bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of Rosiglitazone and Pioglitazone Combined with Metformin on the Prothrombotic State of Patients with Type 2 Diabetes Mellitus and Metabolic Syndrome
Authors: Derosa G , D'Angelo A , Ragonesi PD , Ciccarelli L , Piccinni MN , Pricolo F , Salvadeo S , Montagna L , Gravina A , Ferrari I , Galli S , Paniga S , Cicero AFG
Published: February 2013

In this multicentre, randomized, double-blind, controlled, parallel-group trial, 103 patients with type 2 diabetes mellitus and metabolic syndrome were randomized to receive one of two thiazolidinediones – pioglitazone or rosiglitazone – in combination with 1500 mg/day of metformin, increasing up to 3000 mg/day, for 12 months. Anthropometric, metabolic, coagulation and fibrinolysis parameters were assessed at baseline and after 3, 6, 9 and 12 months. Significant decreases in glycosylated haemoglobin, fasting plasma glucose and post-prandial plasma glucose levels were seen after 9 and 12 months in both groups, and significant decreases in fasting plasma insulin and post-prandial plasma insulin levels were seen after 12 months in both groups. In both groups, improvement in the homeostasis model assessment index compared with baseline was obtained only after 12 months. Plasminogen activator inhibitor-1 levels were significantly lower in both groups after 12 months compared with baseline values. In patients with type 2 diabetes mellitus and metabolic syndrome, the combination of metformin plus thiazolidinediones improved glycaemic control and produced a slight but significant reduction in plasminogen activator inhibitor-1 levels.
Placement of Two Types of Spiral Z-Stents at the Bronchial Carina for the Treatment of Terminal Lung Cancer – a New Method
Authors: Hosokawa Y , Tsujino I , Kiyofuji K , Koura T , Shoda T , Horikoshi A , Sawada S
Published: February 2013

Dumon® Y-stents and Dynamic stents are used to treat carinal stenosis, but their placement severely impairs the expectoration of secretions, making frequent bronchoscopic aspiration necessary. We report here five patients with terminal lung cancer who had stenosis of the lower trachea and main bronchi treated using spiral Z-stents. A long tapered spiral Z-stent was placed in the lower trachea and one main bronchus, and a short straight spiral Z-stent in the contralateral main bronchus. No patients required bronchoscopic aspiration of secretions after stenting. Before stenting, all of the patients were severely dyspnoeic, requiring oxygen and having to sit in the orthopnoeic position. After stenting, the patients' dyspnoea improved, with one patient becoming ambulant without the need for oxygen support. These results suggest that the use of spiral Z-stents in stenosis of the tracheal carina in advanced lung cancer is effective in reducing the need for bronchoscopic aspiration and enhancing quality of life.
Infiltrating T-lymphocyte Receptor Vβ Gene Family Utilization in Autoimmune Thyroid Disease
Authors: Zhang J , Zhang M , Wang Y , Shi B , Zhu B , Si L
Published: February 2013

The expression of T-cell antigen receptor (TCR) Vβ genes in autoimmune thyroid diseases (AITDs) was investigated. RNA was extracted from the thyroid tissue of 23 patients with early-stage Graves' disease, 19 patients with late-stage Graves' disease and 20 patients with Hashimoto's disease. Peripheral blood lymphocytes from patients and 20 normal subjects (controls) were analysed in parallel. AITD was found to be associated with diminished TCR Vβ gene family utilization. In addition, AITDs appeared to select for specific TCR Vβ families. The Vβ3, Vβ5 and Vβ8 families were expressed more frequently in thyroid-infiltrating T-lymphocytes of early-stage Graves' disease than other Vβ gene families. Selective expression was not observed in infiltrating T-lymphocytes obtained from thyroid tissue of patients with late-stage Graves' disease or Hashimoto's disease. Preferentially expressed TCR Vβ gene families may be useful as molecular targets for targeted immunotherapy of AITDs.
Predictors and Prognostic Significance of Troponin-I Release following Elective Coronary Angioplasty
Authors: Izgi A , Tanalp AC , Kirma C , Dundar C , Oduncu V , Akcakoyun M , Ozveren O , Mutlu B
Published: February 2013

The objective of this study was to investigate the predictors and prognostic significance of post-procedural cardiac troponin (cTn)-I elevations in a consecutive series of patients who underwent elective percutaneous coronary intervention (PCI). cTn-I was measured in 100 patients immediately before and within 24 h after the elective PCI. Post-procedural cTn-I elevation was observed in 27 of the 100 patients. In multivariate analysis, basal haemoglobin values and the number of repeated balloon dilatations were found to be independent predictors of cTn-I elevation. During the follow-up period of 12 ± 1.2 months, the cTn-I-positive group had more major adverse cardiovascular events than the cTn-I-negative group (33.3% versus 16.4%, respectively), but the difference was not significant. An increase in cTn-I levels following elective PCI procedures was frequent but did not predict a poor long-term outcome.
Pain Relief for Children after Adenotonsillectomy
Authors: Ertugrul F , Akbas M , Karsli B , Kayacan N , Bulut F , Trakya A
Published: February 2013

