bluuebunny/crossref_metadata_2025 huggingface dataset:
Invasive Pulmonary Aspergillosis
Authors: Škrgat Kristan Sabina , Kern Izidor , Mušič Ema
Published: April 2003

Background: Invasive pulmonary aspergillosis usually occurs in immunocompromised patients. Mild abnormality of host defence is usually present in the chronic necrotising form of the disease. Acute aspergillus pneumonia usually affects patients who are seriously immunocompromised. Objectives: The purpose of the study was to highlight the possibility of occurrence of invasive pulmonary aspergillosis also in patients with mild abnormality of host defence. Methods: In a retrospective study 6 patients were analysed. The inclusion criterion was evidence of Aspergillus sp. invasion in lung tissue. Lung tissue was obtained by biopsy or post mortem examination. Results: There were 4 patients with acute aspergillus pneumonia. Two of them were severely immunocompromised – one with dermatomyositis, who was treated with high doses of corticosteroids and methotrexate, and the other with undiscovered miliary tuberculosis, who was treated for myelodysplastic syndrome instead with low doses of corticosteroids. The other 2 had mild immunosuppression: one was suffering from sarcoidosis and was treated with low doses of corticosteroids, the other had dilated cardiomyopathy, renal insufficiency and diabetes mellitus. The two patients with chronic necrotising pulmonary aspergillosis had mild abnormality of host defence: one had reactivation of tuberculosis and diabetes mellitus, the other had inactive tuberculosis and aspergilloma. Conclusions: Invasive pulmonary aspergillosis must be considered also in patients with mild immunosuppression and pulmonary infiltrates which do not respond to conventional treatment with antibiotic chemotherapy. The key to the diagnosis of invasive pulmonary aspergillosis is the histopathological demonstration of fungal invasion in lung tissue.
Prediction of Functional Reserves after Lung Resection: Comparison between Quantitative Computed Tomography, Scintigraphy, and Anatomy
Authors: Bolliger Chris T. , Gückel Claudius , Engel Hermann , Stöhr Susanne , Wyser Christoph P. , Schoetzau Andreas , Habicht James , Solèr Markus , Tamm Michael , Perruchoud André P.
Published: April 2003

Background and Objectives: We prospectively compared five techniques to estimate predicted postoperative function (ppo F) after lung resection: recently proposed quantitative CT scans (CT), perfusion scans (Q), and three anatomical formulae based on the number of segments (S), functional segments (FS), and subsegments (SS) to be removed. Methods: Four parameters were assessed: FEV1, FVC, DLCO and VO2max, measured preoperatively and 6 months postoperatively in 44 patients undergoing pulmonary resection, comparing their ppo value to the postoperatively measured value. Results: The correlations (r) obtained with the five methods were for CT: FEV1 = 0.91, FVC = 0.86, DLCO = 0.84, VO2max = 0.77; for Q: 0.92, 0.90, 0.85, 0.85; for S: 0.88, 0.86, 0.84, 0.75; for FS: 0.88, 0.85, 0.85, 0.75, and for SS: 0.88, 0.86, 0.85, 0.75, respectively. The mean difference between ppo values and postoperatively measured values was smallest for Q estimates and largest for anatomical estimates using S. Stratification of the extent of resection into lobectomy (n = 30) + wedge resections (n = 4) versus pneumonectomy (n = 10) resulted in persistently high correlations for Q and CT estimates, whereas all anatomical correlations were lower after pneumonectomy. Conclusions: We conclude that both Q- and CT-based predictions of postoperative cardiopulmonary function are useful irrespective of the extent of resection, but Q-based results were the most accurate. Anatomically based calculations of ppo F using FS or SS should be reserved for resections not exceeding one lobe.
Common Eye Diseases of Elderly People: Identifying and Treating Causes of Vision Loss
Authors: Harvey Patricia T.
Published: April 2003

Of the 38 million people who are blind, the majority, 22 million, are 60 years of age or older. The most common causes of vision loss in elderly people are age-related macular degeneration (AMD), cataract, glaucoma, and diabetic retinopathy. Of these, AMD is the leading cause of registered blindness in people over the age of 50 years in the western world. However, until recently, the treatment options for people with AMD have been severely limited. Verteporfin therapy is a new treatment that is efficacious and safe in selected patients with AMD who are at high risk of central vision loss. Physicians who are in regular contact with elderly people can help to minimize vision loss in this group of patients by being alert to the symptoms and signs of age-related eye diseases. This paper reviews each of the common eye diseases, with an emphasis on AMD because of the recent advances in treatment.
Risk assessment and segregation analysis in a pericentric inversion inv(6)(p23q25) carrier using FISH on decondensed sperm nuclei
Authors: Anton E. , Blanco J. , Egozcue J. , Vidal F.
Published: April 2003

Fluorescent in situ hybridization (FISH) in decondensed sperm nuclei has been used to determine the percentage of normal/balanced or unbalanced spermatozoa produced by an inv(6)(p23q25) carrier, and the possible interchromosomal effect (ICE) of the reorganized chromosomes on other chromosome pairs. A dual color FISH with specific subtelomeric probes for the 6p and 6q regions was performed to determine the segregation pattern of the inverted chromosome. ICE on chromosomes 18, X and Y was assessed using a triple color FISH assay. In the segregation analysis 10,049 spermatozoa were analyzed, and only 45.7% of them were normal/balanced. The high number of unbalanced gametes in our carrier could be the consequence of the large size of the inverted segment. This situation could facilitate the formation of an inversion loop, where formation of an odd number of chiasmata (usually one) result in the production of 50% normal and 50% unbalanced sperm. Furthermore, an increase in the disomy rate for chromosome 6 was also observed. In the screening for ICE, 10,007 spermatozoa were analyzed. The disomy rate for the sex chromosomes and chromosome 18 were not significantly different from those found in our controls, suggesting no evidence of interchromosomal effects in this patient. The use of FISH in decondensed sperm nuclei has proved once more to be an accurate approach to determine the chromosome anomalies in sperm and could help to better establish a reproductive prognosis.
Complete cDNA sequence, expression, alternative splicing, and genomic organization of the mouse Nfat5 gene
Authors: Dalski A. , Hebinck A. , Winking H. , Butzmann U. , Schwinger E. , Zühlke Ch.
Published: April 2003

