bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictive Value of Uterine Artery Velocimetry at Midgestation in Low- and High-Risk Populations: A New Perspective
Authors: Caforio Leonardo , Testa Antonia Carla , Mastromarino Carmen , Carducci Brigida , Ciampelli Mario , Mansueto Donata , Caruso Alessandro 
Published: April 2003

<i>Objective:</i> The aim of this study was to assess the value of uterine artery Doppler velocimetry performed at 18–20 and 22–24 weeks of gestation in predicting preeclampsia and adverse pregnancy outcome in low- and high-risk patients. <i>Methods:</i> 865 pregnant women were evaluated: 335 and 530 pregnant women represented the high- and low-risk groups, respectively. Doppler ultrasound examination of the uterine arteries was performed at 18–20 weeks of gestation in 385 patients and at 22–24 weeks of gestation in 659 patients. Pregnancy outcome was evaluated in terms of: onset of preeclampsia; birth weight <2,500 g; birth weight <1,750 g; delivery before 36 weeks, and delivery before 32 weeks. <i>Results:</i> At 18–20 weeks of gestation the sensitivity for the prediction of preeclampsia was 100 and 94% in low- and high-risk groups, respectively. Excellent negative predictive values towards birth weight <1,750 g (97% in low-risk and 93% in high-risk groups) and delivery prior to 32 weeks of gestation (99% in low-risk and 95% in high-risk groups) were obtained. At 22–24 weeks of gestation the sensitivity for the prediction of preeclampsia was 100 and 97% in low- and high-risk groups, respectively. Negative predictive values towards birth weight <1,750 g were 97% in low-risk and 94% in high-risk groups, whereas towards delivery prior to 32 weeks of gestation they were 98% in low-risk and 94% in high-risk groups. <i>Conclusion:</i> Doppler evaluation of the uterine artery at 18–20 and 22–24 weeks of gestation represents a useful predictive test in high-risk pregnancy and can also be used in prenatal surveillance of a low-risk population.
Molecular and Fetal Tissue Biopsy Capabilities Are Needed to Maximize Prenatal Diagnosis of Junctional Epidermolysis bullosa: Fetal Skin Biopsy Using a 1-mm Microendoscope
Authors: Seubert David E. , Feldman Baruch , Krivchenia Eric L. , Evans Mark I. , Barki Gerard , Leach Richard , Johnson Mark P. 
Published: April 2003

<i>Objective:</i> To describe a minimally invasive micro-endoscopic technique for fetal skin biopsy and direct examination for a lethal skin condition. <i>Materials and Methods:</i> Direct fetoscopic examination of a fetus was undertaken along with full thickness skin biopsies at 19 weeks’ gestation. <i>Results:</i> No phenotypic expressions of the lethal condition were visualized and six full thickness skin biopsies were collected. Pathological examination revealed normal skin structures not consistent with junctional epidermolysis bullosa (JEB). <i>Conclusion:</i> Minimally invasive examination with the 1 mm endoscope allows direct fetal phenotypic evaluation, full thickness skin biopsies, with risks similar to amniocentesis.
Efficacy of Oral Iodide Therapy on Neonatal Hyperthyroidism Caused by Maternal Graves’ Disease
Authors: Maragliano G. , Zuppa A.A. , Florio M.G. , Scapillati M.E. , Girlando P. , Crescimbini B. , Cafforio C. , Noia G. , Cavaliere A.F. , Tortorolo G. 
Published: April 2003

<i>Objective:</i> To verify the efficacy of oral iodide therapy in treating a case of early neonatal hyperthyroidism due to maternal Graves’ disease. <i>Methods:</i> We report a case of neonatal hyperthyroidism which occurred in a 2,650-gram, female baby, born at 39 weeks’ gestational age (GA) to a 30-year-old mother affected by Graves’ disease and treated with thionamides (propylthiouracil) from the 20th week of gestation. A fetal goiter, due to maternal therapy, had been observed by ultrasound scan at 31 and 35 weeks of gestation, with contemporary low cord thyroid hormone levels. Two intra-amniotic injections of levothyroxine were then performed at 34 and 36 weeks of gestation, which led to a significant reduction of fetal goiter and to normalization of cord thyroid hormone levels. The neonatal clinical course was characterized by symptoms of hyperthyroidism from the 2nd to 3rd days of life (irritability, tachycardia, tachypnea, hyperphagia), mostly during feeding. Oral treatment with potassium iodide (KI, 8 mg × 3 times a day) was started at 23 days of life. <i>Results:</i> Treatment with KI led to a significant reduction of neonatal clinical symptoms and to a normalization of hormone levels within 4 days of therapy. The treatment was discontinued in 13th week of life because of neonatal well-being and normal hormone levels. <i>Conclusions:</i> We believe that KI therapy is effective in treating neonatal hyperthyroidism and does not cause suppression of neonatal thyroid activity, which is possible using antithyroid drugs like thionamides.
Continuous Monitoring of Fetal pH, pO<sub>2</sub> and pCO<sub>2</sub> Using a Fiberoptic Multiparameter Sensor in Animal Models Reproducing in utero Conditions
Authors: Devlieger R. , Gratacós E. , Wu J. , Yesildaglar N. , Ghysel C. , Barki G. , Deprest J. 
Published: April 2003