Effective pain relief following adenotonsillectomy in children remains a challenge. This study evaluated the effects of intramuscular 0.5 mg/kg ketamine, 1 mg/kg tramadol or 1 mg/kg meperidine on post-operative pain and recovery in 45 children aged 1-7 years undergoing adenotonsillectomy. Anaesthesia was induced with thiopental or sevoflurane (with succinylcholine for intubation) and was maintained with sevoflurane in oxygen and nitrous oxide. Post-operative pain was scored blind using a modified Toddler–Preschooler Post-Operative Pain Scale 30, 60, 120 and 240 min after tracheal extubation. Post-operative agitation scores were also recorded. Mean post-operative pain score was significantly higher in the tramadol-treated group compared with the meperidine-treated group 120 min after extubation. At all other time-points after extubation, mean post-operative pain scores were similar for the three treatment groups. Ketamine was associated with a significantly higher mean agitation score compared with tramadol and meperidine. We conclude that the effects of ketamine, meperidine and tramadol on post-operative pain following adenotonsillectomy in children were similar.
Osteosarcoma in Pre-adolescent Patients
Authors: Cho WH , Lee SY , Song WS , Park JH
Published: February 2013

The medical records of 38 pre-adolescent (aged ≤ 10 years) and 43 adolescent (aged 11-15 years) patients with primary osteosarcoma treated using the same protocol were reviewed in order to determine whether the clinical features and prognosis differed between these two groups. Gender, tumour location, tumour size, serum levels of alkaline phosphatase and lactic dehydrogenase before treatment, and chemotherapy-induced tumour necrosis were recorded, together with survival data. These parameters were compared in the two groups, and their prognostic significance was evaluated in the pre-adolescent patients. There were no statistically significant differences in the clinical parameters between pre-adolescent and adolescent patients. Only a poor level of chemotherapy-induced tumour necrosis was significantly associated with a poor prognosis in pre-adolescent patients. This study indicates that osteosarcoma behaviour is similar in pre-adolescent and adolescent patients, and there appears to be little justification for adopting different therapies in these two groups.
Echocardiography and Carotid Sonography in Diabetic Patients after Cerebrovascular Attacks
Authors: Chlumský J , Charvát J
Published: February 2013

This study evaluated the aetiological factors for cerebrovascular attack (CVA) using echocardiography and sonography of the carotid arteries. Results from 253 patients with CVA were evaluated retrospectively and analysed according to the presence or absence of diabetes and atrial fibrillation. In patients with sinus rhythm ( n = 182), the presence of diabetes was associated with an increased incidence of atherosclerotic changes and significant stenosis of the carotid artery as well as greater intima-media thickness. In contrast, when evaluating signs of thromboembolic risk, there were no statistically significant differences in left atrial diameter or left ventricular ejection fraction between the two groups. In patients with atrial fibrillation ( n = 71), no significant differences were observed between diabetic and non-diabetic patients in any of the parameters measured. These findings suggest that the increased risk of ischaemic CVA in diabetic patients is due to atherosclerosis in the carotid vessels rather than embolism of cardiac origin.
The Influence of Micronutrients on Cognitive Function and Performance
Authors: Huskisson E , Maggini S , Ruf M
Published: February 2013

There has been much media speculation (often sensationalist and conflicting) regarding the potential influence of micronutrients on cognitive function and performance. Our aim was to identify the micronutrients specifically implicated in cognitive function and to review the literature to identify original sources underlying the media coverage. Literature searches were carried out to identify recent clinical trials, reviews, editorials and meetings describing the biochemical and physiological role of individual micronutrients. No attempt was made to grade the evidence. The searches confirmed that the water-soluble vitamins (B group and C), together with the minerals, calcium, magnesium and zinc, are most relevant to cognitive performance. Clinical evidence revealed that marginal deficiencies of one or more of these micronutrients are not uncommon, even in the developed countries, and that such deficiencies may affect cognitive performance, especially in vulnerable groups such as the elderly and those individuals who are exposed to occupational pressures and a stressful lifestyle.
Comparison of the Nutritional Values of Follow-on Formulae Available in Italy
Authors: Riva E , Verduci E , Agostoni C , Giovannini M
Published: February 2013

If breast milk is not available during complementary feeding, ‘follow-on’ formula milk ensures a balanced intake of nutrients and is undoubtedly more suitable for infants than cows' milk. Formula milk provides a lower intake of proteins and saturated fats and a higher concentration of polyunsaturated fats, iron and zinc than cows' milk. In particular, delaying the introduction of cows' milk until the end of the first year of life, or even until after the second year, appears to play a fundamental role in the prevention of iron deficiency anaemia. It may also prevent excess weight gain and obesity and the development of immuno-allergic symptoms, and may be important for neurobehavioural development. More than 30 varieties of follow-on formula milk are currently available in Italy alone. This review outlines the nutritional differences between breast, formula and cows' milks, and compares different brands of formula milk.
Obstructive Sleep Apnoea, Cigarette Smoking and Serum Testosterone Levels in a Male Sleep Clinic Cohort
Authors: Kirbas G , Abakay A , Topcu F , Kaplan A , Ünlu M , Peker Y
Published: February 2013

This study evaluated the impact of obstructive sleep apnoea (OSA) and smoking on total serum testosterone levels in 96 men (mean age 43.3 years; range 25-60 years) attending a sleep clinic. Fifty-five men (57.3%) had OSA, defined as an apnoea–hypopnoea index of ≥ 15 events/h, recorded during overnight polysomnography, and 42 (43.8%) were current smokers. Mean serum total testosterone levels were significantly lower in OSA subjects (3.4 ng/ml) than in non-OSA subjects (3.9 ng/ml), whereas no significant difference was observed between current smokers and non-smokers. In a multiple linear regression analysis, serum testosterone was negatively correlated with body mass index and the apnoea–hypopnoea index, but not with age and pack-years of smoking. Our results support previous observations regarding testosterone levels in men with OSA, but, contrary to some earlier reports, there was no positive relationship between smoking and total testosterone in the present cohort.
Effect of Nicardipine on Haemodynamic and Bispectral Index Changes following Endotracheal Intubation
Authors: Kim J-H , Lee Y-S , Kim W-Y , Kim H-J , Chang M-S , Park J-Y , Shin H-W , Park Y-C
Published: February 2013