Members of the NFAT (nuclear factors of activated T cells) gene family have been investigated in numerous organisms, including man and mouse. All NFATs may be synthesized in several isoforms differing in amino or carboxy termini due to 5′ and 3′ alternative splicing of the corresponding mRNA. Recently, we mapped the murine Nfat5 gene to chro- mosome 8D. In the present paper we describe for the first time the complete sequence and primary structure of murine Nfat5, two new spliced isoforms, and the expression of murine Nfat5 in embryonic and adult mouse tissues.
Chromosomal localization of genes involved in biosynthesis, metabolism or transport of cholesterol in the rat
Authors: Bonné A.C.M. , den Bieman M.G. , Gillissen G.F. , van Lith H.A. , van Zutphen L.F.M.
Published: April 2003

Several genes involved in biosynthesis, transport or metabolism of cholesterol have been localized on rat chromosomes by using a radiation hybrid (RH) panel. The genes, coding for squalene epoxidase (Sqle), mevalonate kinase (Mvk), and farnesyl diphosphate farnesyl transferase 1 (Fdft1) which are involved in cholesterol biosynthesis, have been mapped on chromosome 7, 12, and 15, respectively. The genes coding for phospholipid transfer protein (Pltp), sterol carrier protein-2 (Scp2), ATP binding cassette reporter A7 (Abca7), scav- enger receptor class B, type 1 (Cd36l1), steroidogenic acute regulatory protein (Star), and lecithin:cholesterol acyl transferase (Lcat), which are involved in the transfer and/or metabolism of cholesterol, have been mapped on chromosome 3, 5, 7, 12, 16, and 19, respectively. Each of the genes Scp2, Sqle and Fdft1 maps close to a QTL for serum total cholesterol in rat, suggesting that these three genes might represent candidate genes for the previously mapped QTLs.
Assignment of FUT8 to chicken chromosome band 5q1.4 and to human chromosome 14q23.2→q24.1 by in situ hybridization. Conserved and compared synteny between human and chicken
Authors: Coullin P. , Crooijmans R.P.M.A. , Groenen M.A.M. , Heilig R. , Mollicone R. , Oriol R. , Candelier J.-J.
Published: April 2003

The human FUT8 gene is implicated in crucial developmental stages and is overexpressed in some tumors and other malignant diseases. Based on three different experiments we have assigned the FUT8 gene to chromosome bands 14q23.2→q24.1 and not 14q24.3 as previously shown (Yamaguchi et al., 1999). We found a high degree of identity between human and chicken FUT8 sequences. We mapped the chicken FUT8 gene to chromosome 5q1.4 in an internal rearrangement of a region of conserved synteny described between human 14q and chicken chromosome 5. Based on these findings we propose a new gene position correspondence between chicken and human comparative maps.
Karyologic evidence of diversification of the genus Thrichomys (Rodentia, Echimyidae)
Authors: Bonvicino C.R. , Otazu I.B. , D’Andrea P.S.
Published: April 2003

Karyologic analysis of Thrichomys specimens from different Brazilian localities, in Pantanal, Cerrado and Caatinga biomes, shows different chromosome complements. The 2n = 34, FN = 64 karyotype is found in Mato Grosso do Sul state; the 2n = 30, FN = 54 karyotype in Bahia, Pernambuco, Piauí and Ceará states; the 2n = 30, FN = 56 karyotype in Goiás and Tocantins states, the 2n = 28, FN = 50 karyotype in Minas Gerais state, the 2n = 28, FN = 52 and 2n = 26, FN = 48 karyotypes in Bahia state. Comparisons of G-band patterns allowed the identification of homologies shared by all karyotypes and show that the two karyotypes with the lowest diploid number (2n = 26 and 2n = 28) belong to two different evolutionary lineages. The most proper names for each karyomorphic population are: Thrichomys pachyurus for 2n = 34; Thrichomys apereoides apereoides for 2n = 28, FN = 50; Thrichomys apereoides laurentius for 2n = 30, FN = 54 and Thrichomys inermis for 2n = 26. Two karyotypes (2n = 28, FN = 52 and 2n = 30, FN = 56) could not be attributed to any subspecies. These different karyomorphotypes are allopatric and/or parapatric.
Identification and characterisation of the gene TWIST NEIGHBOR (TWISTNB) located in the microdeletion syndrome 7p21 region
Authors: Kosan C. , Kunz J.
Published: April 2003

We have characterised a 2.4-Mb genomic sequence of a smallest region of overlap (SRO) deleted in the human microdeletion syndrome 7p21 by in silico analysis. Patients harbouring this minimal deletion present in addition to the clinical features of Saethre-Chotzen syndrome (MIM 101400) a distinct learning disability. This genomic region shows a very low gene content. Besides the transcription factor gene TWIST, the Histone Deacetylase 9 (HDAC9), Sorting Nexin 13 (SNX13) and an evolutionarily conserved bHLH transcription factor gene Nephew of Atonal 3 (HNATO3) have been detected previously. Here we describe the localisation and characterisation of the TWIST NEIGHBOR (TWISTNB) gene. Comparison of the predicted proteins of human TWISTNB and mouse Twistnb shows a high degree of conservation. Northern blot analysis of human fetal and adult tissues shows ubiquitous expression in all tissues tested.
Apparent Absence of Claustrum in Monotremes: Implications for Forebrain Evolution in Amniotes
Authors: Butler Ann B. , Molnár Zoltán , Manger Paul R.
Published: April 2003

