bluuebunny/crossref_metadata_2025_split huggingface dataset:
Herniation of the Small Bowel through the Port Site following Removal of Drains during Laparoscopic Surgery
Authors: Komuta Ko , Haraguchi Masashi , Inoue Keiji , Furui Junichiro , Kanematsu Takashi 
Published: April 2003

<i>Background/Aims:</i> Generally, the port site is used as the delivery route for drainage after laparoscopic abdominal surgery. We report this case because of the rarity of the complication related to laparoscopic procedures. <i>Methods:</i> A 75-year-old woman underwent a laparoscopic-assisted sigmoid colectomy for early stage cancer. <i>Results:</i> After the operation, her postoperative course was uneventful. However, just after removing the drains, the small bowel was found to have herniated through the port site used as the insertion route for the drains. An emergency relaparotomy was done and a segment of the necrotic small bowel had to be resected. <i>Conclusion:</i> To prevent this complication, we suggest that, first of all, in elderly and thin patients smaller trocar insertion sites (<10 mm) should be utilized as insertion routes for the drains and, secondly, the fascial defect should be closed just after removing the drains whenever the defect measures 10 mm or more in size.
Total Gastrectomy Is Not Always Necessary for Advanced Gastric Cancer of the Cardia
Authors: Kobayashi Toshihiko , Sugimura Haruhiko , Kimura Taizo 
Published: April 2003

<i>Background:</i> It is unclear whether total gastrectomy (TG) is always necessary for gastric cancer of the cardia. We therefore investigated whether cardiac cancers treated by TG would have been cured by proximal gastrectomy (PG). <i>Methods:</i> Photocopies of the resected stomachs of 55 patients who had received TG for cardiac cancer were reviewed<i>.</i> A simulated resection line for PG was drawn connecting a point 5 cm from the pyloric ring on the lesser curvature with a point 15 cm from the pyloric ring on the greater curvature. The distal surgical margin between the tumor edge and the simulated resection line was measured, and lymph nodes (LN) dissected surgically were examined for tumor involvement. <i>Results:</i> Tumor location fell into three categories, upper-middle (UM, n = 28), upper (U, n = 18), and upper-esophagus (UE, n = 9). The means of the simulated surgical margins were 1.0 cm for UM, 4.7 cm for U, and 5.7 cm for UE tumors. UE tumors had no metastasis to No. 4d, 5, or 6 LN, and only one U tumor showed metastasis to No. 4d and 5 LN. In contrast, UM tumors had a higher incidence of these nodes involved. <i>Conclusion:</i> Advanced gastric cancer located in the U or UE regions is mostly curable by PG.
Atherosclerotic Aortic Arch Plaques in Cryptogenic Stroke: A Microembolic Signal Monitoring Study
Authors: Castellanos Mar , Serena Joaquín , Segura Tomás , Pérez-Ayuso M. Jesús , Silva Yolanda , Dávalos Antoni 
Published: April 2003

<i>Background and Purpose:</i> To find out the prevalence of relevant atherosclerotic plaques in the aortic arch and their potential role as a source of embolism in cryptogenic stroke. <i>Methods:</i> We performed a transoesophageal echocardiography (TEE) on 49 patients with cryptogenic stroke from a total series of 212 non-selected patients with acute ischaemic stroke studied prospectively by cranial computed tomography (CT), colour-duplex and transcranial Doppler (TCD) sonography with micro-embolic signal (MES) monitoring. Cryptogenic stroke was diagnosed in those patients without carotid or intracranial stenosis >50%, nor lacunar or cardio-embolic strokes. We defined relevant plaques as those ≧4 mm thick located in the ascending aorta or proximal arch. <i>Results:</i> Twenty-three patients (46.9%) had atherosclerotic aortic plaques (AAP): 3 in the ascending aorta (in 1 ≧4 mm), 11 in the proximal aortic arch (in 4 ≧4 mm) and 9 in the descending aorta (in 5 ≧4 mm). Hence, 5 patients (10.2%) had relevant plaques. Aortic plaques were significantly related to older age (p < 0.001) and male gender (p = 0.042). A carotid artery stenosis <50% was found in 39% of patients with AAP and in 8% of those without AAP (p = 0.009). MES were detected in 3 patients with plaques ≧4 mm thick, but not in those without AAP or with AAP <4 mm thick (p = 0.006). <i>Conclusion:</i> Although few patients with cryptogenic stroke had relevant plaques in our non-selected population, our results support the hypothesis that relevant aortic plaques have embolic potential.
Drug-Induced Headache: Long-Term Follow-Up of Withdrawal Therapy and Persistence of Drug Misuse
Authors: Fritsche G. , Eberl A. , Katsarava Z. , Limmroth V. , Diener H.C. 
Published: April 2003