We investigated the effect of IV nicardipine on haemodynamic and bispectral index responses to the induction of general anaesthesia and intubation. Forty patients were randomly allocated to two groups of 20 to receive normal saline or nicardipine 15 μg/kg IV 30 s after induction. Ninety seconds later, tracheal intubation was performed. Systolic blood pressure, heart rate and bispectral index were measured at baseline, 1 min after induction, pre-intubation, and every minute until 5 min after endotracheal intubation. Rate–pressure product values were calculated. In the nicardipine group, systolic blood pressure decreased compared with the control group, and heart rate increased compared with the control group. Bispectral index and rate–pressure product showed no differences between the two groups. In conclusion, the administration of 15 μg/kg nicardipine IV does not affect anaesthetic depth in response to the induction of general anaesthesia and intubation.
The Effects of Calcium Channel Blockers are not Related to their Chemical Structure in the Collar Model of the Rabbit
Authors: Yasa M , Kerry Z , Reel B , Anacak G Yetik , Ertuna E , Ozer A
Published: February 2013

Placing a silicone collar around the rabbit carotid artery induces intimal thickening, an early stage in atherosclerosis and restenosis. We investigated whether treatment with oral pranidipine, a new potent, long-lasting dihydropyridine calcium channel blocker (CCB), inhibited collar-induced intimal thickening in addition to the changes in vascular reactivity usually observed in this model. Pranidipine treatment did not inhibit collar-induced intimal thickening. Placing the collar around the carotid artery resulted in the characteristic changes in vascular reactivity, such as increased sensitivity to 5-hydroxytryptamine. Treatment with Nω-nitro-l-arginine (100 μM) and pranidipine, however, did not affect collar-induced changes in vascular reactivity. From results of this and previous studies, we conclude that pranidipine does not prevent collar-induced intimal thickening or collar-induced changes in vascular reactivity. Not all CCBs prevent collar-induced intimal thickening, suggesting that the effects of these agents are not related to their chemical structure and/or their calcium channel-blocking actions.
Effects of Astragalus Polysaccharides and Astragalosides on the Phagocytosis of Mycobacterium tuberculosis by Macrophages
Authors: Xu H-D , You C-G , Zhang R-L , Gao P , Wang Z-R
Published: February 2013

The herb Astragalus membranaceus is used in traditional Chinese medicine to boost immunity. This study investigated the effects of Astragalus polysaccharides (APS) and astragalosides (AS) on the phagocytosis of Mycobacterium tuberculosis by macrophages. Peritoneal macrophages were obtained by peritoneal lavage from mice stimulated by starch gravy culture medium and cultured with M. tuberculosis and varying concentrations of APS and AS. Phagocytotic activity was measured using a real-time polymerase chain reaction assay to detect M. tuberculosis DNA. Levels of interleukin-1β, interleukin-6 and tumour necrosis factor-α secreted by activated macrophages in the culture supernatant were determined using an enzyme-linked immunosorbent assay. Macrophage phagocytotic activity and secreted cytokine levels were significantly increased after treatment with APS and AS. This study provides evidence that APS and AS have strong promoting effects on the phagocytosis of M. tuberculosis by macrophages and the secretion of interleukin-1β, interleukin-6 and tumour necrosis factor-α by activated macrophages.
Arterial Stenosis Detected by Digital Subtraction Angiography and its Relationship with the Oxfordshire Community Stroke Project Classification
Authors: Zhang H , Liu X , Xu G , Zhang R , Yin Q , Zhu W
Published: February 2013

The aim of this study was to assess extra-and intracranial arterial stenosis in first-ever stroke patients and to analyse the relationship between arterial stenosis and the Oxfordshire Community Stroke Project (OCSP) classification. Chinese patients ( n = 817) were classified according to OCSP criteria, and arterial abnormalities were evaluated in 342 of the patients by digital subtraction angiography. Prevalence of significant stenosis in the extracranial internal carotid artery was highest among total anterior circulation infarct patients and lowest among patients with lacunar infarct. There was no evidence that the frequency of patients with intracranial arterial significant stenosis was different among OCSP subtypes. The results suggest that extracranial internal carotid artery stenosis was significantly related to OCSP subtype and that patients with total anterior circulation infarct were more likely to have extracranial internal carotid artery stenosis than patients having partial anterior circulation infarct, posterior circulation infarct or lacunar infarct.
Serum Her-2/neu and Survivin Levels and Their Relationship to Histological Parameters in Early-stage Breast Cancer
Authors: Goksel G , Taneli F , Uslu R , Ulman C , Dinc G , Coskun T , Kandiloglu AR
Published: February 2013