The claustrum, which comprises the claustrum proper and the endopiriform nucleus, is generally thought to be present in all mammals. Some previous reports of its possible absence in monotremes have appeared in the literature, but the question of its presence or absence in this clade has not been formally addressed. Whether monotremes have a claustrum is of some importance for formulating and evaluating hypotheses relating to the evolution of the structures in the lateral sector of the pallium across amniotes. Archival sets of sections through the brains of the platypus and the short-beaked echidna were examined and included material stained for seven different histochemical and immunohistochemical protocols. No cytoarchitectonically distinct claustrum could be identified in this material for either monotreme. We thus conclude that if monotremes have any cell population that is homolgous to the claustrum of therian mammals, it is entirely cryptic. A claustrum might have been present in ancestral mammals and lost in the monotreme clade, or it might have been gained at the origin of therian mammals. Nonetheless, its absence as a cytoarchitectonically discrete and identifiable structure in monotremes fails to support homology of the claustrum of therian mammals with any single part of the sauropsid pallium.
Stereotactic Surgery Has Merged into General Neurosurgery; Functional Neurosurgery Is Increasingly ‘Applied Neurophysiology’
Authors: Sindou Marc P.
Published: April 2003

Stereotactic and functional operations represent, altogether, about 20% of all surgeries in a large number of Neurological Institutions, and this percentage is steadily increasing. To a large extent, stereotactic surgery has essentially merged with general neurosurgery. Therefore stereotactic techniques, at least to perform biopsies, should be available to any well-trained neurosurgeon. Functional neurosurgery is increasingly dependent upon clinical neurophysiology, not only for guidance of the procedure, but also for better selection of patients and objective assessment of results. Therefore, the concept of interventional neurophysiology must be recognized and acknowledged.
Practical Application of fMRI for Surgical Planning
Authors: Heilbrun M. Peter , Lee James N. , Alvord Lynn
Published: April 2003

We report our experience evaluating tasks designed to visualize regions of motor and language brain activation using functional magnetic resonant imaging (fMRI). Our goal was to identify a battery of tasks which would provide a range of brain imaging studies which could be used clinically for surgical planning, with the requirement that they could be performed and analyzed rapidly, thus, cost effectively. These tasks were chosen to assess (1) motor control of the hands, fingers, and feet, and (2) language processing using both auditory and visual task presentations. From January through April 2001, five patients and eight normal subjects were studied. A selection of three or four tasks acquired with an EPI sequence coupled with a high resolution 3D MR sequence were completed in 45– 60 min of scanner time. Identification of the location of eloquent cortex serving aspects of motor and language functions was successful in four of the five patients and all of the eight normal subjects.
Robotics and Radiosurgery – The Cyberknife
Authors: Chang Steven D. , Adler John R.
Published: April 2003

The Cyberknife is a dedicated image-guided robotic radiosurgical device. While clinical results with intracranial lesions are comparable to frame-based radiosurgical techniques, recent experience demonstrates the potential to broadly expand the scope of radiosurgery to many extracranial sites.
Gamma Knife Radiosurgery for Growth Hormone-Secreting Pituitary Adenomas Invading the Cavernous Sinus
Authors: Fukuoka Seiji , Ito Tamio , Takanashi Masami , Hojo Atsufumi , Nakamura Hirohiko
Published: April 2003

The authors assessed whether gamma knife radiosurgery is effective for patients with acromegaly where the pituitary tumors invaded the cavernous sinus. Radiosurgery was performed on 9 patients (average of 20 Gy to the tumor margin), 8 of whom had already undergone transsphenoidal surgery and/or craniotomy with occasional medication of octreotide to reduce tumor size as well as hormonal levels. All tumors have been well controlled so far with follow-up periods ranging from 12 to 69 months (mean: 42). No complications occurred. Forty percent of the patients showed hormonal normalization at 2 years, with the median being 31 months. Similarly, 50% of the patients demonstrated normalization of GH and IGF-I at 36 months. We conclude that gamma knife radiosurgery is a safe and effective tool to treat these tumors invading the cavernous sinus.
Dorsal Rhizotomy with Anterior Sacral Root Stimulation for Neurogenic Bladder
Authors: Vignes J.R. , Liguoro D. , Sesay M. , Barat M. , Guerin J.
Published: April 2003

A spinal cord lesion above the sacral micturition center results in a loss of voluntary control and development of bladder sphincter dysynergia with hyperreflexia of the detrusor and spasticity of the sphincter. Sacral rhizotomy and implantation of an anterior sacral root stimulator appears as an effective method for the treatment not only of voiding dysfunction but also of defecation and sexual disturbance. The surgical technique is described as are the clinical and electrophysiological controls. The results of our series of operated patients with intradural implantation and sacral deaffentation show a constant improvement. 90% have satisfactory continence and no longer require an incontinence appliance. Bladder capacity and compliance have increased to 120% and urethral closure pressure has decreased. 80% have complete voiding or a post-void residue of not more than 50 ml. So, urinary infection rate is dramatically decreased.
SPECT-Based Tailoring of Psychosurgical Procedures: Is It Possible?
Authors: Vilela Filho Osvaldo , Carneiro Filho Omar , Souza Herbert A.O. , Machado Delfino C. , Rodrigues Filho Salomão , Campos João A.O.
Published: April 2003

