bluuebunny/crossref_metadata_2025_split huggingface dataset:
Proximal Tubular Injury Attenuates Outer Medullary Hypoxic Damage: Studies in Perfused Rat Kidneys
Authors: Heyman Samuel N. , Shina Ahuva , Brezis Mayer , Rosen Seymour 
Published: April 2003

The straight segment (S3) of the proximal tubule is predominantly damaged during renal ischemia-reflow, whereas medullary thick ascending limbs (mTALs) are principally affected in other models of hypoxic acute tubular necrosis (ATN). Since the latter injury pattern largely depends on the extent of reabsorptive activity during hypoxic stress, we hypothesized that proximal tubular damage might attenuate downstream mTAL injury by means of diminished distal solute delivery for reabsorption. In isolated rat kidneys perfused for 90 min with oxygenated Krebs-Henseleit solution, mTAL necrosis developed in 75 ± 3% of tubules in the mid-inner stripe of the outer medulla. By contrast, S3 segments in the outer stripe were minimally affected, with tubular fragmentation involving some 5 ± 2% of tubules. In kidneys subjected in vivo to proximal tubular injury and subsequently used for isolated perfusion studies, the injury pattern was inverted: following 20 and 30 min ischemia and reflow for 24 h, S3 fragmentation rose to 18 ± 16% and 72 ± 13%, while mTAL damage was reduced to 33 ± 10 and 24 ± 8%, respectively. In kidneys subjected in vivo to <i>D</i>-serine S3 necrosis rose to 100%, while mTAL damage fell to 1 ± 1% (p < 0.001). Substantial S3 tubular collapse (involving approximately 30% of tubules) and inner stripe interstitial hemorrhage were also noted, exclusively in kidneys subjected to ischemia-reflow. Proximal tubular necrosis alone or in combination with collapse inversely correlated with mTAL necrosis (R = –0.51 and –0.72, respectively, p < 0.003). This cogent inverse association might imply that disruption of the proximal nephron attenuates downstream mTAL necrosis by a reduction of distal tubular reabsorptive workload.
SonoVue<sup>®</sup> (BR1), a New Long-Acting Echocontrast Agent, Improves Transcranial Colour-Coded Duplex Ultrasonic Imaging
Authors: Droste Dirk Wolfgang , Llull Jean Bernard , Pezzoli Carla , Bogdahn Ulrich , Kaps Manfred 
Published: April 2003

<i>Background and Purpose:</i> Visualization of normal or pathological flow in the intracranial arteries using transcranial colour-coded duplex sonography (TCCS) is occasionally obstructed by insufficient temporal bone windows, unfavourable insonation angles, or low flow velocities or volumes. SonoVue<sup>®</sup> (BR1) is a new, long-acting echocontrast agent, which could be helpful in these instances. <i>Methods:</i> SonoVue was studied in two separate multicentre investigations of patients with insufficient bone windows (BR1-014 with 73 patients and BR1-017 with 40 patients) using an identical protocol. The agent was given intravenously as a bolus in four different doses (0.3, 0.6, 1.2 and 2.4 ml). Evaluation was performed on-site and off-site with video clips. <i>Results:</i> The contrast agent was well tolerated. As compared to the precontrast scans, SonoVue facilitated the visualization of vessel patency, stenosis, occlusion, and collateral flow, decreased the need for additional tests, and had an impact on the patient’s treatment. In 66–74%, a non-diagnostic investigation was converted into a diagnostic investigation. The highest dose (2.4 ml) allowed for a clinically useful signal enhancement of a median 1.9–6.3 min. <i>Conclusions:</i> SonoVue at a single dose of 1.2 or 2.4 ml is effective in increasing the detection of normal or pathological flow in the intracerebral arteries in patients who do not have a fully diagnostic unenhanced TCCS examination.
Influence of Interleukin 10 and Transforming Growth Factor-β on T Cell Stimulation through Allogeneic Retinal Pigment Epithelium Cells in vitro
Authors: Enzmann Volker , Hollborn Margrit , Kühnhoff Sandra , Wiedemann Peter , Kohen Leon 
Published: April 2003

