recherche des réflexes stapédiens et l’étude des produits de distorsion.
Sex chromosome aneuploidy in wild small mammals
Authors: Searle J.B. , Jones R.M.
Published: April 2003

We describe four examples of the XO condition in wild mammals. One XO house mouse (Mus musculus domesticus) was caught in nature and subsequently gave birth to three litters in captivity, confirming for wild mice the fertility observed for XO laboratory mice. Two other XO house mice were produced from laboratory crosses of wild-caught mice. An immature XO common shrew (Sorex araneus) was caught in nature; this appears to be the first XO recorded in the order Insectivora. We collected data from researchers studying chromosome variation in house mice and common shrews and found an overall incidence of 0.22% sex chromosome aneuploidy in 4608 mice and 0.05% in 6625 shrews. The discrepancy related to a much higher frequency of XO’s in mice than shrews. Single XXY and XYY shrews and an XXX mouse have been recorded in nature.
Progressive Transformation of Germinal Centers
Authors: Verma Amit , Stock Wendy , Norohna Sandhya , Shah Rajul , Bradlow Basil , Platanias Leonidas C.
Published: April 2003

Progressive transformation of germinal centers (PTGC) is a disease of mostly young adults that presents as unexplained, asymptomatic, localized or generalized lymphadenopathy which is usually persistent or recurrent over periods of many years. Histologically, the germinal centers contain a variable proportion of small mantle zone lymphocytes and thus become progressively transformed and may result in the loss of clear demarcation between them and the mantle zone. Here, we describe two cases of this disease and review the literature on the association of PTGC with lymphocyte-predominant Hodgkin’s disease.
Pyridine Nucleotide Redox Potential in Erythrocytes of Saudi Subjects with Sickle Cell Disease
Authors: Al-Ali Amein K.
Published: April 2003

Key antioxidant defense reactions in RBCs are linked to nicotinamide adenine dinucleotide (NAD+) and nicotinamide adenine dinucleotide phosphate (NADP+). The ratio of reduced (NAD(P)H) to total pyridine nucleotide pool [(NAD(P)T i.e. NAD(P)H plus NAD(P)+], which is known as redox potential, reflects the redox status of erythrocytes. Through the utilization of a spectrophotometric cycling assay, the NAD+ and NADP+ redox potentials were determined in erythrocytes from normal Saudi subjects and those with sickle cell disease (SCD). The sickle erythrocytes NADH/NADT ratio (0.386) was reduced compared to the normal ratio (0.464). This reduction appears to be due to a significant increase in oxidized NAD+ in sickle RBCs. However, the value of the redox potential of erythrocytes in Saudi subjects with SCD is slightly higher than that reported for comparable African Americans. Although the high fetal hemoglobin is the main factor in the amelioration of the clinical course exhibited by Saudi sickle cell patients, it is assumed that the slight improvement in the redox potential may play a part in this process. This is supported by a relatively uninhibited glycolytic pathway in the erythrocytes of Saudi subjects with SCD with a higher level of NADH than their African American counterparts.
CD7+ and CD56+ Myeloid/Natural Killer Cell Precursor Acute Leukemia Treated with Idarubicin and Cytosine Arabinoside
Authors: Handa Hiroshi , Motohashi Sachiko , Isozumi Kazuo , Komatsumoto Satoru , Nara Masaharu
Published: April 2003

We describe a 69-year-old Japanese male with acute leukemia with a CD7+ and CD56+ immunophenotype presenting with multiple lymphadenopathy. He was treated with idarubicin and cytosine arabinoside. Although the leukemia showed partial response, the patient did not achieve complete remission. He died of sepsis due to severe neutropenia after the third course of chemotherapy. His autopsy revealed blast infiltration in the lymph nodes, liver, spleen and vertebral bone marrow. Recently, CD7+ and CD56+ myeloid/natural killer precursor acute leukemia has been associated with a poor prognosis. Our case illustrates that myeloid/natural killer cell precursor acute leukemia shows some response to intensive chemotherapy for acute myeloid leukemia, but such therapy is insufficient to effect a cure. To overcome the resistance of this disease to chemotherapy, further studies should explore other treatment strategies.
Effect of Whole Body Hyperthermia on Ischemia and Reperfusion Injury of Rat Intestine: Real-Time ATP Change Studied Using 31P-MRS
Authors: Sugiura M. , Kuwabara Y. , Mitani M. , Sato A. , Shinoda N. , Kimura M. , Yano M. , Mitsui A. , Suzuki T. , Fujii Y.
Published: April 2003

