bluuebunny/crossref_metadata_2025_split huggingface dataset:
Percutaneous Catheter Drainage of Pancreatic Pseudocysts: Five Years Experience
Authors: Al Saeed Osama M. , Casillas Javier , Sheikh Mehraj 
Published: April 2003

<i>Objective:</i> Pancreatic pseudocysts are common complications of pancreatitis. Pseudocysts can be treated by various drainage procedures such as endoscopic cystenterostomy or transpapillary drainage, percutaneously with image guidance or operatively. We report our experience with image-guided percutaneous evacuation of pancreatic pseudocysts. <i>Materials and Methods:</i> This retrospective study was conducted on 37 consecutive patients who underwent 45 percutaneous catheter placements for the drainage of pseudocysts. The catheters were introduced under ultrasound or computerized tomography guidance. The patients were followed up with a fluoroscopic catheter check for evaluation of size of collection, communication with gastrointestinal tract and the pancreatic duct. The catheter was removed when the patient was asymptomatic and the output from the catheter was less than 10 cm<sup>3</sup> in 24 h. <i>Results:</i> Forty-five procedures of percutaneous drainage of pancreatic pseudocysts were performed in 37 consecutive patients. The size of the cysts ranged between 4 and 20 cm. Drainage was performed on cysts larger than 5 cm in diameter. Forty-eight percent of the patients had communication with the pancreatic duct. Percutaneous drainage was successful in 95% of the cases in our study regardless of pseudocyst communication with the main pancreatic duct. The average duration of catheter drainage was 30 days in cases without communication versus 33 days in patients with communication with the pancreatic duct. <i>Conclusion:</i> Percutaneous drainage is a safe and effective alternative to surgery in patients with pancreatic pseudocysts. The duration of catheter drainage in cases with or without communication with the pancreatic duct was nearly the same.
Adrenal Contribution to Polycystic Ovary Syndrome
Authors: Bayoumy H.A. , Alothman A.N. 
Published: April 2003

<i>Objective:</i> To examine further the dynamics of adrenal steroidogenesis in selected groups of patients with polycystic ovary syndrome (PCOS) compared to normal ovulatory women of the same age. <i>Materials and Methods:</i> Serum cortisol, testosterone, dehydroepiandrosterone sulphate (DHEAS), androstenedione (A), luteinizing hormone (LH), follicle-stimulating hormone, prolactin, 17-hydroxyprogesterone (17-OHP) and sex hormone-binding globulin (SHBG) were measured in the early follicular phase of the period. In addition, 2-day dexamethasone suppression and short adrenotropic hormone (ACTH) stimulation tests were performed for the study group and controls. <i>Results:</i> Serum testosterone (4.3 ± 1.8 nmol/l), LH (7.6 ± 1.9 IU/l), and 17-OHP (4.7 ± 2.3 nmol/l) were higher while SHBG (24.7 ± 14.2 nmol/l) was lower in patients than the control. Testosterone was significantly suppressed after dexamethasone suppression test while the level of 17-OHP increased significantly in patients more than the control after 60 min of ACTH stimulation. In the PCOS, the ratio of 17-OHP/A showed a significant increase after ACTH stimulation while that of DHEAS/A decreased when compared to controls. <i>Conclusion:</i> The study suggests a contribution of adrenal cytochrome P-450C dysregulation in PCOS. This suggestion could lead to another method of treating some PCOS patients when the usual anti-androgens might not be fully effective in controlling most of the symptoms.
Intravenous Immunoglobulins in Lupus Nephritis
Authors: Gupta R.K. , Nampoory M.R.N. , Johny K.V. , Costandi J. , Francis I. 
Published: April 2003