The effect of interleukin 10 (IL-10) and transforming growth factor-β (TGF-β) on the immunological capability of human retinal pigment epithelium (RPE) cells was tested by measuring the proliferation of allogeneic T cells after stimulation through the RPE cells in vitro. For this, human RPE cells were activated with different concentrations of interferon-γ (0, 50, 100 and 250 U/ml) used as stimulator cells. The following T cell proliferation was measured with a tetrazolium-based colorimetric assay over a period of up to 4 days. Our results show that RPE cells are able to stimulate allogeneic T cells in the presence or absence of professional antigen-presenting cells (macrophages). Additionally, the proliferation could be significantly decreased by IL-10 or TGF-β. The maximum of suppression, especially by TGF-β, was found after 48 and 72 h of incubation. This shows that the antigen-presenting properties of human RPE cells can be altered in culture.
Can Haemodialysis-Induced Hypotension Be Predicted?
Authors: Cai Yan , Zimmerman Andre , Ladefoged Søren , Secher Niels H. 
Published: April 2003

<i>Background:</i> During haemodialysis (HD) ultrafiltration may affect the central blood volume to an extent that blood pressure decreases. Thoracic electrical impedance (TI) is applied to monitor the central blood volume and we evaluated if it can be used to predict HD-induced hypotension. <i>Methods:</i> In 12 hypotensive prone (H) and 13 non-hypotensive prone (N) patients, blood pressure and heart rate were recorded during one dialysis session every 30 min, while TI, thoracic intracellular water (Th<sub>ICW</sub>) and total body impedance (TBI) were followed every 10 min. Hypotension was defined as a decrease in systolic blood pressure (SAP) ≧30 mm Hg or a SAP < 90 mm Hg. <i>Results:</i> All 12 H patients developed hypotension after 190 ± 10 min (mean ± SE) as SAP decreased 35 ± 5 mm Hg, while the 13 N patients maintained blood pressure. TBI increased in all patients and the increase was similar (60 ± 5 and 56 ± 6 Ω in H and N patients, respectively). In N patients TI did not change significantly for the first 2 h of HD, while it became elevated by 2.8 ± 0.6 Ω (1.5 kHz) and 2.3 ± 0.7 Ω (100 kHz) by the end of the dialysis. In H patients, the increase in TI took place at the onset of HD to reach higher values (by 7.0 ± 0.5 Ω at 1.5 kHz and 5.9 ± 0.5 Ω at 100 kHz). Th<sub>ICW</sub> was changed only in H patients (decreased by 7.9 ± 2.1 Siemens (S) 10<sup>–4</sup>, p < 0.05), while HR increased (9 ± 2 beats/min) in 8 of 12 H patients, while it decreased in 1 patient (by 9 beats/min). <i>Conclusions:</i> The results suggest that in HD patients hypotension is elicited by a reduction in the central blood volume that affects heart rate and the distribution of red cells within the body. To prevent HD-induced hypotention, the ultrafiltration rate could be reduced when an increase in thoracic impedance approaches 5 Ω, or when an index of intracellular water decreases by 6 10<sup>–4</sup>.
Blood Volume Control by Biofeedback and Dialysis-Induced Symptomatology
Authors: Wolkotte Chantalle , Hassell Daxenos R. , Moret Karin , Gerlag Paul G. , Warmold van den Wall Bake A. , van der Sande Frank M. , Kooman Jeroen P. 
Published: April 2003

In earlier studies, a reduction in intradialytic procedures was observed in patients with severe intradialytic hypotension symptomatology by the use of blood volume controlled biofeedback systems. However, few data are present on the use of biofeedback-controlled treatments in patients experiencing minor intradialytic symptoms. In the present study, 157 standard and 158 biofeedback-controlled treatments were compared during a 2-month period in 16 hemodialysis patients. Both the percentage of hypotensive episodes (6.3 ± 11.3 vs. 15.8 ± 18.3%; p < 0.05) as well as other intradialytic symptoms (cramps, nausea, headache, abdominal pain) (11.0 ± 12.8 vs. 18.1 ± 16.9%; p < 0.05) were significantly less during biofeedback-controlled treatments compared to standard dialysis treatments, despite a similar decline in relative blood volume (8.8 ± 3.5 vs. 8.3 ± 3.1%; p = n.s.). Interdialytic weight gain and intradialytic rise in plasma sodium levels were comparable. Concluding, in this short-term preliminary study, blood volume controlled biofeedback improved dialysis tolerance also in patients with minor intradialytic symptomatology.
Changes in Bone Mineral Density, Insulin-Like Growth Factor-1 and Insulin-Like Growth Factor Binding Protein-3 in Kidney Transplant Recipients
Authors: Söylemezoglu Oguz , Derici Ulver , Arinsoy Turgay , Hasanoglu Alev , Ozkaya Ozan , Dalgıc Aydın , Bideci Aysun , Buyan Necla , Hasanoglu Enver 
Published: April 2003