This study was conducted to investigate the serum levels of her-2/neu and survivin in patients with early-stage breast cancer and their relationship with known histological parameters. Forty-one patients with early-stage breast cancer were investigated. Serum samples were collected from patients on their first admission before adjuvant chemotherapy, and from healthy controls. Serum her-2/neu and survivin levels were determined using an enzyme-linked immunosorbent assay. There was no difference in the levels of serum her-2/neu and survivin between the breast cancer patients and the control group. Serum her-2/neu concentration showed moderate correlations with disease stage and the Ki-67 level, and the serum survivin level showed a moderate correlation with progesterone receptor concentration. Serum levels of her-2/neu and survivin were not significantly related to age and histological parameters in patients with early-stage breast cancer. However, much research continues on the prognostic value of serum her-2/neu and survivin levels, and important new knowledge may ultimately emerge.
Evaluation of the Efficiency of Medical Masks and the Creation of New Medical Masks
Authors: Huang JT , Huang VJ
Published: February 2013

The effectiveness of medical masks in preventing respiratory infection was investigated by testing bacterial leakage, filtration efficiency, respiratory resistance and oxygen concentration of the enclosed space. Polypropylene (PP) fibres were treated with dimethyldioctadecylam-monium bromide to impart a positive electrical charge capable of attracting bacteria. The fluffed PP fibres were used to make a polypropylene mask and to edge standard surgical and N-95 respirators to prevent leakage. A PP napkin was created by melting and blowing PP. The PP edging seal dramatically reduced bacterial leakage of standard masks and was more effective than adhesive paper tape edging in reducing respiratory resistance. Bacterial or viral filtration efficiency was almost 100% for the PP mask and the PP napkin. The specially designed PP mask with a synthetic adhesive at the edge of the mask may be more effective than the standard surgical mask and the N-95 respirator. The PP napkin is an important tool in preventing the spread of pathogens.
The Expression of Interleukin-10 in Patients with Primary Ovarian Epithelial Carcinoma and in Ovarian Carcinoma Cell Lines
Authors: Zhou J , Ye F , Chen H , Lv W , Gan N
Published: February 2013

This study determined interleukin-10 (IL-10) expression in patients with ovarian carcinoma and in ovarian carcinoma cell lines, and investigated its clinical significance in the development and progression of ovarian carcinoma. Expression of IL-10 in ovarian carcinoma, benign ovarian tumour, normal control tissues and ovarian carcinoma cell lines was detected by immunohistochemistry and Western blot analysis. IL-10 concentrations in sera and ascites from patients with ovarian carcinoma, in sera from patients with benign ovarian tumour and normal controls, and in supernatants of ovarian carcinoma cell line cultures were measured by enzyme-linked immunosorbent assay. The tissue level of IL-10 in ovarian carcinoma was significantly higher than in benign ovarian tumour and normal controls. IL-10 expression was detectable in cell lysate and supernatant from ovarian carcinoma cell lines. In patients with ovarian carcinoma the IL-10 level in ascitic fluid was significantly higher than in sera, and the serum IL-10 level in ovarian carcinoma was significantly higher than in benign ovarian tumour and normal controls. Ascitic IL-10 levels in ovarian carcinoma were significantly correlated with disease stage but not cytological grade. These results suggest that ovarian carcinoma cells are able to synthesize and secrete IL-10, which probably assists in promoting the development and progression of ovarian carcinoma.
Serum Anti-Amyloid-β Antibodies and Alzheimer's Disease in Elderly Korean Patients
Authors: Song MS , Mook-Jung I , Lee HJ , Min JY , Park MH
Published: February 2013

Alzheimer's disease (AD) is characterized by the deposition of senile plaques and neurofibrillary tangles in the brain. The presence of the amyloid-β (Aβ) peptide in senile plaques seems to play a central role in the neuropathology of AD. Diagnosis of AD involves neuro-psychological examinations or magnetic resonance imaging and, to date, a specific diagnostic marker indicating AD has not been found. This study analysed anti-Aβ antibodies from the serum of 153 patients with AD using an enzyme-linked immunosorbent assay method. The levels of anti-Aβ antibody from patients in the control group ( n = 193) were compared with those of patients with AD. Our results showed a significantly lower anti-Aβ antibody level in patients with AD than in the control group. These results showed that the anti-Aβ antibody level in serum could potentially be used to diagnose the presence of AD.
Middle-aged and Elderly Outpatients Show Lower Body Temperature Responses than the Young, Even with the Same C-reactive Protein Levels
Authors: Hoshino A , Tamura J , Nakazawa M , Koyama H
Published: February 2013

The variation of body temperature response and C-reactive protein (CRP) levels with age was investigated. A cross-sectional study on new outpatients between January 2004 and June 2005 was carried out. Body temperature and serum CRP levels were examined for screening purposes in 1081 patients. Mean axillary body temperature was maintained at around 36.7°C in early adulthood, and gradually declined in middle age. Middle-aged and elderly outpatients tended to show a lower body temperature response than the young, even with the same CRP levels. The critical age (boundary age) was assumed to be when the relationship between body temperature response and CRP level changed. This study suggests that the boundary age is about 40 years old.
The Effect of Ramipril Therapy on Cytokines and Parameters of Incipient Diabetic Nephropathy in Patients with Type 1 Diabetes Mellitus
Authors: Zdarska D Janickova , Zavadova E , Kvapil M
Published: February 2013

