bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of effects of propofol and midazolam at sedative concentrations on sympathetic tone generation in the isolated spinal cord of neonatal rats
Authors: Ho C.‐M. , Tarng G.‐W. , Su C.‐K. 
Published: June 2007

Background:  Propofol and midazolam are common sedatives for critically ill patients. Little is known about the effects of propofol and midazolam on central sympathetic activity when drug concentrations in extracellular milieu are under precise control. Previous work using an in vitro neonatal rat splanchnic nerve–spinal cord preparation has demonstrated that tonic sympathetic activity is generated spontaneously in the thoracic spinal cord. The aim of this study was to investigate the concentration effects of propofol and midazolam on spinally generated sympathetic activity.Methods:  Using an in vitro neonatal rat splanchnic nerve–spinal cord preparation that allows the precise control of drug concentrations, the central sympathetic effects elicited by the application of propofol (10–640 μm) and midazolam (10–640 μm) were compared.Results:  There was a prompt decrease in sympathetic activity on application of propofol or midazolam in a concentration‐dependent manner. A significant decrease in sympathetic activity was observed on application of propofol at 80–640 μm; however, the application of propofol at 10–40 μm caused only a slight alteration in activity. The sympathetic activity was not altered significantly by 10 μm of midazolam, but the application of midazolam at 20–640 μm caused a significant decrease in activity. Thus, in these experimental conditions, the minimum concentration of propofol causing a significant decrease in sympathetic activity was 80 μm and that of midazolam was 20 μm.Conclusions:  The current findings suggest that the administration of 9–19 μm of propofol or 0.7–0.9 μm of midazolam, the clinically relevant concentrations for sedation, does not alter central sympathetic outflow at the spinal cord level. However, propofol at a concentration of 86 μm, which could be achieved by a single‐bolus loading dose to induce sedation, depresses central sympathetic activity.
The NO donor SIN‐1 improves intestinal–arterial Pco2 gap in experimental endotoxemia: an animal study
Authors: Siegemund M. , Van Bommel J. , Sinaasappel M. , Schwarte L. A. , Studer W. , Girard T. , Vollebregt K. , Ince C. 
Published: June 2007

Background:  Dysfunction of the microcirculation is a prominent feature of sepsis and endotoxemia. Recently, it has been shown that microcirculatory alterations are completely reversed by local or systemic application of vasodilators in severely septic patients. Therefore, we investigated the influence of vasodilator therapy on microcirculatory dysfunction of the ileum during endotoxic shock in a prospective, controlled animal study.Methods:  After baseline measurements, shock was induced in 12 domestic pigs by lipopolysaccharide via the mesenteric vein until the mean arterial pressure fell below 60 mmHg. After 30 min in shock, six animals were resuscitated with either fluid alone (control) or fluid and 2 μg/kg/min of the vasodilator 3‐morpholino‐sydnonimine (SIN‐1). The systemic and regional hemodynamics and oxygenation parameters, tonometric ileal Pco2 and microvascular oxygen pressures (μPo2) (by oxygen‐dependent Pd‐porphyrin phosphorescence) were measured simultaneously.Results:  The ileal–arterial Pco2 gap increased during shock and the ileal mucosal and serosal μPo2 decreased concurrently. SIN‐1 in addition to fluid resuscitation significantly improved the ileal–arterial Pco2 gap, whereas fluid alone failed to decrease the Pco2 gap. The SIN‐1‐induced improvement in the Pco2 gap was accompanied by an increase in serosal μPo2 above shock levels. Mucosal μPo2 was resuscitated to baseline levels in both groups.Conclusion:  The application of the vasodilator SIN‐1 in addition to fluid resuscitation improves the ileal–arterial Pco2 gap and mucosal μPo2, together with a moderate increase in serosal μPo2, after endotoxic shock. This finding is consistent with the concept that vasodilators may correct pathologic flow distribution within the intestinal wall.
Oscillation frequency of skin microvascular blood flow is associated with mortality in critically ill patients
Authors: Knotzer H. , Maier S. , Dünser M. , Stadlbauer K. H. , Ulmer H. , Pajk W. , Hasibeder W. R. 
Published: June 2007