<i>Background:</i> Osteopenia is a major complication of renal transplantation (RTx). This cross-sectional and longitudinal study was planned to better define long-term bone status and relationship to IGF system components. <i>Methods:</i> Serial measurements of bone mineral density (BMD) and serum markers were performed in 30 patients prior to RTx and at 6 and 12 months following RTx. Serum concentrations of insulin-like growth factor-1 (IGF-1), insulin-like growth factor binding protein-3 (IGFBP-3), vitamin D, and intact parathyroid hormone (iPTH) were measured. <i>Results:</i> Serum creatinine, phosphate, alkaline phosphatase and osteocalcine levels decreased, serum calcium levels increased and serum iPTH levels did not change significantly after transplantation. The mean BMD of the vertebrae was 0.97 ± 0.22 g/cm<sup>2</sup> at the time of RTx, 0.87 ± 0.21 g/cm<sup>2</sup> 6 months post-RTx (p < 0.05), and 0.81 ± 0.21 g/cm<sup>2</sup> 12 months post-RTx (p < 0.05). Femur BMD also declined from 0.79 ± 0.16 to 0.72 ± 14 g/cm<sup>2</sup> at 12 months (p < 0.05). There was a significant increase in the IGF-1 and a significant reduction in the IGFBP-3 concentrations at 6 months post-RTx (p < 0.05). Significant correlations between serum IGF-1 concentrations and vitamin D concentrations were noted only at 6 months. There was no significant correlation between the BMD and serum IGF system. <i>Conclusions:</i> These results demonstrate a significant loss of BMD after RTx. The circulating levels of IGF-1 and IGFBP-3 stimulated by the reduction in BMD and IGF-1 secretion are increased in order to restore bone formation.
Efficacy and Safety of Losartan in Patients with Proteinuria
Authors: Leu Jyh-Gang , Huang Chee-Ming , Kao Shang-Jyh , Jiang Wey-Wen 
Published: April 2003

The renoprotective effect and safety of an angiotensin II receptor blocker, losartan, were studied in 11 diabetic and 14 nondiabetic patients with a daily urinary protein excretion >500 mg. Once-daily losartan was administered to all patients for 16 weeks without diuretics or other antihypertensive agents. A daily dose of 50 mg was given to those patients with a sitting systolic blood pressure of between 130 and 170 mm Hg; 25 mg was given to patients with a systolic blood pressure of between 110 and 130 mm Hg. Sixteen patients (6 diabetic and 10 nondiabetic patients) had a more than 25% decrease of their daily urinary protein excretion (response rate 64%). The mean decrease in these 16 patients was 57 ± 17% (p < 0.05). Two patients (1 diabetic and 1 nondiabetic) had more than a 25% increase of their urinary protein excretion. The trough sitting systolic blood pressure of all patients (n = 25) decreased from 142 ± 17 to 125 ± 13 mm Hg (p < 0.05) and the trough sitting diastolic blood pressure from 87 ± 11 to 78 ± 11 mm Hg (p < 0.05). Serum uric acid was measured in 16 patients; a decrease from 7.3 ± 1.6 to 6.6 ± 1.4 mg/dl (a 9.6% decrease, p < 0.05) was found after 16 weeks. Our study showed that in both diabetic and nondiabetic proteinuric patients once-daily losartan, given as monotherapy at doses of 25 or 50 mg, was effective in reducing blood pressure, serum uric acid levels, and daily urinary protein excretions.
Clinical Outcome in Children Undergoing Tethered Cord Release Utilizing Intraoperative Neurophysiological Monitoring
Authors: von Koch Cornelia S. , Quinones-Hinojosa Alfredo , Gulati Mittul , Lyon Russ , Peacock Warwick J. , Yingling Charles D. 
Published: April 2003