In contrast to the other areas of functional neurosurgery, psychosurgery has remained basically empiric and unchanged since the seventies, except for the recent suggestion to use chronic stimulation instead of ablative surgery. In this study, the authors investigated the value of SPECT abnormalities to guide psychosurgery and correlated the surgical results with the postoperative SPECT. This new approach, SPECT-based tailored psychosurgery, was applied in 4 of 11 patients referred for surgery, who fulfilled the inclusion criteria adopted. Excellent results were obtained in all of them after a follow-up of 30–52 months. Postoperative SPECT normalized in every case. We conclude, based on this small series, that it is possible to individualize and lateralize (tailor) psychosurgical procedures for every patient and that, to achieve this goal, SPECT is a rather impressive means and that postoperative SPECT closely correlated with the surgical results.
Spinal Cord Stimulation Prevents the Effects of Combined Experimental Ischemic and Traumatic Brain Injury
Authors: Visocchi Massimiliano , Tartaglione Tommaso , Romani Rossana , Meglio Mario
Published: April 2003

Spinal cord stimulation (SCS) interferes with cerebral blood flow (CBF). In this paper we try to evaluate the possible preventing effect of SCS in an animal model of combined ischemic and traumatic injury. We studied 20 New Zealand rabbits undergoing ligature of both carotid arteries and a right hemispheric craniectomy and about 3 h mechanical injury (200 mg) over the dura. In 10 animals (control group) SCS was not delivered; in 10 (SCS group) cervical SCS was started 20 min after arterial ligation and before the craniectomy and the mechanical injury. MR examination was performed in all the animals at the end of the experiments. Compared to the control group none but one of the SCS showed lesional pattern far from the craniectomy suggesting a ‘preventing’ effect of SCS on the secondary damage associated with our model combined ischemic and traumatic brain injury.
The Effect of L-Arginine, a Nitric Oxide Synthase Substrate, on Retinal Cell Proliferation in the Postnatal Rat
Authors: Kim Keun-Young , Moon Jung-Il , Lee Eun-Jin , Lee Yeon-Jung , Kim In-Beom , Park Chan Kee , Oh Su-Ja , Chun Myung-Hoon
Published: April 2003

The effects of L-arginine, a nitric oxide synthase (NOS) substrate, on cell proliferation in the developing postnatal rat retina were studied by immunocytochemistry using anti-bromodeoxyuridine (BrdU) antiserum, and by terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL). Densitometric analysis by immunoblotting confirmed that neuronal NOS expression significantly increased in the L-arginine-treated retinas in comparison with the control retinas at postnatal day (P) 5 to P10. In the retinas of the control and L-arginine-treated rats, BrdU-labeled cells were only seen in the neuroblastic layer of the retinas up to P7. BrdU-labeled cells were significantly more numerous in the retinas of L-arginine-treated rats than in control retinas at P5 in the central retina and at P5 and P7 in the peripheral retina. In addition, TUNEL-positive apoptotic cells were more numerous in the retinas of L-arginine-treated rats at P5 and P7. Our results suggest that NO might play an important role in retinal maturation through regulating proliferative phases in the early stages of rat postnatal development.
Advanced Glycation End Products and Advanced Oxidation Protein Products in Hemodialyzed Patients
Authors: Kalousová M. , Zima T. , Tesař V. , Lachmanová J.
Published: April 2003

Chronic renal failure is associated with increased oxidative and carbonyl stresses that contribute to long-term uremic complications. In our study, we determined two markers of these stresses – AGEs (advanced glycation end products) and AOPP (advanced oxidation protein products) in chronic hemodialysis patients in order to find out their relationship to the dialysis treatment. Plasmas of 20 hemodialyzed patients treated with modified cellulose membranes were examined at 0 and 15 min and at the end (i.e. after 4 h) of the dialysis session. AGEs were estimated using a spectrofluorometric method (excitation 350 nm, emission 440 nm) and are expressed in AU (arbitrary units)/g protein. AOPP were determined spectrophotometrically (absorbance at 340 nm) and are expressed in chloramine units per gram of protein (µmol/g). AOPP decrease slightly from 0 to 15 min of the dialysis procedure (4.0 ± 1.5 vs. 3.0 ± 0.9 µmol/g, p < 0.01). However, they are increased at the end of the session (5.0 ± 2.1 µmol/l vs. 15 min, p < 0.01, not significant vs. beginning). On the other hand, AGEs decrease continuously from the beginning to the end of the session (mainly in the first minutes of the dialysis) (1.52 ± 0.34 × 104 AU/g at 0 min, 1.39 ± 0.33 × 104 AU/g at 15 min, p < 0.001 vs. beginning, 1.30 ± 0.33 × 104 AU/g at the end, p < 0.001 vs. beginning, not significant vs. 15 min). Neither AGEs nor AOPP correlate with the age of hemodialyzed patients and with the number of years of the dialysis treatment. AOPP correlate with AGEs before the dialysis session (r = 0.62, p < 0.05) but not after the session (r = 0.29, not significant). According to our results, AGEs may serve more as a marker of chronic damage while AOPP may better describe acute oxidative stress during the dialysis treatment.
Hemodynamics of Venous Cuff Interposition in Prosthetic Arteriovenous Fistulas for Hemodialysis
Authors: Lemson Susan , Tordoir Jan H.M. , Ezzahiri Raja , Leunissen Karel M.L. , Kitslaar Peter J.E.H.M. , Hoeks Arnold P.G.
Published: April 2003