Patients suffering from migraine, tension-type headache (TTH), or combined headache (CH) are at risk of developing drug-induced headache (DIH) due to regular use of analgesics, ergot alkaloids, and triptans. The aim of our study was to determine (1) the clinical features of DIH, (2) the outcome of withdrawal therapy using high methodological standards, and (3) predictors which could explain the high relapse rate (more than 40%) after a previously successful withdrawal therapy. We retrospectively reviewed 103 patients with migraine or TTH who underwent withdrawal therapy between 1994 and 1998. The long-term follow-up (2–4 years after therapy) was conducted by phone and by specially trained psychologists using a structured interview which enclosed characteristics of headache and medication behavior as well as patients global assessment of success. Complete sets of data were available from 83 patients (38 migraine, 26 TTH, 19 CH). The most frequently abused drugs were caffeine-combined analgesics (24%), followed by caffeine-combined ergotamines (19%), pure ergot alkaloids (17%), and monoanalgesics (17%). 48.5% of the patients suffered an abuse relapse within 4 years and developed the complete features of DIH again. Analgesic and ergot alkaloid combinations with caffeine lead significantly more often to a relapse. A long-term successful therapy is connected with a significant reduction of the frequency of headache attacks. Under relapse conditions, the patients reached their former headache frequency level. The data show a higher relapse rate than previously assumed and that certain substance groups bear a higher relapse risk.
Risk Factors of Aspiration Pneumonia in Alzheimer’s Disease Patients
Authors: Wada Hideki , Nakajoh Kazushi , Satoh-Nakagawa Takuma , Suzuki Tomoko , Ohrui Takashi , Arai Hiroyuki , Sasaki Hidetada 
Published: April 2003

<i>Background:</i> Pneumonia is the reported cause of death of a high proportion of Alzheimer’s disease (AD) patients. <i>Objectives:</i> This study assessed swallowing function to explore the potential risk factors of aspiration pneumonia in AD patients. <i>Methods:</i> Data were gathered on 121 AD patients (mean age 78.2, SD 7.5, male/female ratio = 48/73) treated in two psychiatric hospitals. Multiple logistic regression analysis was used to estimate odds ratios for the risk of aspiration pneumonia. The following risk factors were considered: age, severity of dementia, silent brain infarction (SBI) in the basel ganglia, use of psychotropic drugs (neuroleptics and benzodiazepines), and gender. The latency time of the swallowing reflex was analyzed (1) among groups based on the severity of dementia; (2) between groups with and without SBI in the basal ganglia; (3) before and after the use of psychotropic drugs in the group without SBI in the basal ganglia, and (4) between males and females. <i>Results:</i> Aspiration pneumonia in ambulatory AD patients was significantly and independently associated with severe dementia, presence of SBI in the basal ganglia, intake of neuroleptics, and the male gender. The mean latency of the swallowing reflex in the severe AD group was significantly longer compared to that in the mild-to-moderate AD group. The mean latency of the swallowing reflex after the intake of neuroleptics was significantly prolonged compared to that obtained before any neuroleptic intake, whereas there was no significant difference in the mean latency of the swallowing reflex before and after benzodiazepine intake. <i>Conclusion:</i> We recommend the use of the smallest efficacious dosage of neuroleptics especially in treating severely demented AD patients with basal-ganglia infarction. As soon as the behavioral and psychiatric problems are resolved, drug tapering or discontinuation should be considered in order to prevent life-threatening aspiration pneumonia.
Postcesarean Small Bowel Volvulus
Authors: Sherer David M. , Abulafia Ovadia 
Published: April 2003