We compared the levels of transforming growth factor β1 (TGF-β1), vascular endothelial growth factor (VEGF) and other biochemical parameters in patients with type 1 diabetes mellitus with and without incipient diabetic nephropathy (iDN) and compared them with healthy control subjects. We also measured the effect of 3 and 6 months of ramipril treatment in diabetes patients with iDN. Compared with healthy controls, TGF-β1 levels were increased in both groups of diabetes patients, whereas VEGF was only elevated in patients with iDN. Ramipril did not have a significant effect on TGF-β1 or VEGF levels. We observed a significant decrease in microalbuminuria and cystatin C following ramipril treatment. Increased VEGF levels in patients with iDN suggest a role for this cytokine in the pathogenesis of diabetic nephropathy. Cystatin C would make a suitable marker for the screening and assessment of iDN, and for the evaluation of the therapeutic efficacy of drugs.
Vitamin B12, Folate, Homocysteine and Urinary Methylmalonic Acid Levels in Infants
Authors: Karademir F , Suleymanoglu S , Ersen A , Aydinoz S , Gultepe M , Meral C , Ozkaya H , Gocmen I
Published: February 2013

Serum vitamin B12 and folate, and their functional markers, plasma homocysteine and urinary methylmalonate (uMMA) were measured in 204 healthy, term infants at birth, and at 2 and 6 months. Compared with infants receiving formula food, those fed mother's milk had lower vitamin B12 and folate at 2 and 6 months. In infants receiving mother's milk, vitamin B12 levels were similar at birth (238 pg/ml) and 2 months (243 pg/ml), whereas with formula milk the level was significantly higher at 2 months (558 pg/ml) than at birth (257 pg/ml). Vitamin B12 was negatively correlated with homocysteine at birth and 6 months. The level of uMMA (mmol/mol creatinine) was higher at 2 (mother's milk, 25.5; formula, 23.97) and 6 months (19.77; 15) than at birth (11.97; 10.88), and was not correlated with vitamin B12 levels. Homocysteine may be a reliable marker of vitamin B12 status in neonates and infants; however, uMMA is not suitable as a marker of vitamin B12 status.
Changes in the Plasma Amino Acid Profile in Anorexia Nervosa
Authors: Palova S , Charvat J , Masopust J , Klapkova E , Kvapil M
Published: February 2013

We evaluated and measured by high performance liquid chromatography the plasma amino acid levels in 11 female patients with anorexia nervosa during a period of significant loss of body weight, compared with 11 healthy age-matched controls. Total amino acid and total branched-chain amino acid levels were similar in both groups, however significantly higher levels of glycine and ornithine were found in anorexia nervosa patients, as well as significantly lower levels of leucine, tyrosine and lysine compared with controls. The glycine/valine and phenylalanine/tyrosine ratios were significantly higher in anorexia nervosa patients than in control subjects. The levels and ratios of other amino acids were within the normal range, with no significant differences between the two groups. Changes in the plasma amino acid profile in anorexia nervosa patients can be explained by chronic severe malnutrition and prolonged stress.
Propofol Increased the Interleukin-6 to Interleukin-10 Ratio more than Isoflurane after Surgery in Long-term Alcoholic Patients
Authors: von Dossow V , Baur S , Sander M , Tønnesen H , Marks C , Paschen C , Berger G , Spies CD
Published: February 2013

This study investigated the effect of an anaesthetic regimen on the immune response in 40 long-term alcoholic patients undergoing surgery. Patients were randomly allocated to receive either propofol or isoflurane during surgery. Plasma cytokines interleukin (IL)-6 and IL-10 were measured at defined times and rates of post-operative infections were documented. The IL-6/IL-10 ratio significantly increased with propofol compared with isoflurane on day 1 after surgery and the IL-10 level significantly increased with isoflurane on day 1 after surgery. The overall post-operative infection rate was significantly higher in isoflurane-treated patients. Our findings indicate that propofol anaesthesia might be the more favourable regimen, with the IL-6/IL-10 ratio indicating an attenuation of the immune imbalance after surgery in long-term alcoholic patients. These results support the undertaking of a properly powered clinical trial to determine if propofol anaesthesia can reduce the postoperative infection rate in this special patient population.
Primary Small-bowel Non-Hodgkin's Lymphoma: A Study of Clinical Features, Pathology, Management and Prognosis
Authors: Yin L , Chen CQ , Peng CH , Chen GM , Zhou HJ , Han BS , Li HW
Published: February 2013

The records of 34 patients diagnosed with primary small bowel non-Hodgkin's lymphoma during a 10-year period between January 1996 and December 2005, including 27 cases for which complete follow-up records were available, were studied. Abdominal pain (70.6% of patients) was the main presenting symptom, followed by intestinal obstruction (38.2%). The most common primary site was the ileum (58.8%), followed by the jejunum (26.5%) and duodenum (17.6%); one case had tumours at two sites in the small bowel. Twenty-seven patients had small bowel B-cell lymphoma (24 diffuse large B-cell lymphoma; three mucosa-associated lymphoid tissue B-cell lymphoma) and seven patients had small bowel T-cell lymphoma. Cumulative survival in patients with small bowel B-cell lymphoma was higher than that in patients with small bowel T-cell lymphoma. Data on 16 male and eight female patients with diffuse large B-cell lymphoma showed that 62.5% of these patients presented with disease stages I or II and 37.5% with stages III or IV. Cumulative survival in patients at stages IE or IIE was significantly higher than that of patients at stages IIIE or IVE. Four of five patients who died from diffuse large B-cell lymphoma had abnormal levels of lactate dehydrogenase and serum albumin.
Hysterectomy with Preservation of both Ovaries does not Result in Premature Ovarian Failure
Authors: Atay V , Ceyhan T , Baser İ , Gungor S , Goktolga Ü , Muhcu M
Published: February 2013