Purpose: The durability of prosthetic arteriovenous fistulas (AVF) for hemodialysis is jeopardized by thrombotic occlusions due to intimal hyperplastic stenoses. In arterial reconstructive surgery, peripheral arterial bypasses with prosthetic material benefit from a venous cuff at the distal anastomosis. Therefore, a study was performed to assess the effect of a venous cuff at the venous anastomosis of PTFE graft AVFs in terms of stenosis development, hemodynamics and patency rates. Methods: A subset of 40 patients from a multicenter study were enrolled into the study, of which 20 patients were randomized for venous cuff interposition. Duplex measurements to detect stenoses and volume flows were performed at 6, 12, 26 and 52 weeks postoperatively. Relative distension (RD) and wall shear rate (WSR) were calculated by means of vessel wall Doppler tracking (VWDT). Results: The total number of stenoses was significantly less in the cuff group (21 vs. 33; p = 0.045). This feature was found at the site of the venous anastomosis (cuff 5; no cuff 12). Volume flow, graft and efferent vein diameters, RD and WSR in the graft and efferent vein were comparable for both groups. WSR in the venous anastomosis tended to be lower in the cuff group (768 vs. 1,448 s–1, p = 0.068).Volume flows and WSR were significantly lower in failing grafts. Patency rates were similar in both groups (primary patency 13 vs. 29%; secondary patency 78 vs. 67%). Conclusions: A venous cuff at the venous anastomosis of PTFE graft AVFs results in less stenoses, but improved patency rates could not be demonstrated.
Pitfall of Newborn Screening for Congenital Adrenal Hyperplasia due to 21-Hydroxylase Deficiency
Authors: Rohrer Tilman R. , Gassmann Katja F. , Pavel Marianne E. , Dörr Helmuth G.
Published: April 2003

We report on a newborn with a severe salt-wasting crisis due to congenital adrenal hyperplasia (CAH) with 21-hydroxylase deficiency, in spite of prenatal diagnosis of CAH and awareness of this diagnosis by the parents and the gynecologic and pediatric practitioners. Due to the diagnosis of CAH in the older sister, prenatal treatment with dexamethasone (Dexa) was initiated. Prenatal diagnosis showed an affected male fetus and the prenatal treatment was stopped. The parents and the involved physicians were informed about the diagnosis, treatment, follow-up, and possible complications. Amniotic infection led to preterm delivery in another hospital. Due to perinatal asphyxia, the male newborn received Dexa during mechanical ventilation. Neonatal CAH screening was unsuspicious. An acute salt-wasting crisis with metabolic acidosis at the age of 3 weeks finally led to the correct diagnosis. This experience emphasizes the need to obtain a careful medical history. Furthermore, this case illustrates that neonatal screening for CAH is falsely negative in the event of neonatal Dexa treatment.
Frontotemporal Dementia: Paroxetine as a Possible Treatment of Behavior Symptoms
Authors: Moretti Rita , Torre Paola , Antonello Rodolfo M. , Cazzato Giuseppe , Bava Antonio
Published: April 2003

Frontotemporal dementia (FTD) represents an important cause for degenerative disruption and is increasingly recognized as an important cause (up to 25%) of degenerative dementia among late-middle-age individuals. The serotoninergic system is tightly bound to frontal circuits, whose degeneration subserves FTD. Patients aged 64–68 years, with a diagnosis of FTD, were randomized to receive paroxetine up to 20 mg/day (n = 8) or piracetam up to 1,200 mg/day (n = 8). At 14 months, the patients treated with paroxetine showed significant improvements in behavioral symptoms, reflected by a reduction of caregiver stress. Side effects were easily tolerable, and there was no dropout. The results are presented with an overview of the literature on the topic.
Histological and Immunohistochemical Study of the Bronchial Stump with Flap Coverage in an Animal Model
Authors: Carbognani P. , Corradi A. , Bobbio A. , Cantoni AnnaMaria , Mazzei M. , Pazzini L. , Galimberti Alessandra , Rusca M.
Published: April 2003

Objective: The purpose of our study was to evaluate the healing process of the bronchial stump after pneumonectomy reinforced with different pedicled flaps in an animal model. The specimens were analyzed by means of histology and immunohistochemistry. Materials and Methods: We have considered 45 New Zealand White male rabbits that underwent a left pneumonectomy under general anesthesia. Nine animals had no bronchial coverage and represented the controls. The other 36 rabbits were divided into three groups of 12 and had bronchial coverage with either diaphragmatic, intercostal or pericardial flaps. The histological examinations were performed on the animals sacrificed 7, 14 and 30 days after surgery. Immunohistochemical analyses were done on the specimens on postoperative day 7 and 14. On postoperative day 7, the specimens were examined for expression of proliferating cell nuclear antibody (PCNA) expression. On postoperative day 14, neoangiogenesis was measured by CD31 expression. The measurements of antibody expression were done with a computer-assisted morphometric count and analyzed with the t test. Results: On postoperative day 14, standard histology showed more evident neoangiogenesis in the bronchial stump specimens covered with intercostal and diaphragmatic flaps compared to pericardial flaps and controls. The immunohistochemical evaluation of PCNA by morphometric computer-assisted analysis did not show any statistically significant differences among the groups. The CD31 morphometric count revealed a higher and statistically significant antibody expression in muscular flaps compared to pericardial flaps and controls. Conclusions: Our study showed that bronchial coverage with a pedicled muscular flaps promotes the production of new vessels and gives the possibilities to optimize the healing process of a bronchial stump after pneumonectomy.
Portal Flow Diversion Is Essential for Graft Survival in Canine Auxiliary Partial Orthotopic Liver Transplantation
Authors: de Jonge J. , Zondervan P.E. , Kooi P.P.M. , IJzermans J.N.M. , Metselaar H.J. , Tilanus H.W.
Published: April 2003