<i>Objective:</i> The study is aimed at demonstrating the effectiveness of intravenous immunoglobulin (IVIg) in resistant lupus nephritis. Lupus nephritis was considered resistant when it failed to show adequate clinical and laboratory response to treatment with steroid, azathioprine and pulse cyclophosphamide in combination for a period not less than 1 year. <i>Methods:</i> During the past 7 years 4 subjects (M = 1, F = 3) with systemic lupus erythematosus (SLE) and lupus nephritis WHO IV were selected to receive IVIg. Their age ranged from 19 to 48 years. The 3 female patients had severe extrarenal manifestations including skin rash, photosensitivity, fever, headache and severe polyarthralgia requiring large doses of analgesics. The male patient had steroid-dependent, relapsing autoimmune hemolytic anemia (AIHA) in addition to extrarenal manifestations. All subjects had microscopic hematuria, proteinuria (2–6 g/24 h), hypoalbuminemia (24–33 g/l), mild renal impairment (serum creatinine 90–160 µmol/l) and active serology for SLE. These patients had not responded satisfactorily to several courses of steroids, azathioprine and pulses of intravenous cyclophosphamide in 23–180 months. All 4 patients were started and continued on IVIg as per our protocol. <i>Re</i><i>sults:</i> During the 9 months to 7.5 years of follow-up, these patients showed excellent response to IVIg. Their extrarenal symptoms had totally disappeared, serological activity subsided, proteinuria decreased (0.5–2 g/24 h), serum albumin improved (30–42 g/l) and renal function remained stable. The subject with AIHA did not suffer any further relapses and his hemoglobin remained above 110 g/l with only 10 mg of prednisolone daily. Repeat renal biopsy done in 2 patients showed definite histological reversal of active lesions. Clinical and immunological improvements might be related to the modulation of macrophage T cell function and enhancement of suppressor T cell function. <i>Conclusion:</i> IVIg has shown excellent therapeutic effect as an alternative drug in treatment of renal and extrarenal manifestations of SLE, which are resistant to other modalities of treatment.
Human Recombinant Interferon-α2a and Interferon-αA/D Have Different Effects on Bleomycin-Induced Lung Injury
Authors: Berkman N. , Kremer S. , Or R. , Lossos I.S. , Christensen T.G. , Goldstein R.H. , Breuer R. 
Published: April 2003

<i>Background:</i> Bleomycin (Bleo)-induced lung injury in mice serves as an animal model of pulmonary fibrosis. The pathogenesis of pulmonary fibrosis remains unclear, but it comprises both inflammatory and fibrotic components. The cytokine interferon (IFN)-α is produced by macrophages and may modulate both fibrogenesis and the determination of T lymphocyte phenotype in pulmonary fibrosis. <i>Objective:</i> To investigate the effect of two preparations of recombinant IFN-α (IFN-αA/D and IFN-α2a) on Bleo-induced lung injury in C57BL/6 mice. <i>Methods:</i> Mice were treated by a single intratracheal (IT) instillation of 0.06 mg of Bleo in 0.1 ml of saline or saline alone. One of two different IFN-α preparations, IFN-αA/D or IFN-α2a in saline, or saline alone were administered by daily intraperitoneal injections starting 1 day prior to IT instillation. The treatment groups were as follows: IT Bleo and intraperitoneal saline; IT Bleo and intraperitoneal IFN-α2a; IT Bleo and intraperitoneal IFN-αA/D; IT saline and intraperitoneal IFN-αA/D or IFN-α2a; IT saline and intraperitoneal saline. The animals were sacrificed 14 days after IT instillation. Lung injury was evaluated by total and differential cell count in bronchoalveolar lavage (BAL) fluid, by a semiquantitative morphological index of lung injury and a quantitative image analysis of cellularity and fibrosis fraction and by biochemical analysis of lung hydroxyproline content. <i>Results:</i> In Bleo-treated mice, IFN-α2a treatment caused a significant rise in BAL lymphocytes and in cellularity and fibrosis fractions in lung tissue. In contrast, IFN-αA/D treatment had no effect on Bleo-induced lung injury. <i>Conclusion:</i> IFN-α may enhance Bleo-induced lung injury but this effect varies with different IFN preparations.
Bronchiolitis obliterans with Organizing Pneumonia Associated with Acute <i>Coxiella burnetii </i>Infection
Authors: Pérez de Llano L.A. , Veres Racamonde A. , Rivas Bande M.J. , Ortiz Piquer M. , Bal Nieves F. , Rodríguez Feijoo A. 
Published: April 2003

We report the case of a 62-year-old man who developed bronchiolitis obliterans with organizing pneumonia (BOOP) associated with acute <i>Coxiella burnetii </i>infection. The diagnosis of BOOP was made by fiber-optic transbronchial biopsy. Treatment with corticosteroids resulted in rapid clinical improvement and complete resolution of airspace opacities. To the best of our knowledge, this is the first well-documented case of BOOP associated with <i>C. burnetii </i>infection. This case suggests that this infection might trigger the development of BOOP.
Physiologic Evaluation of 4 Weeks of Nocturnal Nasal Positive Pressure Ventilation in Stable Hypercapnic Patients with Chronic Obstructive Pulmonary Disease
Authors: Nava Stefano , Fanfulla Francesco , Frigerio Pamela , Navalesi Paolo 
Published: April 2003