This study investigated ovarian function and adnexial pathology following total abdominal hysterectomy with preservation of both ovaries compared with that in a control group. Data from 29 patients who had undergone total abdominal hysterectomy at age ≤ 40 years and 42 menopausal patients with no previous ovarian pathology were evaluated retrospectively. The mean (± SD) age of menopause was 49.7 ± 1.5 years in the total abdominal hysterectomy group and 50.1 ± 1.3 years in the control group; this difference was not statistically significant. The incidences of cyst and hydrosalpinx were 31% and 6.9%, respectively, in the total abdominal hysterectomy group and 44.8% and 0%, respectively, in the control group. The increased incidence of cysts in the total abdominal hysterectomy group was statistically significant. In conclusion, patients who undergo total abdominal hysterectomy without oophorectomy do not experience premature menopause. Preservation of the ovaries may avoid the disadvantages of hormone replacement therapy at the expense of a higher risk of developing adnexial pathology.
Brucella Pancarditis with Dissecting Aortic Root Abscess, Left Ventricular Pseudoaneurysm and Ventricular Septal Defect
Authors: Biyik I , Oto O , Ergene O
Published: February 2013

A rare case of Brucella pancarditis is reported in a 38-year-old male farmer who presented with heart failure. Brucella pancarditis was diagnosed with positive serology, and echocardiographic examination showed pericardial effusion, vegetation and mycotic aneurysms on the aortic root. The development of a fistula between the aorta and right ventricle, aortic dissection, a subaortic ventricular septal defect, and left ventricular pseudoaneurysm were observed. This case illustrates that life-threatening cardiac complications may develop, even under aggressive antibiotic therapy. It is recommended that echocardiographic follow-up and close collaboration between colleagues working in infectious disease, cardiology and cardiovascular surgery are crucial in the treatment of Brucella pancarditis.
No Duplicate KRAS Mutation is Identified on the Same Allele in Gastric or Colorectal Cancer Cells with Multiple KRAS Mutations
Authors: Kimura K , Nagasaka T , Hoshizima N , Sasamoto H , Notohara K , Takeda M , Kominami K , Iishii T , Tanaka N , Matsubara N
Published: February 2013

Codon 12 and 13 mutations in 170 colorectal cancer (CRC) and 66 gastric cancer (GC) specimens were analysed by an ‘enriched’ polymerase chain reaction–restriction fragment length polymorphism (PCR–RFLP) method. All identified mutations were verified by direct sequencing of the second PCR products. Among the 170 CRC specimens, mutations were identified in 47 (28%) and 13 (7.6%) cases in codons 12 and 13, respectively. In the 66 GC specimens examined, however, mutations in codons 12 and 13 were only detected in two (3.0%) and one (1.5%) cases, respectively. Mutations in both codon 12 and 13 were found in 3/170 (1.8%) CRCs and 1/66 (1.5%) GCs. Duplicate mutations were never identified in the same allele, which was confirmed by direct sequencing of the second amplified products. The majority of colorectal and gastric cancer cells with KRAS mutations are homogeneous because they have the same KRAS mutation. A few colorectal or gastric cancers, however, showed heterogeneity, as verified by the fact that single mutations were identified in the same allele.
Use of 99mTc-Sulesomab for the Diagnosis of Prosthesis Infection after Total Joint Arthroplasty
Authors: Pakos Ee , Fotopoulos AD , Stafilas KS , Gavriilidis I , Boukarali G Al , Tsiouris S , Xenakis TA
Published: February 2013

This study aimed to evaluate the diagnostic efficacy of antigranulocyte scintigraphy using the antibody fragment 99mTc-sulesomab (LeukoScan®) for the diagnosis of prosthesis infection in patients with total hip or knee arthroplasty. The results from 19 patients with suspected total joint arthroplasty infection who had undergone a three-phase bone scan and a subsequent examination with 99mTc-sulesomab during a 1-year period were reviewed. Twelve patients were shown to have prosthesis infection on culture of aspirated synovial fluid or intra-operative samples. The overall sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy for 99mTc-sulesomab were 75%, 86%, 90%, 66% and 79%, respectively, compared with 54%, 83%, 88%, 45% and 63%, respectively, for the three-phase bone scan. This study showed that 99mTc-sulesomab had good diagnostic value for the detection of prosthesis infection. The combination of 99mTc-sulesomab with other laboratory or imaging examinations may improve diagnostic performance in prosthesis infection and should be investigated further.
Inhibitory Effect of Triptolide on Glioblastoma Multiforme In Vitro
Authors: Lin J , Chen L , Lin Z , Zhao M
Published: February 2013

This study investigated the effect of triptolide, derived from the traditional Chinese herb Tripterygium wilfordii, on the growth of glioblastoma multiforme (GBM) cells. Glioma cell lines U251MG and U87MG and normal human fetal astrocytes were exposed to various concentrations of triptolide, and 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium and colony formation assays were used to measure cell growth and survival. Cell apoptosis was determined using annexin V. Levels of the oncogenic transformation-related proteins Ras-guanosine triphosphate (Ras-GTP), extracellular signal-regulated kinase (ERK) and Akt were determined by Western blotting. Triptolide caused a dose-dependent decrease in proliferation and increase in apoptosis in the glioma cell lines. Since U87MG has a wildtype p53 gene while U251MG harbours a mutated p53 gene, these results indicate that triptolide induces apoptosis in GBM cells via a p53-independent pathway. Treatment of GBM cells with triptolide attenuated both the Ras/ERK and the Ras/Akt signalling pathways. This could provide a theoretical basis for triptolide treatment in GBM, but further animal studies and clinical research are necessary.
Apocynin Attenuates Cerebral Infarction after Transient Focal Ischaemia in Rats
Authors: Tang LL , Ye K , Yang XF , Zheng JS
Published: February 2013