After auxiliary partial orthotopic liver transplantation for inborn errors of metabolism, finding a balance in portal blood flow distribution between native liver and graft is complicated. We investigated the correction of hypoallantoinuria in the Dalmatian dog with a reduced-size Beagle orthotopic auxiliary liver graft, depending on intra-operative intervention in the portal flow. There were three groups: a ligation group, where the host portal vein was tied off, a free-flow group with random flow to both livers and a banding group, where the host portal vein was banded with an adjustable strapband. Metabolic correction was initially seen in all groups, but ligation led to portal hypertension and early mortality. In the free-flow group, correction was lost after 7 days, while banding preserved correction until 6 weeks. We conclude that acute ligation can lead to portal hypertension and free-flow leads to hypoperfusion and early loss of metabolic correction. Banding divided the portal blood flow between host liver and graft and prolonged metabolic correction.
Prolonged Improvement of Total Pancreatic Allograft Function by Previous Intrathymic Bone Marrow Cell Injection in Rats
Authors: Drevillon Catherine , Elian N. , Zinzindohoue F. , Carnot Françoise , Bailbe Danielle , Cugnenc P.-H. , Altman J.-J.
Published: April 2003

Donor-specific induction of tolerance was previously achieved in the diabetic rat by intrathymic injection of pancreatic islets. It allowed a secondary islet graft in any site without immunosuppression. Since total pancreatic graft in man is metabolically more proficient than islet graft, we attempted tolerance induction for total vascularized pancreas transplantation in diabetic BN recipient rats by an intrathymic bone marrow cell (BMC) injection from Lewis donor rats, associated to an antilymphocyte antibody (ALS) administration. Control groups consisted of isogenic grafts, allogenic grafts without tolerance induction and allogenic grafts with ALS alone. In all grafted groups, mean blood glucose and plasma insulin were normalised within 24 h. Graft rejection (clinically suggested by diabetes recurrence and later confirmed by histology) appeared at 18 ± 2 postoperative days in the absence of intrathymic BMC injection and at 36 ± 8 days in the group with BMC injection (p < 0.05). Intrathymic bone marrow graft was successful in delaying rejection in our study.
The Efficacy of Intravitreal Levofloxacin and Intravitreal Dexamethasone in Experimental Staphylococcus epidermidis Endophthalmitis
Authors: Yildirim Özlem , Öz Özay , Aslan Gönül , Cinel Leyla , Delialioğlu Nuran , Kanık Arzu
Published: April 2003

This study was designed to investigate the efficacy of intravitreal levofloxacin, and intravitreal levofloxacin and dexamethasone combined in Staphylococcus epidermidis endophthalmitis. Albino rabbits (n = 25), infected with an intravitreal inoculum of S. epidermidis (1.0 × 105 colony forming units/0.1 ml), were divided into five groups (n = 5). Groups 1 and 2 received treatment 24 h after the inoculation, and groups 3 and 4 48 h after the inoculation. No treatment was given to the control group. Treatment efficacy was assessed by vitreous culture, clinical examination and histopathology. Five days after treatment, groups 1 and 2 had significantly lower clinical scores than the control group (p = 0.004, p = 0.007). The culture results of the treatment groups were sterile. The histopathological scores of the treatment groups were lower than the control group (p = 0.007). Studies on retinal toxicity and dose-response relation are needed to prove the efficacy of levofloxacin in S. epidermidis endophthalmitis.
Geographic and Temporal Distribution of Mortality Rates for Multiple Sclerosis in Canada, 1965–1994
Authors: Warren Sharon , Warren K.G. , Svenson Lawrence W. , Schopflocher Donald P. , Jones Allyson
Published: April 2003

Statistics Canada data were used to calculate multiple sclerosis (MS) mortality rates per 100,000 population in the Canadian provinces from 1965 to 1994. For the period 1965–1994, the highest average annual MS mortality rates were in Quebec (4.4) and Ontario (3.9), while the Western Provinces had an intermediate rate (2.1) and the Atlantic Provinces had the lowest rate (1.2). Female mortality rates exceeded male rates in each of the four regions. Average annual MS mortality rates in Canada overall fluctuated during the past 30 years, with rates of 3.4 in 1965–1969, 4.2 in 1970–1974, 3.2 in 1975–1979, 2.3 in 1980–1984, 2.8 in 1985–1989 and 3.9 in 1990–1994. Female mortality rates exceeded male rates during each 5-year period. The highest mortality rates for both genders were in the 65 years plus age group. Rates in the under 45 years age group have remained stable, while rates in both the 45–64 and 65 years plus age groups have fluctuated. There is no apparent relationship between prevalence and mortality rates among the Canadian provinces.
Incidence and Outcome of Subtypes of Ischaemic Stroke: Initial Results from the North East Melbourne Stroke Incidence Study (NEMESIS)
Authors: Dewey Helen M. , Sturm Jonathan , Donnan Geoffrey A. , Macdonell Richard A.L. , McNeil John J. , Thrift Amanda G.
Published: April 2003

Information about the incidence and outcome of stroke subtypes is necessary to understand the likely impact of stroke prevention and treatment strategies. The purpose of this study was to determine the incidence and outcome of subtypes of cerebral infarction (CI). All strokes occurring in a population of 133,816 in Melbourne, Australia, during a 12-month period of 1996 and 1997 were identified and cases of CI subtyped according to the Oxfordshire Community Stroke Project classification. 276 ‘first-ever-in-a-lifetime’ stroke cases were registered. CI accounted for 72% of cases. Annual incidence rates per 100,000 persons adjusted to the ‘world’ population were 11 (95% CI, 4–18) for TACI, 25 (95% CI, 15–35) for PACI, 17 (95% CI, 9–25) for POCI and 18 (95% CI, 10–26) for LACI. 28-day case fatality was highest for TACI (35%; 95% CI, 19–51%) and first year recurrence rate highest for PACI (17%; 95% CI, 8–26%). TACI had the poorest functional outcome at 3 and 12 months. These findings are similar to those of two previous studies conducted in the northern hemisphere.
Erfahrung mit der Unterwassergeburt
Authors: Geissbühler Verena , Eberhard Jakob
Published: April 2003