Background:  Microcirculatory dysfunction has been hypothesized to play a key role in the pathophysiology of multiple organ failure and, consequently, patient outcome. The objective of this study was to investigate the differences in reactive hyperemia response and oscillation frequency in surviving and non‐surviving patients with multiple organ dysfunction syndrome.Methods:  Twenty‐nine patients (15 survivors; 14 non‐survivors) with two or more organ failures were eligible for study entry. All patients were hemodynamically stabilized, and demographic and clinical data were recorded. A laser Doppler flowmeter was used to measure the cutaneous microcirculatory response. Reactive hyperemia and oscillatory changes in the Doppler signal were measured during 3 min before and after a 5‐min period of forearm ischemia.Results:  Non‐survivors demonstrated a significantly higher multiple organ dysfunction score when compared with survivors (P= 0.004). Norepinephrine administration was higher in non‐survivors (P= 0.018). Non‐survivors had higher arterial lactate levels (P= 0.046), decreased arterial pH levels (P= 0.001) and decreased arterial Po2 values (P= 0.013) when compared with survivors. A higher oscillation frequency of the skin microvasculature at rest (P= 0.033) and after an ischemic stimulus (P= 0.009) was observed in non‐survivors. The flow motion frequency observed in reactive hyperemia was associated with the severity of multiple organ dysfunction (P= 0.009) and, although not statistically significant, with the arterial lactate concentration (P= 0.052).Conclusion:  Increased skin microvascular oscillation frequency at rest and in the hyperemic state after an ischemic stimulus is associated with increased mortality in patients suffering from multiple organ dysfunction. The underlying mechanism could be a response of the skin microvasculature to an impaired oxygen utilization of the skin tissue.
Computed Tomography (CT) of the Lungs of the Dog Using a Helical CT Scanner, Intravenous Iodine Contrast Medium and Different CT Windows
Authors: Cardoso L. , Gil F. , Ramírez G. , Teixeira M. A. , Agut A. , Rivero M. A. , Arencibia A. , Vázquez J. M. 
Published: June 2007

SummaryThe aim of this study was to determine the accuracy of helical computed tomography (CT) for visualizing pulmonary parenchyma and associated formations in normal dogs. CT scan was performed by using intravenous contrast medium and by applying different types of CT windows: soft tissue and lung windows, and high‐resolution computed tomography of the lung. This technique allowed, especially with lung window types, a good view of the parenchyma, bronchial tree, vascular structures and pleural cavity. The selected images, with high anatomical quality and tissue contrast, may be a reference for future clinical studies of this organ. Thus, helical CT is a promising non‐invasive method of diagnosing a wide variety of pulmonary diseases in dogs.
Expression of Neuronal Nitric Oxide Synthase in the Pancreas of the Sheep
Authors: Arciszewski M. B. 
Published: June 2007

SummaryIn numerous mammals, nitric oxide (NO) influences the activity of the exocrine and endocrine pancreas. In this study, immunocytochemistry was utilized to investigate the expression of neuronal nitric oxide synthase (nNOS) in the pancreas of sheep. In double immunocytochemical staining, the co‐localization of nNOS with vasoactive intestinal polypeptide (VIP), neuropeptide Y (NPY) or substance P (SP) was studied. The presence of nNOS was confined to the intrapancreatic neurones (9.6 ± 1.3%) as well as to nerve fibres of the endocrine pancreas and intrapancreatic ganglia. nNOS‐immunoreactive (IR) neurones were round and oval in shape and predominantly (83.3 ± 2.6%) belonged to the middle‐size group (25–50 μm). Numerous, fine islets supplying nNOS‐IR nerve terminals were devoid of VIP, SP or NPY. Moderately numerous, non‐varicose nNOS‐IR nerve fibres of intrapancreatic ganglia frequently expressed VIP or NPY, but not SP; 2.2 ± 0.6% of nNOS‐IR intrapancreatic neurones displayed lack of VIP, whereas 7.5 ± 0.8% were VIP‐IR. All nNOS‐IR neurones were devoid of SP. The frequencies of nNOS‐IR/NPY‐IR and nNOS‐IR/NPY‐negative intrapancreatic neurones were 2.2 ± 0.4% and 6.1 ± 1.1%, respectively. Comparison with other mammals indicated that nitrergic innervation of the ovine pancreas is species‐determined and may be a reflection of the ruminants’ digestion specificity. The possible origin of nNOS‐IR nerve fibres and functional significance of NO in the pancreas of sheep were discussed.
Casual Discovery of a Thoracic Tumour Showing Histological Features of Undifferentiated Pleomorphic Sarcoma in a Male Wistar Laboratory Rat
Authors: Lavranos G. , Paschalis G. , Angelopoulou R. , Karandrea D. , Goutas N. 
Published: June 2007