This study investigated whether inhibition of reduced nicotinamide adenine dinucleotide phosphate (NADPH) oxidase attenuates cerebral infarction after transient focal ischaemia in rats. Focal ischaemia (1.5 h) was produced in male Sprague-Dawley rats (250 − 280 g) by middle cerebral artery occlusion. Some rats also received treatment with 50 mg/kg apocynin, a NADPH oxidase inhibitor, by intraperitoneal injection 30 min prior to reperfusion. Two hours after reperfusion, brains were harvested to measure NADPH oxidase activity and superoxide levels. After 24 h, the remaining brains were harvested to investigate infarct size. NADPH oxidase activity and superoxide level were all augmented 2 h after reperfusion compared with controls. Apocynin treatment significantly reduced NADPH oxidase activity and superoxide levels. Cerebral infarct size was significantly smaller in the apocynin-treated group compared with those undergoing ischaemia/reperfusion alone. These results indicate that inhibition of NADPH oxidase attenuates cerebral infarction after transient focal ischaemia in rats, suggesting that inhibition of NADPH oxidase may provide a therapeutic strategy for ischaemic stroke.
Efficacy of Atorvastatin Therapy in Ischaemic Heart Disease – Effects on Oxidized Low-density Lipoprotein and Adiponectin
Authors: Miyagishima K , Hiramitsu S , Kato S , Kato Y , Kitagawa F , Teradaira R , Shinohara R , Mori K , Kimura H , Ueda T , Ohtsuki M , Morimoto S , Hishida H
Published: February 2013

The lipid-lowering and anti-atherosclerotic effects of atorvastatin (10 mg/day) were investigated by measuring changes in the levels of oxidized low-density lipoprotein (LDL), serum lipids (total cholesterol [TC], LDL-cholesterol [LDL-C] and triglycerides [TG]), and in the protein adiponectin. This was undertaken in 22 patients with ischaemic heart disease and serum LDL-C levels > 100 mg/dl. After 3 months of therapy, atorvastatin significantly decreased serum lipids, oxidized LDL was reduced from 457.0 ± 148.6 to 286.9 ± 88.5 nmol/l, and adiponectin increased from 9.7 ± 7.4 to 13.9 ± 9.98 μg/ml. No significant correlation was observed between adiponectin and LDL-C, TG and high-density lipoprotein cholesterol. Atorvastatin therapy was not associated with side-effects, such as myalgia and gastrointestinal disorders, and did not give abnormal laboratory test results. It is concluded that atorvastatin decreases serum lipid and oxidized LDL levels, and increases adiponectin levels in patients with ischaemic heart disease.
Detection of Metastases in Patients with Cutaneous Melanoma Using FDG-PET/CT
Authors: Akcali C , Zincirkeser S , Erbagcý Z , Akcali A , Halac M , Durak G , Sager S , Sahin E
Published: February 2013

This study aimed to detect metastases in patients with stage III or IV cutaneous melanoma by 18F-fluorodeoxyglucose positron emission tomography combined with computed tomography (FDG-PET/CT). Thirty-nine patients with clinically evident stage III or IV melanoma underwent whole-body FDG-PET/CT scans for metastatic disease and these results were compared with those of biopsy. Scans for 38 of the patients were evaluated; one patient's scan could not be evaluated. There were 11 true-positive, two false-positive, 24 true-negative and one false-negative scans for the detection of melanoma metastases, with sensitivity 91%, specificity 92%, accuracy 92%, and positive and negative predictive values 84% and 96%, respectively. False-positive FDG-PET/CT scans were due to sarcoidosis in the lung and infected cyst in the liver. It is concluded that FDG-PET/CT scanning has high sensitivity and specificity for detecting stage III or IV metastatic melanoma.
Resistance of Haemophilus influenzae Isolates in Children Under 5 Years Old with Acute Respiratory Infections in China between 2000 and 2002
Authors: Shen XZ , Lu Q , Deng L , Yu S , Zhang H , Deng Q , Jiang M , Hu Y , Yao KH , Yang YH
Published: February 2013

This prospective, three-centre study tested for antimicrobial susceptibility in 898 isolates of Haemophilus influenzae between 2000 and 2002 in Chinese children aged under 5 years with acute upper respiratory tract infection. The average incidence of β-lactamase production was 12.0%. Overall, 88.0% of isolates were susceptible to ampicillin, 100.0% were susceptible to amoxicillin/clavulanic acid, ceftriaxone, cefuroxime and azithromycin, and 99.0% were susceptible to ciprofloxacin. Isolates from Beijing and Shanghai had a lower susceptibility to tetracycline (57.0% and 61.0%, respectively) compared with those from Guangzhou (81.0%), while trimethoprim/sulfamethoxazole susceptibilities in Shanghai (47.0%) and Guangzhou (54.0%) were significantly higher than in Beijing (35.0%). A total of 34.5% of all the isolates were susceptible to all eight of these antimicrobial agents and 12.8% were multi-drug resistant. Ampicillin resistance increased over the duration of the study. These findings show that β-lactamase production and ampicillin resistance among isolates from Chinese children with upper respiratory tract infection are increasing, and highlight the strong correlation between ampicillin resistance and resistance to cefaclor, chloramphenicol and tetracycline in H. influenzae isolates.
A Mutation in the 5′ Untranslated Region of the BRCA1 Gene in Sporadic Breast Cancer Causes Downregulation of Translation Efficiency
Authors: Wang J , Lu C , Min D , Wang Z , Ma X
Published: February 2013