Die Frauenfelder Geburtenstudie, eine prospektive Beobachtungsstudie seit 1991, untersucht, ob die Gebärmethode – insbesondere die Wassergeburt – einen Einfluss auf kindliche und mütterliche Morbidität und Mortalität hat. Verglichen werden 3617 Wassergeburten mit 5901 Landgeburten. Mittels Fragebogen wurden alle Daten zu Mutter und Kind erhoben. Die Auswertung der Resultate zeigt, dass Wassergeburten genau so sicher sind wie Landgeburten, wenn geburtsmedizinische Richtlinien beachtet werden. Risiken wie Präeklampsie, Infekte, mekoniumhaltiges Fruchtwasser und pathologisches CTG finden sich häufiger bei Landgeburten und sind Ausdruck einer unter der Geburt sicheren, prospektiven Geburtsleitung durch das Gebärsaalteam.
The Retina of Five Atherinomorph Teleosts: Photoreceptors, Patterns and Spectral Sensitivities
Authors: Reckel F. , Melzer R.R. , Parry J.W.L. , Bowmaker J.K.
Published: April 2003

We investigated the spectral and morphological features of the photoreceptors of five atherinomorph teleosts, representing two different orders, and with different life styles and habitats, the Beloniformes and Atheriniformes. The retinae of Belone belone (Belonidae), Dermogenys pusillus (Hemiramphidae), Atherina boyeri (Atherinidae), Marosatherina ladigesi (Telmatherinidae), and Melanotaenia maccullochi (Melanotaeniidae) were examined by light and electron microscopy and microspectrophotometry. In addition to rods, five morphologically different cone types were identified: short, intermediary and long single cones, and double cones which are arranged in distinct specific mosaics. Sporadically, triple cones were also found. Double cones were longer-wave-sensitive, but no general correlation between single cone morphology and spectral sensitivity could be demonstrated. The rods had λmax close to 506–509 nm. The λmax of cone visual pigments ranged from about 368 nm to 578 nm. Ultraviolet-sensitive single cones were present in the three freshwater species, M. ladigesi, M. maccullochi and D. pusillus and three spectrally distinct short-wave-sensitive single cone classes were identified in M. maccullochi. In M. ladigesi, spectral sensitivity varied among individuals due to varying rhodopsin/porphyropsin mixtures. In D. pusillus and M. maccullochi polymorphism of the longer-wave cone pigments might occur. These findings are discussed with respect to phylogeny, photic habitat, behavior and feeding habits.
Rituximab for Immune Hemolytic Anemia following T- and B-Cell-Depleted Hematopoietic Stem Cell Transplantation
Authors: Corti P. , Bonanomi S. , Vallinoto C. , Balduzzi A. , Uderzo C. , Cazzaniga G. , Gaipa G. , Dassi M. , Perseghin P. , Rovelli A.
Published: April 2003

The treatment of immune-mediated hemolytic anemia (IHA) complicating hematopoietic stem cell transplantation (HSCT) is often unsatisfactory. We report a case of IHA which occurred after T- and B-cell depleted unrelated donor HSCT carried out for mucopolysaccharidosis type I-H (Hurler syndrome) which was successfully treated with anti-CD20+ monoclonal antibody
Antihistone and Other Autoantibodies in β-Thalassemia major Patients Receiving Iron Chelators
Authors: Pradhan Vandana , Badakere Suresh , Ghosh Kanjaksha
Published: April 2003

This study was designed to find out the incidence of various autoantibodies in patients receiving iron chelators. Two groups were studied for comparison. One group consisted of thalassemia major cases on deferiprone (L1) and the second group were those receiving desferrioxamine therapy. Various autoantibodies such as antihistone antibodies and its subfractions H1, H2A-H4B, H2B, H3, ANF, anti-dsDNA, anti-nRNP, anti-Sm, ANCA and rheumatoid factor were tested. Out of 180 patients 50 patients (27.8%) were on desferrioxamine therapy, and 60 patients (33.3%) were taking deferiprone, whereas 70 patients (38.9%) were untreated. Antihistone antibodies were found in 30% of patients receiving deferiprone and 48% in the desferrioxamine group, respectively, as compared to control thalassemics (14.3%). Also, the levels of antihistone antibody were significantly elevated in the chelator groups as compared to controls. When antibodies to subfractions of the histone molecule were studied, it was observed that antibodies to H1 were most commonly seen and IgG was the major immunoglobulin subclass. Anti-dsDNA and anti-Sm antibodies, which are the diagnostic markers of idiopathic SLE, were absent in these patients. β-Thalassemia major patients on iron chelators such as desferrioxamine and deferiprone show changes in their autoimmune profile suggestive of some humoral immune alterations.
Characteristics, Treatment and Outcome of Patients with Non-ST-Elevation Acute Coronary Syndromes and Multivessel Coronary Artery Disease: Observations from PURSUIT (Platelet Glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrelin Therapy)
Authors: Breeman Arno , Mercado Nestor , Lenzen Mattie , van den Brand Marcel M.J. , Harrington Robert A. , Califf Robert M. , Topol Eric J. , Simoons Maarten L. , Boersma Eric
Published: April 2003