Volvulus is an uncommon cause of bowel obstruction during pregnancy. We present an unusual case in which cesarean delivery at 26 weeks of gestation was complicated by volvulus of the small bowel 1 week following delivery. At laparotomy, detorsion of the loop of the terminal ileum sufficed, and bowel resection was not required. We review the literature pertaining to volvulus of the bowel during pregnancy and discuss recent new diagnostic imaging modalities for midgut volvulus, which may assist early noninvasive diagnosis of this condition.
Fetal Circulatory Responses to Maternal Blood Loss
Authors: Suzuki Shunji , Tateoka Sachi , Yagi Shutaro , Ishikawa Gen , Ohshita Tomoko , Sawa Rintaro , Yoneyama Yoshio , Asakura Hirobumi , Araki Tsutomu 
Published: April 2003

We examined the fetal circulatory responses to maternal blood loss in pregnant women during the third trimester. Seven healthy women with placenta previa and singleton pregnancies underwent phlebotomies in an autologous donation program. Four hundred milliliters of blood was collected within 15 min at 34 and 35 weeks of gestation. Continuous electric recordings of fetal heart rate were performed during the first blood collection, and the maternal uterine artery (UtA), umbilical artery (UmA) and fetal middle cerebral artery (MCA) Doppler velocity waveforms were recorded before, immediately after and 24 h after the second collection in each patient. The average fetal heart rate, maternal UtA and UmA pulsatility indices did not change measurably during or after maternal blood collections. However, the average fetal MCA pulsatility index decreased significantly 24 h after maternal blood loss. The observation of a decrease in fetal MCA pulsatility index may indicate delayed fetal asphyxia following mild maternal hemorrhage.
Assisted Reproductive Technologies in Conjunction with Conservatively Treated Endometrial Adenocarcinoma
Authors: Ogawa Shuichi , Koike Toshimitsu , Shibahara Hiroaki , Ohwada Michitaka , Suzuki Mitsuaki , Araki Shigeo , Sato Ikuo 
Published: April 2003

This case report illustrates the successful use of assisted reproductive technologies (ARTs) in a patient receiving conservative treatment for endometrial adenocarcinoma. A 31-year-old infertile woman, diagnosed as FIGO stage Ia endometrial adenocarcinoma (grade 1), received oral medroxyprogesterone acetate 400 mg/day for 12 weeks. Endometrial curettage was performed and the absence of endometrial carcinoma was confirmed. A single pregnancy was achieved with in vitro fertilization and embryo transfer. A healthy female infant was born via cesarean section at 42 weeks’ gestation. The carcinoma has not recurred, and the patient now desires a second child. We conclude that ART combined with progesterone treatment might be a powerful option for the treatment of infertile patients with early stage, well-differentiated endometrial adenocarcinoma.
Primary Role of CD4+ T Cells and Supplemental Role of Mast Cells in Allergic Pulmonary Eosinophilia
Authors: Ogawa Koji , Kaminuma Osamu , Kikkawa Hideo , Kameda Rieko , Ikezawa Katsuo , Suko Matsunobu , Okudaira Hirokazu , Akiyama Kazuo , Mori Akio 
Published: April 2003