We screened 117 breast tumour samples in Chinese females for mutations in the breast cancer 1 ( BRCA1) gene and identified a novel mutation in the 5′ untranslated region (5′ UTR) in two patients with grade III infiltrating ductal breast carcinoma. We examined whether this 5′ UTR mutation affected the translational efficiency of BRCA1 protein. A vector was constructed containing the mutated 5′ UTR up-stream of luciferase and we compared its translational efficiency with a wild-type 5′ UTR. The expression of BRCA1 protein in breast tumour samples was evaluated using immunohistochemistry. The mutated 5′ UTR of BRCA1 resulted in less luciferase activity compared with the wild-type 5′ UTR, while there were no significant differences in luciferase mRNA levels. BRCA1 protein was much less expressed in breast tumour tissue from patients with the 5′ UTR mutation than in samples from patients without the mutation. Our results show that a mutation in the 5′ UTR of the BRCA1 gene downregulates translational efficiency of the protein.
Enzyme Replacement Therapy in Patients with Fabry's Disease
Authors: Tsuboi K
Published: February 2013

Fabry's disease, a disorder affecting the gene for the lysosomal enzyme α-galactosidase A (α-GAL A), can cause accumulation of globotriaosylceramide (GL-3) in the vascular endothelial cells. Symptoms include pain, angiokeratoma, corneal clouding, and damage to the heart and kidneys. Human recombinant α-GAL A for use as an enzyme replacement therapy was launched in Japan in April 2004. Eleven ambulatory patients with Fabry's disease were given replacement α-GAL A therapy. Three patients died due to factors associated with Fabry's disease. The enzyme replacement therapies in the remaining eight patients continued safely without any notable adverse events. The following were observed: a lowering of the plasma levels of GL-3 in seven cases, an improvement in the daily activities in six cases, and a reduction in corneal clouding in three cases. Although careful observation is necessary, these results suggest that replacement α-GAL A therapy may be a safe and effective treatment of Fabry's disease.
Probiotic Agents in the Treatment of Irritable Bowel Syndrome
Authors: Guslandi M
Published: February 2013

Irritable bowel syndrome (IBS) is characterized by abdominal pain and alterations in bowel habits. Several pathogenetic factors, such as altered intestinal motility, visceral hypersensitivity, serotonin system abnormalities and psychic disturbances have been identified. Recently, a pathogenetic role of intestinal microflora has been shown in IBS: viral or bacterial infection can trigger post-infectious IBS; some patients have small intestinal bacterial overgrowth; the composition of patients' enteric flora is altered; and minimal inflammatory changes, consistent with the pro-inflammatory role of bacteria, have been demonstrated. Probiotics may, therefore, offer a rational therapeutic approach to IBS. The data available on the use of probiotics in IBS are still limited and results of controlled clinical trials are contradictory because they have been performed using different species, dosages, treatment durations and end-points for results evaluation. A critical evaluation of the therapeutic role of the various probiotics in IBS is presented in this article.
Effects of Low Dose Ketamine on Tourniquet-induced Haemodynamic Responses during General Anaesthesia
Authors: Park J-W , Jung Y-H , Baek C-W , Kang H , Cha S-M
Published: February 2013

This study investigated the effect of a pre-operative low dose of intravenous ketamine on tourniquet-induced haemodynamic changes. Ten minutes after induction of general anaesthesia, 0.1 mg/kg ketamine in 10 ml of saline (ketamine group, n = 14) or 10 ml of normal saline (control group, n = 14) were administered intravenously. Systolic and diastolic blood pressures, and heart rate relative to tourniquet inflation and deflation were recorded and compared within and between groups. Systolic and diastolic blood pressures in the control group significantly increased relative to baseline during the observation period following tourniquet inflation, but generally did not significantly increase in the ketamine group. The control group had a greater percentage of patients with a 30% rise in blood pressure at 60 min after tourniquet inflation compared with the ketamine group (28.6% vs 7.1%), but this was not statistically significant. We conclude that a pre-operative low dose (0.1 mg/kg) of intravenous ketamine can prevent a systemic arterial pressure increase for at least 60 min after tourniquet inflation under general anaesthesia.
Intrathecal Morphine Suppresses Immune Function in Rats with Inflammatory-induced Pain
Authors: Zou W , Guo Q , Wang E , Cai J , Cheng Z
Published: February 2013

Acute and chronic systemic administration of morphine is known to suppress immune function; however, the effect of chronic intrathecal (IT) morphine on immune function in inflammatory-induced pain is still unclear. This study examined the effects on the immune system of IT morphine in rats with formalin-induced pain. Lumbar IT catheters were implanted in rats and saline or 2.5, 5.0 or 10.0 μg/h morphine were administered for 7 days. On the last day, formalin-induced inflammatory pain was induced in rat hind paws and pain intensity was assessed. Rat spleens were then harvested for immune function assay. The IT morphine induced a dose-dependent analgesic effect and lactic acid dehydrogenase release assay showed dose-dependent suppression of natural killer cell activity. Concanavalin-A-induced splenocyte proliferation assay showed IT morphine to suppress T lymphocyte function in a dose-dependent manner. Flow cytometry showed IT morphine significantly to decrease T lymphocyte function and the percentages of T lymphocyte subsets in a dose-dependent manner. Hence, in inflammatory-induced pain IT morphine was found to suppress immune function. Chronic IT morphine should be used cautiously to treat chronic pain in immunocompromised cases.