Background: The 6-month clinical outcome of patients with multivessel disease enrolled in PURSUIT (Platelet Glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy) is described. Patients with complete angiography data were included; multivessel disease was stratified according to the treatment strategy applied early during hospitalization, i.e. medical treatment, percutaneous coronary intervention (PCI) (balloon), PCI (stent), or coronary artery bypass grafting (CABG). Methods: Patients were divided into three groups according to the treatment strategy applied during the first 30 days of enrolment. Patients who did not undergo a percutaneous or surgical coronary intervention were classified as medically treated. Patients who underwent a PCI (prior to a possible CABG) were separated from those who underwent a CABG (prior to a possible PCI). The PCI group was further subdivided: patients receiving ≧1 coronary stents were separated from those in whom no stents were used. Results: The mortality rate at 30 days was 6.7, 3.9, 2.4 and 4.8% for the medical treatment, PCI (balloon), PCI (stent) and CABG groups, respectively (p value = 0.002). Differences as observed at 30 days were still present at 6-month follow-up with 11.1, 5.8, 5.5 and 6.5% mortality event rates for the aforementioned groups (p value = 0.002). The 30-day myocardial infarction (MI) rate according to the opinion of the Clinical Events Committee was lower among medically than non-medically treated patients, with the highest event rate observed in the CABG group (27.7%). Approximately half of the MIs in the PCI and CABG subgroups occurred within 48 h after the procedure. Conclusions: The observed differences in clinical outcomes are explained by an imbalance in baseline characteristics and comorbid conditions between the analyzed groups of patients.
A Reappraisal of the Locomotion and Habitat Preference of Theropithecus oswaldi
Authors: Elton Sarah
Published: April 2003

The one modern member of the genus Theropithecus, T. gelada (Primates, Cercopithecidae), inhabits grassland and is highly terrestrial. It is often supposed that Theropithecus oswaldi, one of the most common primates of the Plio-Pleistocene of East and southern Africa, was also a highly terrestrial open habitat species. Ecomorphic analysis was used to assess the locomotor strategy and habitat preference of T. oswaldi, and it was found that this species was unlikely to have had a locomotor strategy and habitat preference identical to that of T. gelada, with T. oswaldi possibly using arboreal substrates in a manner similar to some modern baboon groups. Thus, it appears that there has been considerable ecological diversity in the genus Theropithecus over the course of its evolution, mirroring the diversity evident in the hominin fossil record.
Chromoendoscopy: From a Research Tool to Clinical Progress
Authors: Peitz U. , Malfertheiner P.
Published: April 2003

Chromoendoscopy, the intravital staining of gastrointestinal epithelia, provides additional diagnostic information with respect to the epithelial morphology and pathophysiology. Based on experience gathered mainly in Japan, chromoendoscopy is now in more widespread use, in particular to identify preneoplastic and neoplastic lesions. The most promising techniques are the depiction of squamous epithelium neoplasia of the esophagus with Lugol’s solution, staining of Barrett’s mucosa by methylene blue, including the potential to identify neoplasia, and the demarcation of neoplasia with indigo carmine in stomach and colon for local endoscopic resection. However, the optimal methodology is still to be defined as well as diverging results of diagnostic accuracy to be clarified. High-resolution and magnifying endoscopy have breathed new life into chromoendoscopy. Innovative applications and refinement of the existing ones are soon to be expected.
Pediatric Skull Base Surgery
Authors: Gruber David P. , Brockmeyer Douglas
Published: April 2003

Surgical pathology of the pediatric cranial base is uncommon, but in affected children, traditional operative techniques and management philosophies predominate. While the creation of multidisciplinary skull base teams synergistically pools the talents of individual specialties, a better understanding of the developmental anatomy of the cranial base becomes essential in order for such teams to safely implement these approaches in children. The extant neurosurgical literature lacks a comprehensive review of this anatomy. This report discusses the developmental anatomy and embryology of the cranial base within the context of specific surgical approaches. Detailed development of the calvaria, midface skeleton and orbit is excluded.
Comparison of Total versus Partial Revision of Initial Ventriculoperitoneal Shunt Failures
Authors: McGirt Matthew J. , Wellons III John C. , Nimjee Shahid M. , Bulsara Ketan R. , Fuchs Herbert E. , George Timothy M.
Published: April 2003

Background: Optimal surgical management of patients presenting with shunt failure in the age of neuroendoscopy remains complex. The value of replacing the entire shunt system as opposed to a single shunt component has not been assessed. Methods: We reviewed the records of all pediatric patients who underwent their first shunt revision between January 1992 and December 1998. Patients with primary shunt failure attributed solely to proximal catheter obstruction or distal catheter obstruction were included for analysis. Shunt revisions were classified as total (entire shunt replaced) or partial (only malfunctioning component replaced). Kaplan-Meier (shunt survival curves) and log rank analysis were used to compare failure rates between partially and totally revised shunts according to the underlying diagnosis and failed shunt part. Significant differences in univariate analysis were confirmed with a multivariate proportional hazards regression model. Results: 301 pediatric patients underwent primary shunt revision (183 total, 118 partial revisions). All shunts utilized distal slit peritoneal catheters. In shunt failures attributed to proximal obstruction, reutilization of the distal catheter was associated with a 57% increased risk of subsequent shunt failure (hazard ratio 1.57, 95% confidence interval 1.19–3.49). In shunt failures attributed to distal obstruction, subsequent shunt survival was not affected by reutilization of the proximal catheter (p = 0.581). When stratified according to the etiology of hydrocephalus, only patients with intraventricular hemorrhage (IVH) failed to demonstrate greater survival of totally revised shunts. Conclusions: In this series, in the setting of proximal shunt catheter obstruction, reutilizing the functional distal catheter was associated with an increase in subsequent shunt failure rates compared to revising the entire shunt system. Total revision was not associated with improved shunt survival in patients with IVH.