We studied the effect of hyperthermia pretreatment on subsequent small intestinal ischemia and reperfusion (I/R) injury in the rat. Systemic hyperthermia has been reported to induce heat shock proteins (HSPs) in several organs [1-6]. We examined the expression of HSP72 in the small intestinal mucosa using Western blotting and immunohistochemistry. We monitored energy metabolism using magnetic resonance spectroscopy continuously during a 60-min ischemia and the following 120 min of reperfusion. Expression of HSP72 in the small intestine was significantly increased at 6–8 h after hyperthermia. Intestinal ischemia was induced by clamping the superior mesenteric artery. Heating of the rat conferred substantial resistance to the I/R injury. In the untreated rats, β-ATP decreased during ischemia (37.1 ± 15.5% of the pre-ischemic value) and recovered on reperfusion, but reached only ∼50% of the pre-ischemic value after 120 min of reperfusion. However, β-ATP in the pretreated rats was maintained during ischemia at significantly higher levels and on reperfusion reached ∼80% of the pre-ischemic value. These results indicate that hyperthermia protects the rat intestine from the I/R injury by unknown mechanisms which may include the induction of HSPs.
Efficacy of Continuous Hemodiafiltration for Patients with Congestive Heart Failure
Authors: Nakanishi Kazuya , Hirasawa Hiroyuki , Sugai Takao , Oda Shigeto , Shiga Hidetoshi , Kitamura Nobuya , Sadahiro Tomohito , Hirano Takeshi , Abe Ryuzo , Nakada Takaaki , Hirasawa Go
Published: April 2003

Background/Aims: The basic principle of treatment of congestive heart failure is achieving adequate control of preload and afterload through enhancement of cardiac contractility. In severe cases, however, we have usually applied continuous hemodiafiltration (CHDF) as a type of mechanical support. In this study, we investigated hemodynamic changes caused by CHDF in patients with congestive heart failure. Methods: We treated seven patients with congestive heart failure complicated by multiple organ failure by CHDF over 72 h, during which we measured hemodynamic parameters to determine their changes. Results: Implementation of CHDF resulted in a significant decrease in pulmonary artery occluded pressure and significant increases in cardiac index and left ventricular stroke work index. In addition, 72-hour cumulative water balance was found to be –1,791 ± 2,119 ml, and systemic vascular resistance index decreased significantly. Conclusion: Hemodynamics of patients were improved with CHDF through strict control of preload and consequently tissue oxygen metabolism was improved.
Improved Iron Utilization and Reduced Erythropoietin Resistance by On-Line Hemodiafiltration
Authors: Lin Chun-Liang , Huang Chiu-Ching , Yu Chun-Chen , Wu Ching-Herng , Chang Ching-Tung , Hsu Hsiang-Hao , Hsu Po-Yaur , Yang Chih-Wei
Published: April 2003

Background: Recent investigation has shown that on-line hemodiafiltration (HDF) can reduce the amount of recombinant human erythropoietin (rhEPO) deemed necessary to reach the target hematocrit. The aim of this study was to analyze the potential effect of on-line HDF on rhEPO resistance in relation to iron utilization and anemia-related parameters, when compared to conventional hemodialysis (HD). Methods: Ninety-two chronic uremic patients were treated with conventional HD and then shifted to on-line HDF. Measurements of various erythropoiesis-related parameters were collected during HD and on-line HDF periods for statistical analysis for erythropoietin resistance. Results: Patients treated with on-line HDF switching from conventional HD significantly contributed to the reduction of EPO dose to reach a higher mean hematocrit level (31.8 ± 4.4% vs. 29.5 ± 3.9%, p < 0.001) and a reduction of the serum ferritin level (322.5 ± 268.4 vs. 544.9 ± 642.4, p < 0.001). The median EPO/Hct ratio was greater in the HD period (504.6 ± 310.1) than in the on-line HDF period (307.6 ± 334.4) (p < 0.001). These results indicated a reduced EPO resistance and improved iron utilization by on-line HDF. By multiple regression analysis, the significant predictors of EPO resistance are ferritin, transferrin, albumin, and TACurea (Time average concentration of urea) in HD treatment. In on-line HDF modality, in addition to ferritin and albumin, the duration of on-line HDF is a negative predictor in EPO resistance. Conclusion: When on-line HDF is recommended to chronic dialysis patients, long-term use of this technique provides an efficient means of achieving the goal of an elevated hemoglobulin by reducing EPO resistance, improved iron utilization and may further improve the quality of life.
Improvement of Anemia in Hemodialysis Patients Treated by Hemodiafiltration with High-Volume On-Line-Prepared Substitution Fluid
Authors: Bonforte Giuseppe , Grillo Paolo , Zerbi Simona , Surian Maurizio
Published: April 2003