SummarySarcomas are neoplasms of mesenchymal origin, with a predominant cell population mimicking the organization of various soft tissues and/or bones. Previous categorizations also included the possibility of the presence of tissue macrophage‐like (histiocytes) neoplasm cells, in a tumour described as malignant fibrous histiocytoma, but this group has been considered as a variety of undifferentiated pleomorphic sarcomas. Although this kind of malignancy is not rare in humans, only few cases have been reported in laboratory animals. We report an unusual single case of spontaneous tumour growth, detected by casual observation, in the left thoracic area of an 18‐month‐old male laboratory Wistar rat. Both this individual and his ancestors were not exposed to any known carcinogenic substance or radiation, thus suggesting the development of the neoplasm as a spontaneous event. The mass was extracted surgically under general anaesthesia, and slices were examined histologically and immunohistochemically, using photon microscopy. The pathologist reported the presence of a combination of fibroblasts and undifferentiated mesenchymal cells arranged in a storiform pattern. Immunohistochemistry was performed on the tissue using specific antibodies for several proliferation (Ki‐67) and differentiation (S‐100, CD‐34, CD‐68, pan‐keratin, desmin and smooth muscle actin‐SMA) markers. Positive reaction was observed for S‐100, Ki‐67, CD‐68, desmin and SMA (limited) but not for CD‐34 or cytokeratin.
Effect of a gluten‐free diet on growth and small‐bowel histology in children with celiac disease in India
Authors: Yachha Surender K , Srivastava Anshu , Mohindra Samir , Krishnani Narendra , Aggarwal Rakesh , Saxena Anita 
Published: June 2007

AbstractBackground and Aim:  Follow‐up studies on growth and histological recovery of children with celiac disease (CD) while on a gluten‐free diet (GFD) are lacking from Asia. We therefore assessed the effects of this diet.Methods:  Forty‐two children with CD were enrolled. Weight and height were expressed as weight for height (WfH) and height standard deviation scores (HSDS), respectively. Twenty‐five children had repeated duodenal biopsies after 1–2 years and 14 had a third biopsy after 3–7 years of GFD. Compliance was checked by regular interview and IgA antiendomysial antibody estimation (EMA).Results:  At diagnosis (n = 25), mean HSDS was −3.3 ± 1.6 with 76% having a HSDS of <−2; 60% were undernourished (WfH mean 81.6 ± 5.7). Over a mean follow up of 3.7 years, HSDS improved to −1.3 ± 1.7 and 84% cases achieved normal nutrition. Mean height velocity was 13.9 cm during first year and 5.6 cm in subsequent years. Small‐bowel biopsies at diagnosis showed subtotal villous atrophy (Marsh IIIb) in 18 (72%) and partial villous atrophy (Marsh IIIa) in seven (28%) patients. Repeat biopsy at 1–2 years showed shift from subtotal to partial villous atrophy in 94% (n = 17/18) and normalization in one patient. In patients with Marsh IIIa improvement of partial villous atrophy was observed in all. Immunoglobulin A endomysial antibody was negative in 81%. Repeat biopsies at 5 years of GFD showed improvement to Marsh I–II, but none normalized.Conclusion:  The majority of children with CD show normalization of nutrition and growth after GFD. Small‐bowel histology improves markedly but does not normalize even after 5 years of GFD.
Antiviral action of interferon‐α against hepatitis C virus replicon and its modulation by interferon‐γ and interleukin‐8
Authors: Jia Yintang , Wei Lai , Jiang Dong , Wang Jianghua , Cong Xu , Fei Ran 
Published: June 2007

AbstractBackground and Aim:  Interferon‐α (IFN‐α) based therapy is the main treatment used to control hepatitis C virus (HCV) infection. The aim of this study was to understand the mechanisms of IFN‐α inhibition of HCV replication and the resistance of HCV to IFN‐α therapy, and improve the efficiency of HCV treatment.Methods:  The inhibitory effects of IFN‐α on a HCV replicon system were examined and the potential regulatory effects of interferon‐γ (IFN‐γ) and interleukin‐8 (IL‐8) on the antiviral actions of IFN‐α were also investigated in this report.Results:  The results showed that IFN‐α can effectively inhibit the replication of HCV replicon. Pretreatment of HCV replicon cells with IFN‐γ could significantly potentiate the inhibitory effects of IFN‐α on the HCV replicon. Direct addition of IL‐8 to the culture medium of HCV replicon cells could partially rescue the HCV replicon from the inhibition of IFN‐α, which may be the result of IL‐8 down‐regulation of interferon‐stimulated genes.Conclusion:  Our study demonstrated that IFN‐γ has synergistic antiviral effects with IFN‐α; whereas IL‐8 can attenuate the anti‐HCV actions of IFN‐α and is associated with HCV resistance to interferon‐α therapy.
Further validation of magnifying chromocolonoscopy for differentiating colorectal neoplastic polyps in a health screening center
Authors: Emura Fabian , Saito Yutaka , Taniguchi Makoto , Fujii Takahiro , Tagawa Kazumi , Yamakado Minoru 
Published: June 2007