<i>Background:</i> The long-term daily use of noninvasive mechanical ventilation (NIMV) to treat chronic respiratory failure in chronic obstructive pulmonary disease (COPD) patients is not widely recommended, partly because of a lack of clear clinical results and partly because the physiological mechanisms by which the daily application of NIMV would be helpful in these patients have not yet been clarified. <i>Objectives:</i> We designed a physiological study in order to assess the effects of supervised long-term NIMV on gas exchange, respiratory muscle function, pulmonary mechanics and to ascertain the possible effect of the treatment in responders and nonresponders. <i>Methods:</i> Fourteen consecutive inpatients with stable hypercapnic COPD (pH = 7.37 ± 0.01; PaCO<sub>2</sub> = 56.73 ± 6.48 mm Hg) underwent 4 weeks of nocturnal NIMV delivered with a bilevel ventilator ‘physiologically’ set to reduce tidal transdiaphragmatic pressure (Pdi) by at least 50% and the amount of dynamic intrinsic positive end-expiratory pressure by 70%. Various measurements were compared with those obtained in a control group of consecutive patients with comparable baseline characteristics who refused NIMV and underwent breathing exercises for the same period of time. <i>Results:</i> By the end of the 4 weeks NIMV had induced a slight but significant (p < 0.01) reduction in resting PaCO<sub>2</sub> (53.78 ± 5.64 mm Hg) associated with a decrease in the pressure time product of the diaphragm per minute (from 172 ± 60 to 136 ± 61 cm H<sub>2</sub>O/l/s; p < 0.05). This latter value was primarily due to a significant shortening of the inspiratory duty cycle, while Pdi and lung mechanics were not modified. Eight of the 13 NIMV-treated patients (1 dropped out for nonmedical reasons) had a clear reduction in PaCO<sub>2</sub> (>3 mm Hg or >5% from enrollment) and were classified as responders. The acute reduction in PaCO<sub>2</sub> during the first trial with NIMV resulted to be a strong index of the final response. The subgroup of responders had a significantly increased maximal Pdi (from 41 ± 19 to 49 ± 23 cm H<sub>2</sub>O, p < 0.05) and an enhanced ability of the ventilatory pump to clear CO<sub>2</sub> (9.7 ± 3.4 vs. 7.2 ± 2.9 cm H<sub>2</sub>O × s/min; p < 0.01). No significant changes were observed in the control group. <i>Conclusions:</i> These results suggest that in a remarkable and identifyable proportion of patients with stable hypercapnic COPD, nocturnal NIMV may decrease resting PaCO<sub>2</sub>, reraising the role of chronically supporting the respiratory pump.
Percutaneous Resection of Renal Transitional Carcinoma: Venous Injury and Its Conservative Management
Authors: Goel M.C. , Roberts J.G. 
Published: April 2003

An interesting observation encountered at percutaneous resection of a renal transitional cell carcinoma and its conservative management is described. During resection of the tumour sudden heavy haematuria was encountered. Nephroscopic inspection revealed the blood to be coming from behind a loop-generated flap, the raising of which allowed entry of the endoscope into a sizeable vein and thence upwards into the renal vein and inferior vena cava (IVC). On table nephrostogram confirmed contrast outlining the renal vein and IVC. Placement and clamping of a nephrostomy tube was followed by stabilization of the patient and the bleeding stopped. The urine became clear within 24 h. Later on repeat nephrostogram showed an intact pelvicalyceal system with an acceptable tumour clearance. This case highlights the importance of a trial of conservative management in the treatment of bleeding complications during nephroscopy.
Anisodamine Counteracts Lipopolysaccharide-Induced Tissue Factor and Plasminogen Activator Inhibitor-1 Expression in Human Endothelial Cells: Contribution of the NF-κB Pathway
Authors: Ruan Qiu-Rong , Zhan g Wei-Jian , Hufnagl Peter , Kaun Christoph , Binder Bernd R. , Wojta Johann 
Published: April 2003