<i>Background:</i> We have recently demonstrated that allergic eosinophilic inflammation is transferred to unprimed mice by infusing IL-5-producing CD4+ T cells. The contribution of mast cells to the development of eosinophilic inflammation is controversial. <i>Methods:</i> To clarify the possible different roles of CD4+ T cells and mast cells in eosinophilic inflammation, we compared antigen-induced airway eosinophilia between mast-cell-deficient mice (WBB6F1-W/W<sup>v</sup>) and their congenic normal littermates (WBB6F1-+/+). <i>Results:</i> The time course study indicated that equivalent numbers of eosinophils were recruited into the airway of both +/+ and W/W<sup>v</sup> mice 6, 24, 96, and 216 h after antigen challenge, whereas the number of eosinophils 48 h after antigen challenge was significantly lower in W/W<sup>v</sup> compared to +/+ mice. Administration of either anti-CD4 or anti-IL-5 monoclonal antibody almost completely inhibited antigen-induced eosinophil recruitment in W/W<sup>v</sup> mice 48 h after antigen challenge. In contrast, the inhibitory effect of these antibodies in +/+ mice were partial (∼50% inhibition). Anti-CD4 and anti-IL-5 antibodies equally suppressed airway eosinophilia in both +/+ and W/W<sup>v</sup> mice 96 h after antigen challenge. <i>Conclusion:</i> Our study indicates that CD4+ T cells are crucially involved in the development of allergic eosinophilic inflammation, while mast cells may play a supplemental role depending on the kinetics of the response.
Systemic T Helper 2 Cell Activation Is Not Sufficient for Antigen-Induced Eosinophil Recruitment into the Airways
Authors: Nakajima Hiroshi , Nakao Atsuhito , Kumano Kotaro , Yamamoto Hiroshi , Iwamoto Itsuo 
Published: April 2003

<i>Background:</i> Airway eosinophilic inflammation is a characteristic feature of asthma. We have previously shown that antigen-induced eosinophil recruitment into the airways of sensitized BALB/c mice is mediated by CD4+ T cells and IL-5. However, the basis for the eosinophil recruitment into the airway are still largely unknown. <i>Methods:</i> To determine the regulatory mechanisms that control the magnitude of antigen-induced eosinophilic inflammation in the airways, we analyzed antigen-induced eosinophil and T cell infiltration into the trachea in several strains of mice, including BALB/c (H-2<sup>d</sup>), BALB/b (H-2<sup>b</sup>), C57BL/6 (H-2<sup>b</sup>), C57BL/10 (H-2<sup>b</sup>), and B10.D2 (H-2<sup>d</sup>) mice. In addition, cytokine production from antigen-stimulated splenocytes and the titer of antigen-specific IgE antibody in serum were assessed. <i>Results:</i> Antigen-induced eosinophil recruitment into the trachea in BALB/c mice was more than 20 times as abundant as that in C57BL/6 mice, the latter of which was also mediated by CD4+ T cells. In contrast, systemic Th2 responses, which were evaluated by the titers of antigen-specific IgE antibody in serum and antigen-induced IL-4 and IL-5 production from splenocytes, were similarly observed in BALB/c mice and C57BL/6 mice. In addition, the antigen-induced eosinophil recruitment into the trachea was high in BALB/b mice, like BALB/c mice, but low in B10.D2 mice. <i>Conclusions:</i> Systemic Th2 responses are not sufficient for causing antigen-induced eosinophil recruitment into the airways and an undefined determinant(s) that exists in the BALB background mice rather than the H-2 haplotype is vital for the regulation of antigen-induced eosinophil recruitment into the airways.
Immunochemical Characterization of Antigenic Fragments of <i>Olea europaea</i> and <i>Phleum pratense</i>
Authors: Fernández-Caldas Enrique , González Romano Leticia , Gallego Mayte , Casanovas Miguel , Guerra Francisco , Ferrer Angel , Berrens Lubertus 
Published: April 2003