Background: Hemodiafiltration (HDF) is associated with a lower incidence of neuropathy, carpal tunnel syndrome, joint pain, and partial correction of anemia. HDF with on-line-prepared substitution fluid (OL HDF), as compared with conventional hemodialysis, increases the treatment tolerance and, as compared with standard HDF, avoids storage problems and allows a higher substitution volume at low cost. Methods: Thirty-two hemodialysis patients treated by OL HDF for at least 9 months were studied. Hemoglobin, hematocrit, iron metabolism, serum albumin, dialysis dose and dry body weight were determined under a settled condition with regular hemodialysis 3 months before the transfer to OL HDF. The same parameters were analyzed 3, 6 and 9 months after the beginning of the new treatment modality. Results: During OL HDF, hemoglobin values significantly increased in patients without addition of recombinant human erythropoietin (rHuEPO): baseline vs. 6 months 11 ± 1.7 vs. 12 ± 1.8 g/dl (p < 0.01); baseline vs. 9 months 11 ± 1.7 vs. 12 ± 1.6 g/dl (p < 0.05). In patients on a maintenance dose of rhuEPO, this could be significantly reduced, while the target hemoglobin levels were maintained (10.6 ± 0.9 g/dl): baseline 99.8 ± 50.4 U/kg/week, 3rd month 76.2 ± 43 U/kg/week, 6th month 64.3 ± 37 U/kg/week, and 9th month 59.4 ± 38.6 U/kg/week (p = 0.007, p = 0.0006, and p = 0.0007, respectively, vs. baseline). Iron metabolism, dialysis dose, dry body weight and serum albumin levels did not significantly change during the follow-up period. Further, a stability of the rHuEPO supplementation was observed in 14 patients followed up for 24 months. Conclusions: OL HDF influences anemia and rHuEPO dose. It allows considerable anemia correction in patients without rHuEPO treatment, while it significantly reduces rHuEPO doses in those on rHuEPO treatment as compared with standard hemodialysis. The rHuEPO costs are consequently reduced.
Dimensional Growth of the Rabbit Eye
Authors: Barathi A. , Thu Moe K. , Beuerman Roger W.
Published: April 2003

The rabbit eye has been used experimentally in research in vision and ophthalmology. However, there is little information about postnatal growth. The purpose of this study was to determine growth patterns of the rabbit globe from birth to young adult status focusing in particular on the fibrous outer tunic of the globe, the sclera. Eyes of both sexes of New Zealand White rabbits were examined on postnatal days 1, 7, 14, 28, 42 and 56. Axial length, equatorial diameter and corneal diameter were measured using a digital caliper. Plastic-embedded tissue was used to quantify scleral thickness and cellular density at anterior, equatorial and posterior sites. Axial length increased 230% between postnatal days 1 and 56. The rate of growth was not linear and revealed two peaks. The first peak occurred between postnatal days 1–7, and the second between days 14–28. Eye opening occurred on days 9–11. Sex differences were seen, with the male eye being larger (p = 0.00001). Surface area measurements of sclera and cornea revealed that the sclera occupies approximately 5/6 of the outer surface of the globe and the cornea 1/6. Scleral thickness increased from day 1 to day 42 (70–155 µm at the equator) while fibroblast density was found to decrease (0.32 to 0.05 cells/µm2). The results suggested that eye opening precedes a unique increase in the rate of eye growth and visual processes may be playing a role in modulating the growth pattern between days 14 and 28.
Microvascularization of the Mucocutaneous Junctions of the Head in Fetuses and Neonates
Authors: Wolfram-Gabel R. , Sick H.
Published: April 2003

The mucocutaneous junctions of the head (oral, nasal and palpebral) are transitional zones between the integuments and the mucosa. Their microvascularization is studied in the heads of fetuses and neonates by injection of agarized China ink into the vascular system. These zones are situated deep with respect to the free edge of the oral or nasal cavity or relative to the free margin of the eyelid. They present cutaneous-type microvascularization with a papillary network and reticular networks. Long capillary loops connected to the deep reticular network are their main feature. In the lips and eyelids, the morphology of the networks and their relationship with the orbicular muscles are suggestive of a functional structure.
Theoretical Study of the Decrease in the Femoral Neck Anteversion during Growth
Authors: Fabeck L. , Tolley M. , Rooze M. , Burny F.
Published: April 2003

This theoretical analysis tries to explain the decrease of the femoral neck anteversion during growth according to well-established concepts. In the frontal plane, it was demonstrated that the capital epiphyseal plate inclination allows the plate to remain perpendicular to the resultant force applied to the hip during gait. In the transversal plane, the projection of this force varies from –24°, outwards and forwards (heel strike), to 20°, outwards and backwards (toe off). A mathematical formula calculates the instantaneous coordinates of the plate in this plane during gait. This kinematic study points out that the physiological value of the capital epiphyseal plate anteversion at the end of the growth is theoretically the ideal value to obtain in the transversal or horizontal plane a perpendicular relation between the orientation of this plate and the projection of the resultant force during walking.
Fetal Anemia, Thrombocytopenia, Dilated Umbilical Vein, and Cardiomegaly due to a Voluminous Placental Chorioangioma
Authors: Mara Michal , Calda Pavel , Zizka Zdenek , Sebron Vaclav , Eretova Vladimira , Dudorkinova Daniela , Dundr Pavel , Binder Tomas , Hajek Zdenek
Published: April 2003