In this study we aimed to investigate whether the therapeutic efficacy of anisodamine in the treatment of bacteraemic shock could – at least in part – be brought about by its direct interference with the lipopolysaccharide (LPS)-induced activation of endothelial cells. Thus, we investigated the effect of anisodamine on LPS-induced expression of plasminogen activator inhibitor-1 (PAI-1) and tissue factor (TF), two major markers of endothelial activation. PAI-1 was measured in the conditioned media of human umbilical vein endothelial cells (HUVEC) by a specific enzyme-linked immunosorbent assay (ELISA) whereas TF activity was measured in the lysates of these cells by using a single step clotting assay. Results obtained in these assays were confirmed on the level of specific mRNA expression by Northern blotting using specific probes for human PAI-1 or TF. In order to evaluate a possible contribution of the NF-ĸB pathway on the effects observed, electrophoretic mobility shift assays (EMSA) were performed using nuclear extracts from HUVEC and NF-ĸB-binding oligonucleotides. When HUVEC were treated with 1 µg/ml LPS a significant increase in PAI-1 and TF activity was observed compared with cells incubated without LPS. Anisodamine dose-dependently inhibited this LPS-induced upregulation of PAI-1 and TF. Anisodamine alone had no effect on the constitutive expression of PAI-1 and TF in these cells. These effects were also confirmed on the level of specific PAI-1 and TF mRNA expression by Northern blotting. Furthermore, we could show by EMSA that anisodamine completely abolished LPS-induced NF-ĸB DNA binding activity in nuclear extracts from HUVEC treated with LPS together with anisodamine. Thus, we provide evidence that anisodamine counteracts endothelial cell activation by inhibiting LPS-induced PAI-1 and TF expression in these cells. Its interference with the NF-ĸB pathway might – at least in part – contribute to this effect. The ability of anisodamine to counteract LPS effects on endothelial cells might be one underlying mechanism explaining its efficacy in the treatment of bacteraemic shock.
Responder Characteristics to a Single Oral Dose of Cholinesterase Inhibitor: A Double-Blind Placebo-Controlled Study withTacrine in Alzheimer P atients
Authors: Almkvist O. , Jelic V. , Amberla K. , Hellström-Lindahl E. , Meurling L. , Nordberg A. 
Published: April 2003

A proportion of Alzheimer’s disease (AD) patients treated for several months with cholinesterase (ChE) inhibitors have shown some favorable response on cognition, but the characteristics of the responders are still unclear. This study attempts to identify the characteristics of individuals with a positive behavioral response after a double-blind randomized administration of a single oral dose of tacrine (40 mg) and placebo to AD patients. Furthermore, the relationship between single-dose and long-term responders are examined. Twenty-four mildly to very mildly demented AD patients participated in the study. They all fulfilled the diagnosis of probable AD according to NINCDS-ADRDA criteria. Active treatment (tacrine 40 mg) and placebo was administered in random order on 2 consecutive days, and the effects were evaluated within 2 h using neuropsychological tests (assessing visuospatial ability, episodic memory and attention), registration of EEG activity and measurement of red blood cells (RBC) acetylcholinesterase (AChE), ChE activity and concentrations of tacrine and its metabolites in plasma. Results demonstrated significant improvement, tacrine compared to placebo, in measures of attention, but not in episodic memory or visuospatial ability. A single-dose response was therefore defined in terms of improvement in attention. The tacrine plasma concentration (pcTHA) showed a positively skewed distribution (mean ± SD: 10.5 ± 11.8, range: 1.0–51.8 ng/ml). There were no significant differences between single-dose responders compared to nonresponders in pcTHA, metabolites of tacrine, inhibition of AChE in RBC, tau levels in CSF, AChE activity in CSF or plasma and demographic variables. However, single-dose responders showed a higher right frontal alpha/theta ratio on EEG and had lower glucose metabolism in the parietal-temporal association cortex at baseline. In addition, the frequency of apolipoprotein E (APOE) &#917;4 alleles was higher in responders. Interestingly, the single-dose response was related to the long-term response, although not significantly, which probably was due to lack of power. To conclude, the present study identified single-dose responders in terms of improved attentional performance associated with a relatively higher alpha/theta activity in the right frontal regions of the brain measured on EEG and predominance of APOE &#917;4 allele.
<i>Helicobacter pylori</i> Infection Increases Mucosal Permeability of the Stomach and Intestine
Authors: Fukuda Yoshihiro , Bamba Hiroko , Okui Masanori , Tamura Kazutami , Tanida Noritoshi , Satomi Masamichi , Shimoyama Takashi , Nishigami Takashi 
Published: April 2003

It is important to study the effect of <i>Helicobacter pylori</i> infection on the permeability of the intestine. Permeability was evaluated by oral sucrose tolerance test using sucrose 25 g in 200 ml of water. Existence of <i>H. pylori</i> itself was associated with increased permeability of sucrose. Also, the permeability of sucrose increased as polymorphonuclear and lymphocyte infiltration increased. The increase of mucosal permeability suggests that antigens like protein penetrate into the body and result in systemic reactions. Thus, it is important to study the implication of increased permeability in relation not only to gastric diseases but also certain systemic diseases.
Gastrointestinal Stromal Tumors: Experience of an Emergency Surgery Department
Authors: Catena Fausto , Pasqualini Eddi , Campione Orazio 
Published: April 2003