<i>Background:</i> The modulation of T cell responses by natural peptides is of potential use in the treatment of allergic diseases and reduces the risk of IgE-mediated reactions. The objectives of this study were to evaluate the allergenicity of depigmented, pepsin-digested fragments of <i>Oela europaea</i> and <i>Phleum pratense</i> extracts and their capacity to induce T cell proliferation. <i>Methods:</i> Lyophilized <i>O. europaea</i> and <i>P. pratense</i> extracts were depigmented following standardized methods, digested with pepsin and fractionated by ultrafiltration; a fraction containing components in the molecular weight range of 1–10 kD was selected. The blood of 20 allergic individuals was used to conduct T cell proliferation studies. <i>Results:</i> Pepsin-digested fragments of both pollen extracts lost more than 95% of their IgE-binding capacity by ELISA inhibition. Greater proliferation indexes than their respective native extracts were obtained in 55% of <i>O. europaea</i> and in 95% of <i>P. pratense</i> allergic patients. <i>Conclusions:</i> This study demonstrates that pepsin-digested allergenic fragments of depigmented extracts can be produced in a standardized, reproducible manner. These fragments are significantly less allergenic and retain, or even increase, their capacity to induce T cell proliferations.
Effect of the H<sub>1</sub>-Receptor Antagonist Cetirizine on the Stimulated Expression of Adhesion Molecules and the Activation of NFκB in Human Endothelial Cells
Authors: Ambrosch Andreas , Borgmann Stefan , Rihoux Jean-Pierre , König Wolfgang 
Published: April 2003

<i>Background:</i> In the present work, we studied the effect of cetirizine on the cytokine-stimulated immune response of human umbilical vein endothelial cells (HUVECs). <i>Methods:</i> Our research was directed to analyze the effect of preincubation of HUVECs with cetirizine (1 µg/ml) on (1) the TNFα-, IL-4- and IFNγ-induced surface expression of ICAM-1 and VCAM-1, (2) the secretion of IL-6 and IL-8, (3) the recruitment of NFĸB and AP-1 and (4) the adhesion of histiocytic monocytes (U937) to activated endothelial monolayers. <i>Results and Conclusion:</i> Cetirizine exerts a stimulus-dependent pattern of regulatory action on various parameters of endothelial cell activation. In detail, cetirizine significantly reduces the expression of ICAM-1 and VCAM-1 paralleled by a reduced monocytic adhesion in particular to TNFα-activated HUVECs. With regard to the cytokine release, dual effects are obtained by cetirizine: IL-6 and IL-8 secretion is suppressed by cetirizine in TNFα and IL-4-activated cells, whereas the IFNγ-induced suppression of IL-8 is nearly abrogated. In this context, the TNFα-induced signal transduction with regard to NFĸB and AP-1 was also suppressed by cetirizine.
Differential Regulation of Cathepsin B and Prorenin Gene Expression in Renal Juxtaglomerular Cells
Authors: Todorov Vladimir , Müller Markus , Kurtz Armin 
Published: April 2003

Cathepsin B (cathB) is a lysosome cysteine proteinase. It has been suggested to process prorenin to renin in the renin producing juxtaglomerular (JG) cells of the afferent arterioles (AA) of the kidney. Whether cathB expression is regulated similarly to prorenin production is yet unknown. We have measured prorenin and cathB mRNA levels as well as cathB protein levels in renal AA of Sprague-Dawley rats subjected to low (0.02% w/w) salt diet and ramipril treatment (10 mg/kg/day), or to normal (0.6%) or high (4%) salt diet. Prorenin and cathB expression were also analyzed in the JG cell line As4.1. Prorenin mRNA levels in animals on normal (plus ramipril), low or high salt diet correlated as 1:10:0.5, respectively, while cathB mRNA levels correlated as 1:1:0.6, respectively. Treatment of the As4.1 cells with 100 n<i>M</i> phorbol-12-myristate-13-acetate (PMA) for 16 h inhibited prorenin mRNA expression 3-fold relative to the control conditions. CathB mRNA abundance was not different between the PMA treated and the control As4.1 cells. Western analysis of the cathB protein abundance has shown no difference between the rats on normal and low salt diet, and decrease by 50% in the rats on high salt diet. The results of this study suggest that prorenin and cathB gene expression in renal JG cells are differentially regulated.
Hippurate Metabolism as a Hydroxyl Radical Trapping Mechanism in the Rat Kidney
Authors: Mályusz M. , Kähler W. , Gronow G. 
Published: April 2003