We report a case of voluminous placental chorioangioma diagnosed by ultrasound and color Doppler imaging during the 20th week of pregnancy. The size of the tumor was enlarging progressively (up to 10 cm in the 32nd week), and during this time the signs of fetal intrauterine volume overload and blood cell consumption, such as cardiomegaly, umbilical vein dilation, hydramnios, anemia, and thrombocytopenia, were observed. In the 32nd week of pregnancy, the signs of uteroplacental insufficiency and fetal hypoxia appeared; therefore, the pregnancy was terminated by cesarean section, and a female infant weighing 1,870 g was delivered. She was discharged, fully recovered, after 48 days. Histopathological examination of the placental tumor showed a benign, vascular-type chorioangioma.
Application of Ductus venosus Doppler Velocimetry for the Detection of Fetal Aneuploidy in the First Trimester of Pregnancy
Authors: Murta Carlos G.V. , Moron Antônio F. , Avila Márcio A.P. , Weiner Carl P.
Published: April 2003

Objective: To test the hypothesis the application of ductus venosus Doppler velocimetry may serve as a screening tool between 10 and 14 weeks’ gestation for the detection of fetuses with chromosomal abnormalities. Methods: 372 consecutive fetuses were studied. Based on prior study, a chromosomal abnormality was suspected when either the nuchal translucency was above the 95th centile, or there was reversed or absent flow in the ductus venosus during atrial contraction. Sensitivity, specificity, and the negative and positive predictive values were calculated. Results: There were 29 chromosomally abnormal fetuses. Of these 29 fetuses, ductus venosus blood flow during atrial contraction was either absent (n = 2) or reversed (n = 25) in 93.1%. In the chromosomally normal fetuses (n = 343), only 6 (1.7%) had abnormal Doppler profiles in the ductus venosus (specificity = 98.3%, positive and negative predictive values = 81.8% and 99.4%, respectively). Conclusion: The Doppler waveform of the ductus venosus was at least equal to NT thickness measurement for the detection of chromosomal abnormalities.
Prenatal Diagnosis of an Aorto-Pulmonary Window by Fetal Echocardiography
Authors: Collinet Pierre , Chatelet-Cheront Carla , Houze de l’Aulnoit Denis , Rey Christian
Published: April 2003

Congenital aorto-pulmonary window or congenital aorto-pulmonary septal defect is a rare fetal malformation usually diagnosed after birth by echocardiography and usually associated with other congenital cardiovascular abnormalities (interrupted aortic arch, ventricular septal defect, atrial septal defect, tetralogy of Fallot). The authors report the first case of prenatal diagnosis of an aorto-pulmonary window associated with a ventricular septal defect identified by fetal ultrasonography at 28 weeks of pregnancy. The diagnosis was based on the echocardiographic images of normal semilunar aortic and pulmonic valves with evidence of a septal defect between the ascending aorta and pulmonary artery. The purpose of this report is to demonstrate the feasibility of antenatal diagnosis of this fetal malformation and help professionals who would be faced with such an unexpected prenatal image.
Limb Constriction as a Complication of Intra-Uterine Vesico-Amniotic Shunt: Fetoscopic Release
Authors: Chan Fung Yee , Borzi Peter , Cincotta Robert , Burke John , Tudehope David
Published: April 2003

Complete fetal bladder outlet obstruction was first diagnosed in a fetus at 13.5 weeks. After sequential vesicocentesis had shown good renal function, a vesico-amniotic shunt was inserted at 17 weeks with a Rodeck catheter. The procedure was successful and amniotic fluid volume re-accumulated to normal levels. A detailed scan at 20 weeks showed that the distal free end of the catheter was wound round the left fetal thigh. As the fetus grew, there was progressive constriction of the fetal thigh by the catheter. By 29 weeks, Doppler blood flow changes to the left leg were apparent. Fetoscopic surgery was performed at 30 weeks to release the constriction. The catheter was divided successfully, but the divided end of the shunt subsequently retracted into the fetal abdomen, producing urinary ascites, bilateral hydroureter and hydronephrosis. The baby was delivered at 31.5 weeks in good condition. Endoscopic resection of anterior and posterior urethral valves was performed at 6 months of age. At 2 years, the child has normal renal function, growth parameters and developmental milestones. Mild indentation of the left thigh was still apparent, although there was no functional impairment.