Release of tethered spinal cord by sectioning of the filum terminale carries a risk of injuring neighboring motor and sensory nerve roots involved in bowel and bladder control. Therefore, intraoperative neurophysiological monitoring techniques have been developed to prevent neurological complications postoperatively. We performed a retrospective chart review of 63 patients who had undergone tethered cord release. We excluded adult patients, those lost to follow-up and patients with either a myelomeningocele and/or lipoma. This limited our study to 25 pediatric patients, aged 4 months to 12 years, who underwent tethered cord release for either a thickened filum terminale and/or a low-lying conus. For intraoperative monitoring, we utilized electrical stimulation of the filum terminale, lumbosacral nerve roots and electromyography recordings. Ventral nerve roots were identified and their electrical thresholds obtained. The mean was 0.32 V, the mode 0.1 V and the range 0.05– 1.0 V. These values were compared to electrical thresholds obtained by stimulation of the filum terminale. The mean was 26.1 V, the mode 20.0 V and the range 8–100 V. In over 70% of patients, muscle activation via the filum required 100 times the voltage needed to activate a motor root. This motor root to filum threshold of 1:100 was useful in identifying the filum. Clinical outcome showed no significant worsening with respect to bowel and bladder control or pain and motor indices. Significant bowel and bladder improvement was seen in 4 out of 25 patients, motor improvement in 9 out of 25 patients and improvement of pain in 4 out of 25 patients. Three patients developed postoperative urinary tract infections, but no cerebrospinal fluid leaks or pseudomeningoceles were encountered. These results suggest that patients with a thickened filum or low-lying conus can safely undergo tethered cord release. Intraoperative neurophysiological monitoring provides a helpful adjunct to distinguish nerve roots from the filum. A ratio, rather than an absolute number, is beneficial in distinguishing motor roots from the filum and eliminates variability due to patients’ individual differences in electrical thresholds.
Pancreatic Protease Inhibition during Shock Attenuates Cell Activation and Peripheral Inflammation
Authors: Fitzal Florian , DeLano Frank A. , Young Corey , Rosario Henrique S. , Schmid-Schönbein Geert W. 
Published: April 2003

Intestinal ischemia contributes to shock-induced multiple organ failure. Our recent evidence suggests that pancreatic proteases may be involved in the formation of inflammatory activators within an ischemic intestine. These inflammatory mediators are released early into the circulation and may contribute to the severe systemic inflammatory response syndrome (SIRS) during shock. We examined the impact of intra-intestinal pancreatic protease inhibition on acute intestinal ischemia-induced hypotension, the formation of activating factors for cardiovascular cells, as well as cremaster muscle cell death and intestinal injury by intravital microscopy. Male Wistar rats were divided into four groups: (1) a sham group; and experimental groups with 100 min of superior mesenteric artery occlusion (2) without (SMAO group), and (3) with intestinal lavage using Krebs-Henseleit solution (LAV group), or (4) lavage using the protease inhibitor gabexate mesilate in Krebs-Henseleit solution (FOY group, 0.37 m<i>M</i>). Intestinal ischemia and reperfusion-induced hypotension upon reperfusion was accompanied by a significant increase in the level of neutrophil-activating factors in the intestine and plasma. During reperfusion, a significant increase in leukocyte-endothelium interactions in postcapillary venules and parenchymal cell death were observed in the cremaster muscle in LAV and SMAO animals suggesting peripheral neutrophil cell activation. Intra-intestinal pancreatic protease inhibition resulted in a stable blood pressure throughout the experiment. Cell activation, leukocyte-endothelial interactions and cell death in the cremaster muscle were almost completely abolished in the FOY group. In addition, ischemia-induced intestinal mucosal injury was attenuated with intestinal pancreatic protease inhibition. These results indicate that intestinal pancreatic protease inhibition significantly attenuates intestinal ischemia-induced shock by reducing SIRS and gut injury.
Extracorporeal Circulation Induced Microvascular Perfusion Injury of the Small Bowel
Authors: Sack F.-U. , Dollner R. , Reidenbach Bettina , Schledt A. , Taylor Sarah , Gebhard Martha Maria , Hagl S. 
Published: April 2003

Gastrointestinal complications following cardiopulmonary bypass (CPB) are relatively uncommon, but are associated with a high mortality rate. Impairment of bowel perfusion during and following CPB may serve as a trigger for the development of multiorgan failure. The aim of our study was the development of a new animal model allowing quantitative analysis of small bowel microcirculation during and after CPB. Twelve Landrace pigs served as laboratory animals. A 15-cm loop of the terminal ileum was exteriorized for microscopic observation. In 6 animals, a normothermic, partial left heart bypass (pLHB) was established for 2 h with a flow rate of 2,000 ml/min. Arterioles, collecting venules and the capillaries of the small bowel were recorded for the analysis of the microcirculation. All parameters were recorded prior to, during pLHB and up to 2 h after weaning off the bypass. Six sham operated animals served as controls. Despite unchanged hemodynamics, pLHB leads to microvascular perfusion disturbances of the small bowel. In pLHB animals, blood cell velocity in postcapillary venules (30–70 µm) was significantly decreased during and following bypass. Capillary density was also reduced during bypass and decreased even further after pLHB to only 30% of the control values. With this new large animal model for quantitative assessment of microvascular perfusion of the small bowel during CPB, it could be clearly demonstrated that partial normothermic left heart bypass leads to a significant disturbance of the small bowel microcirculation even under stable hemodynamic conditions.
Magnitude and Variability of Oral Pressure in Tracheoesophageal Speech
Authors: Searl Jeffrey P. 
Published: April 2003