AbstractBackground and Aim:  The accuracy of conventional colonoscopy to differentiate neoplastic and non‐neoplastic polyps is limited, justifying a biopsy for histologic analysis. Magnifying chromocolonoscopy has emerged as the best tool available for differentiating adenomatous and hyperplastic polyps during colonoscopy; however, magnifying endoscopes are rarely used in endoscopy units. This study aimed to further validate the effectiveness of magnifying chromocolonoscopy in the diagnosis of neoplastic colorectal polyps in a screening center.Method:  Five hundred average‐risk subjects were randomly divided into two groups: a magnifying chromocolonoscopy group and a conventional chromocolonoscopy group, each of 250 subjects. Lesions were analyzed according to Kudo's classification of pit pattern (types I–V) and additionally subdivided into non‐neoplastic (types I–II) and neoplastic (types III–V). Lesions judged as neoplastic were resected and those judged as non‐neoplastic were left in situ. Only lesions ≤10 mm were included in the study. Resected lesions were analyzed with histopathological examination.Results:  The overall accuracy of magnifying chromocolonoscopy for differentiating neoplastic lesions (95%, 135 of 142), was significantly higher than that of conventional chromocolonoscopy (84%, 102 of 122; P < 0.01). The accuracy of magnifying chromocolonoscopy for differentiating neoplastic lesions ≤5 mm was 94% (135 of 142), whereas that of conventional chromocolonoscopy was only 78% (69 of 89; P < 0.001). Results were not affected by the macroscopic types.Conclusion:  Magnifying chromocolonoscopy is superior to conventional chromocolonoscopy for the diagnosis of colorectal neoplastic lesions in the setting of a health testing center.
Non‐alcoholic fatty liver disease in the Asia–Pacific region: Definitions and overview of proposed guidelines
Authors: Chitturi Shivakumar , Farrell Geoffrey C , Hashimoto Etsuko , Saibara Toshiji , Lau George KK , Sollano José D ,   the Asia–Pacific Working Party on NAFLD
Published: June 2007

AbstractNon‐alcoholic fatty liver disease (NAFLD) is the most common liver disorder in Western industrialized countries, affecting 20–40% of the general population. Large population‐based surveys in China, Japan, and Korea indicate that the prevalence of NAFLD is now 12% to 24% in population subgroups, depending on age, gender, ethnicity, and location (urban versus rural). There is strong evidence that the prevalence of NAFLD has increased recently in parallel with regional trends in obesity, type 2 diabetes, and metabolic syndrome; and that further increases are likely. The relationship between NAFLD, central obesity, diabetes, and metabolic syndrome is clearly evident in retrospective and prospective Asian studies, but the strength of association with these metabolic risk factors is only appreciated when regional definitions of anthropometry are used. Pathological definition of NAFLD, particularly its activity and the extent of liver fibrosis, requires histological examination, but liver biopsy is often not appropriate in this disorder for logistic reasons. An alternative set of operational definitions is proposed here. Clinicians need guidelines as how best to diagnose and manage NAFLD and its associated metabolic disorders in countries with scant healthcare resources. The Asia–Pacific Working Party (APWP) for NAFLD was convened to collate evidence and deliberate these issues. Draft proposals were presented and discussed at Asia–Pacific Digestive Week at Cebu, Philippines, in late November 2006, and are published separately in this issue of the Journal as an Executive Summary. The present document reviews the reasoning and evidence behind the APWP‐NAFLD proposals for definition, assessment, and management of NAFLD in the Asia–Pacific region.
How common is non‐alcoholic fatty liver disease in the Asia–Pacific region and are there local differences?
Authors: Amarapurkar Deepak N , Hashimoto Estsuko , Lesmana Laurentius A , Sollano José D , Chen Pei‐Jer , Goh Khean‐Lee ,   for the Asia–Pacific Working Party on NAFLD
Published: June 2007