Hippurate (Hip) is considered to be the end product of benzoate (BA) metabolism. However, the kidney is able to metabolize Hip. Although only Hip but no BA is present in the blood, rat urine contains under normal conditions less Hip (about 0.4 m<i>M</i>) than BA (about 4.5 m<i>M</i>) and of hydroxylated derivatives of BA (hydroxy-BAs = HB and dihydroxy-BAs = DHB). Generation of HBs and DHBs is the result of radical substitution by free OH radicals (·OH). Thus, rate of synthesis of HBs and DHBs may reflect the production rate of ·OH in the kidney. ·OH generation is elevated following ischemic stress. Therefore, production of HBs and DHBs can be expected to be elevated in postischemic injury. The validity of this assumption was tested in vitro on isolated tubular segments and in vivo in the rat. Metabolism of Hip at 0.1 mmol l<sup>–1 </sup>(0.1 m<i>M</i>) as well as of BA resulted in enlarged production of both HBs (especially 3-HB and 4-HB) and of DHBs (especially 2,6-DHB). Production of 2,3- and especially of 2,5-DHB was elevated in the presence of high concentration (1.0 m<i>M</i>) of salicylate (2-HB) only. In vivo both in acute (120 min) and in chronic (5 days) experiments ligation of one renal artery for 30 respectively 60 min resulted in enlarged excretion of HBs and DHBs, especially of 2,6- and 3,5-DHB. This finding is noteworthy since (a) formation of 2,6-DHB necessitates as precursor salicylate which could not be detected in our experiments and (b) the spontaneous attack of ·OH upon the benzol ring would prefer the positions 2,3- 2,5- and 3,4-. Therefore, the existence of regulating factor(s) guiding OH groups to definite positions is a distinct possibility. These results indicate that metabolism of Hip leading to hydroxylated BAs may be a renoprotective mechanism against attack of ·OH in reoxygenated renal tissue.
Effects of Sex Hormones on Na<sup>+</sup>/Glucose Cotransporter of Renal Proximal Tubular Cells following Oxidant Injury
Authors: Han Ho Jae , Park Soo Hyun , Park Hyung Joo , Lee Jang Hern , Lee Byung Cheon , Hwang Woo Suk 
Published: April 2003

It was reported that reactive oxygen metabolites play an important role in the pathogenesis of several renal diseases including glomerulonephritis, ischemia and acute tubular necrosis. However, the effect of oxidants and protective effect of sex steroid hormones on Na<sup>+</sup>/glucose cotransporter of renal proximal tubular cells is not yet elucidated. In the present study, we examined the effect of sex steroid hormones against tert-butyl hydroperoxide (t-BHP)-induced alteration of Na<sup>+</sup>/glucose cotransporter activity in primary cultured rabbit renal proximal tubule cells (PTCs). t-BHP inhibited α-methyl-<i>D</i>-glucopyranoside (α-MG) uptake in a dose-dependent manner. t-BHP-induced inhibition of α-MG uptake was due not to K<sub>m</sub> but to the decrease of V<sub>max</sub>. 0.5 m<i>M</i> t-BHP-induced inhibition of α-MG uptake was significantly blocked by estradiol-17β, but not by progesterone and testosterone. This protective effect was not blocked by estrogen receptor antagonist or transcription and translation inhibitor. In addition, 0.5 m<i>M</i> t-BHP increased [<sup>3</sup>H]-arachidonic acid (AA) release and Ca<sup>2+</sup> uptake. These effects of t-BHP were also significantly blocked by estradiol-17β, but not by progesterone and testosterone. Protective efficacy of estradiol-17β on t-BHP-induced inhibition of α-MG uptake is exhibited between antioxidants and iron chelators. In conclusion, estradiol-17β, but not progesterone and testosterone, partially prevented t-BHP-induced inhibition of α-MG uptake through its antioxidant activity dependent upon phenol structures and inhibition of AA release and Ca<sup>2+</sup> influx.