The purpose of this study was to compare mean oral pressure (P<sub>o</sub>) and P<sub>o</sub> variability: (1) between tracheoesophageal (TE) and laryngeal speakers, and (2) between TE speakers’ voiced and voiceless phonemes. Sixteen TE and 10 laryngeal speakers produced stops and fricatives in a phrase while P<sub>o</sub> was recorded. The TE group produced greater mean P<sub>o</sub> and P<sub>o</sub> variability than the control group. TE speakers did maintain a P<sub>o</sub> difference between cognate members with greater pressure on voiceless consonants. A number of possible explanations for the findings are reviewed, although clearer delineation of the issue will require further study.
Genetic Diversity in the Human Major Histocompatibility Complex: Lessons for Vaccination Approaches to HIV Infection
Authors: Mehra N.K. , Kaur G. , Jaini R. 
Published: April 2003

The major histocompatibility complex (MHC) harbours genes that have a primary function of regulating immune responsiveness. Our data on the distribution patterns of molecular subtypes of HLA class I and II extended haplotypes in India suggest that: (1) Asian Indians have extreme diversity in the MHC region, with several novel and unique alleles and disease-associated MHC haplotypes (e.g. the autoimmune-favouring A26-B8-DR3 haplotype); (2) there have been selective environmental and microbial pressures in India that directed either the generation of novel alleles through founder effect or the expansion of other alleles due to geophysical or socio-economic barriers, and (3) Asian Indians have a unique repertoire of peptide-presenting molecules to deal with pathogen-derived autoreactive antigens. This level of polymorphism concentrated within the MHC presents a formidable obstacle to the development of peptide-based vaccines, e.g. for AIDS. Further, studies conducted by us and others have provided a genetic basis for the possible predisposition and fast progression of HIV infections in the Indian population. Since there is selective predominance of different HLA alleles and haplotypes in different populations, a dedicated global screening effort is required to develop MHC-based vaccines against infectious diseases.
Open-Label Evaluation of Venlafaxine Sustained Release in Outpatients with Generalized Anxiety Disorder with Comorbid Major Depression or Dysthymia: Effectiveness, Tolerability and Predictors of Response
Authors: Perugi Giulio , Frare Franco , Toni Cristina , Ruffolo Giuseppe , Torti Carlo 
Published: April 2003

In a setting of routine clinical practice, 32 outpatients with generalized anxiety disorder (GAD) and major depression (MD) (n = 21) or dysthymia (n = 11), according to DSM-IV criteria, were consecutively treated with flexible dosages of sustained-release venlafaxine (SR-VF) for at least 8 weeks. In a 16-week follow-up, SR-VF daily dose could be modified on the basis of the therapeutic response and of the side effect profile. Symptomatological modifications were explored by means of the Clinical Global Impression (CGI) scale, Hamilton Rating Scale for Depression (HAM-D), and Hamilton Anxiety Scale (HAM-A). SR-VF was well tolerated and only 2 patients interrupted the treatment before 24 weeks; the mean final dose ± SD was 135.5 ± 71.8 mg (range 75–225); in 26 (81.2%) patients, a statistically significant response was observed in depressive symptomatology within the first 8 weeks. The mean total score of HAM-D showed a significant reduction during the first 8 weeks of treatment, while the mean total score of HAM-A did not present a significant reduction until week 24. In patients with MD, a statistically significant response was observed after the first 8 weeks, while the reduction of the anxiety scores required more time and, in some cases, did not appear at all. Conversely, in patients with GAD and dysthymia, anxious and depressive symptomatology improved simultaneously. Stepwise multiple regression indicated that the improvement of depression is negatively related to a high score of CGI anxiety severity, and the improvement of anxiety is related to the presence of dysthymia and, to a lesser extent, to a short duration of the illness. Our data confirm the effectiveness and tolerability of SR-VF in mixed anxiety-depressive states. The differential response suggests a pathophysiologic and clinical distinction between GAD with comorbid MD or dysthymia.