<i>Background/aims:</i> Gastrointestinal stromal tumors (GISTs) are a rare group of neoplasias of the gastrointestinal tract that have not yet been fully investigated. In this article the authors present the experience of an emergency surgery department in the diagnosis and treatment of patients with such neoplasms and discuss the approaches to these ‘strange’ tumors. <i>Methods:</i> A review of our 4-year experience in emergency surgery was performed and 9 patients were found with the diagnosis of GIST. The median follow-up was 32.3 (range 18–45) months. <i>Results:</i> 7 patients had evidence of gastrointestinal blood loss, 1 patient had abdominal pain, and the last patient had anorexia, vomiting and fever. Five tumors were located in the stomach and 4 in the small bowel. All the patients underwent complete resection. On histological examination 5 tumors were of myogenic origin, 1 was a gastrointestinal autonomic nerve tumor and 1 was a mixed neural-myoid tumor. The remaining 2 could not be differentiated. Of the 9 patients who underwent curative resections, 1 had a recurrence and died. <i>Conclusion:</i> GIST treatment mainly involves surgical resection with the goal of complete removal which can be curative. The histologic grade and tumor size are the most important prognostic factors.
Comparison of Buprenorphine and Methadone Maintenance in Opiate Addicts
Authors: Eder Harald , Fischer Gabriele , Gombas Wolfgang , Jagsch Reinhold , Stühlinger Georg , Kasper Siegfried 
Published: April 2003

As a maintenance agent for opioid dependency, buprenorphine offers advantages such as a lower level of dependence and minimal withdrawal symptoms, due to its partial agonist properties at the µ-opioid receptor. Previous studies have shown 8 mg sublingual buprenorphine to be equivalent to 60 mg oral methadone in terms of retention rate and opioid-negative urine levels. In a 24-week, ongoing European study, 34 opioid-dependent subjects were assessed; 16 receiving buprenorphine and 18 methadone. A free dosing schedule was used with no upper limit for methadone dosing but with a maximum buprenorphine dose of 8 mg. Screening prior to the study excluded subjects with polysubstance dependence, somatic disease and/or HIV infection. Primary outcome measures were abstinence from other drugs, for which subjects provided weekly urine samples for analysis of opioids, cocaine and benzodiazepines, and retention in treatment. Patients in the buprenorphine group provided a greater proportion of negative urine samples, in particular cocaine-negative samples, compared with the methadone group, although this was not statistically significant. Retention in the buprenorphine group was significantly lower than in the methadone group, suggesting that the 8 mg buprenorphine limit may have biased the results in favour of methadone, and that this dose may have been too low for those subjects with high levels of dependence. However, buprenorphine is clearly effective in the more motivated subjects and further investigation in this subgroup is recommended.
Neutrophils Mediate Acute Lung Injury in Rabbits: Role of Neutrophil Elastase
Authors: Kinoshita M. , Ono S. , Mochizuki H. 
Published: April 2003

We investigated the roles of neutrophil and neutrophil elastase in acute lung injury (ALI) to elucidate the mechanism of ALI. We designed two protocols. Protocol I: Experimental ALI was induced by endotoxin (0.02 mg/kg) and platelet-activating factor (8 µg/kg/4 h) in untreated rabbits (control group I), in neutropenic rabbits pretreated with nitrogen-N-oxide hydrochloride, and in untreated rabbits infused with a neutrophil elastase inhibitor (ONO-5046; 20 mg/kg/4 h). Protocol II: ALI was induced by smaller doses of endotoxin (0.015 mg/kg) and platelet-activating factor (7 µg/kg/4 h) than those used in protocol I in untreated rabbits (control group II), in neutrophilic rabbits pretreated with human recombinant granulocyte colony-stimulating factor, and in neutrophilic rabbits infused with ONO-5046 (as in protocol I). The severity of ALI was assessed by the protein concentration, the elastase activity in the bronchoalveolar lavage fluid, and the histologic pulmonary edema ratio. The degree of pulmonary neutrophil accumulation was assessed by pulmonary myeloperoxidase activity and histological findings. Both ALI and pulmonary neutrophil accumulation were suppressed by neutropenia (protocol I), while they were exacerbated by neutrophilia (protocol II). The neutrophil elastase inhibitor could suppress ALI, but it could not suppress pulmonary neutrophil accumulation in both untreated and neutrophilic rabbits (protocols I and II). These findings indicate that neutrophils play an important role in the pathogenesis of ALI via neutrophil elastase.