AbstractRisk factors for development of non‐alcoholic steatohepatitis include obesity, especially central adiposity, glucose intolerance or type 2 diabetes mellitus (T2DM), and dyslipidemia. Non‐alcoholic fatty liver disease (NAFLD) is now considered a manifestation of metabolic syndrome. During the last two decades, NAFLD has become the most common chronic liver disease in North America and Europe, but until recently was thought to be uncommon (perhaps due to the lack of study) in Asia. Fatty liver can be identified on imaging modalities (ultrasonography, computed tomography scans, and magnetic resonance imaging) with high sensitivity, but steatohepatitis and fibrosis cannot be distinguished. Thus, an inherent drawback in studying the epidemiology of NAFLD is the lack of definitive laboratory tests, no uniform definition—with different studies using cut‐off values of alcohol consumption from <20 g/week to 210 g/week, and case selections where biopsy was used for definition. In studies outside the region, the prevalence of NAFLD varies from 16% to 42% by imaging, and 15–39% of liver biopsies. The major risk factors for NAFLD, central obesity, T2DM, dyslipidemia, and metabolic syndrome, are now widely prevalent and are increasing geometrically in the Asia–Pacific region. It is therefore not surprising that NAFLD is common in this region. Estimates of current prevalence range from 5% to 30%, depending on the population studied. Central obesity, diabetes, and metabolic syndrome are the major risk factors. To date, however, data on the natural history and impact of NAFLD causing serious significant chronic liver disease are lacking and there is a need for prospective, cooperative studies.
Long‐term mortality following stroke, myocardial infarction and fractured neck of femur in Western Australia
Authors: Beer C. , Xiao J. , Flicker L. , Almeida O. P. 
Published: June 2007

AbstractBackground: Population ageing will increase the burden of stroke, myocardial infarction (MI) and fractured neck of femur (FNF). These age‐dependent conditions are associated with increased mortality, although the pattern and extent of this increased mortality is poorly understood. The aim of this study was to compare mortality from stroke, MI and FNF.Methods: Retrospective inception cohort study of 2818 subjects more than the age of 60 years in Western Australia recorded in a linked database as having sustained a stroke, MI or FNF in the year 1990.Results: Early adjusted mortality rates associated with FNF were relatively low compared with stroke and MI. Medium‐term to longer‐term mortality associated with FNF was greater than MI, but stroke was associated with the highest long‐term adjusted mortality.Conclusion: The poorer medium‐term to longer‐term survival following stroke and FNF (relative to that following MI) may relate to a greater burden of comorbidity. Stroke and FNF may thus be markers of medical frailty.
Influence of rheumatoid arthritis on work participation in Australia
Authors: Shanahan E. M , Smith M. , Roberts‐Thomson L. , Esterman A. , Ahern M. 
Published: June 2007

AbstractBackground: The aim of the study was to determine the prevalence of work disability in a cohort of Australians with rheumatoid arthritis.Methods: A cross‐sectional study of a sample of 497 individuals aged 18–65 years with rheumatoid arthritis in Adelaide, South Australia, was carried out.Results: Of those employed, 130 (51%) were in full‐time employment (≥ 35 h per week) work and 124 (49%) were in part‐time employment (average 20 h per week). Overall, the observed/expected numbers working were 254/316 (relative risk 0.8 (0.69–0.91)). Using a comparator adjusted by removing those on the disability support pension, the relative risk of the working was 0.74. The observed/expected numbers working part time in the study group were 124/89 (relative risk 1.4 (1.25–1.65)). Those who continued to work had lower Health Assessment Questionnaire scores, less morning stiffness, superior scores for patient assessed level of function, lower pain scores, lower joint counts, a lower C‐reactive protein, better measures of ‘patient global assessment’ and higher levels of education compared with the group who had ceased work. Overall, of those working at the time of diagnosis, 20% had ceased work within 5 years and approximately 40% had ceased work by 20 years. Of those who ceased work, the mean duration from time of diagnosis to work cessation was 7 years with half the subjects who ceased work doing so within 4 years of diagnosis.Conclusion: Work disability associated with rheumatoid arthritis in Australia is very significant and costly. Work disability occurs relatively early in the disease and is associated with several identifiable variables, many of which may be amenable to intervention strategies.