<i>Objectives:</i> To evaluate the feasibility and accuracy of continuous fetal monitoring with a multiparameter intravascular sensor (MPIS) in animal models mimicking the fetal metabolic status. <i>Methods:</i> First, the accuracy of the MPIS in hypoxic conditions was tested in adult rabbits (n = 6). The carotid artery (n = 4) or vein (n = 2) was catheterized with a 20-gauge cannula, housing a 500-μm Neotrend<sup>®</sup> fiberoptic sensor for pCO<sub>2</sub>, pO<sub>2</sub>, pH and temperature. Fiberoptic readings were compared with arterial blood-gas (ABG) analyses. Secondly, the feasibility of continuous fetal fiberoptic sensing was tested during experimental fetoscopic surgery in lambs (n = 4). An identical sensor was introduced in a chorionic artery and readings were compared to ABG analyses of fetal blood samples. <i>Results:</i> The overall bias and precision in the first experiment (147 measurement pairs) were –4.2 and 10.9 mm Hg for pO<sub>2</sub>, +1.6 and 8.2 mm Hg for pCO<sub>2</sub> and –0.015 and 0.031 for pH, respectively. In the sheep experiments, continuous readings for all parameters were only available during 50% of the operation time, mainly due to disturbances induced by movement, contact with vessel wall and interference by endoscopic light. 20 sample pairs were obtained resulting in an overall bias and precision of –3.9 and 4.3 mm Hg for pO<sub>2</sub>, –0.74 and 3.68 mm Hg for pCO<sub>2</sub> and –0.0032 and 0.02 for pH. <i>Conclusions:</i> Fiberoptic microsensors are potentially useful for monitoring acid-base status in the low pO<sub>2</sub> range present in fetal life.
Treatment of Reflux-Related and Non-Reflux-Related Dysphonia with Profound Gastric Acid Inhibition
Authors: Willems-Bloemer L.H. , Vreeburg G.C.M. , Brummer R.-J.M. 
Published: April 2003

Thirty-eight patients with dysphonia exceeding 3 months, not caused by trauma, infection, paralysis or allergy, were studied. In all patients a 24-hour ambulatory dual-probe pH monitoring, 5 and 20 cm above the lower oesophageal sphincter was performed. Subsequently they were treated with lansoprazole 30 mg once daily during 6 weeks. A voice range profile, perceptual evaluation of the voice and videolaryngostroboscopy were performed in all patients before and after treatment. A questionnaire about laryngeal symptoms and heartburn was completed on the same two occasions. Thirty-nine percent (15 out of 38) of the patients had an abnormal pH profile and were considered to have reflux-related dysphonia. Only these patients showed a significant improvement in their subjective score on dysphonia (p < 0.05), chronic cough (p < 0.05), dysphagia (p < 0.05) and heartburn (p < 0.01). Also posterior erythema decreased significantly in these patients (p < 0.01). Only 2 of the 15 subjects did not complain of heartburn.
Basal Synthesis of Heat Shock Protein 70 Increases with Age in Rat Kidneys
Authors: Maiello Michele , Boeri Daria , Sampietro Lorenzo , Pronzato Maria A. , Odetti Patrizio , Marinari Umberto M. 
Published: April 2003

The heat shock protein (HSP) system is a mechanism of cell defense induced by stress, constitutively expressed during basal conditions and essential to the maintenance of cellular integrity. Acutely induced HSP synthesis decreases with aging, but the effect of age on the basal expression of HSP70 has not been specifically addressed so far. The aim of this work is to study the age-dependent basal concentrations of HSP70 mRNA in rat kidneys. In 8 young (2–3 months), 6 adult (6–11 months) and 6 old male Wistar rats (22–27 months), steady-state concentrations of HSP70 and γ-actin mRNA and of rRNA were measured. Pentosidine was measured by HPLC. The basal, unstimulated HSP70 mRNA is increased in young and old rats compared with adult subjects [young: 182% of adult levels (100–299), old: 167% of adults (142–209); p < 0.005]. The amount of pentosidine increases with age (young: 0.6 ± 0.1; adult: 1.65 ± 0.15; old: 2.3 ± 0.3 pmol/mg of protein; p < 0.0001). It seems likely that different mechanisms are responsible for the increased HSP70 basal synthesis in both the young and old animals. The prevalence of anabolic activity can trigger the increased basal production of HSP70 in young rats. The accumulation of posttranslational modified proteins, documented by pentosidine, can chronically enhance HSP70 synthesis in aged animals. The suppression of the synthesis of other proteins accompanying HSP-selective production might contribute to the impairment of specific cell functions in aging.
Prevalence Study of Thyroid Dysfunction in the Elderly of Taiwan
Authors: Chuang Chia-Chang , Wang Shan-Tair , Wang Pei-Wen , Yu Mei-Lin 
Published: April 2003

The present study was aimed at investigating the prevalence of thyroid dysfunction in the elderly, aged 65 years or older, in a community of southern Taiwan. By using the records of the local household registry, a sampling frame for the elderly population was constructed, and a sample of 1,400 subjects was drawn by simple random sampling. After the exclusion of nonresponse subjects, 917 subjects aged between 65 and 88 years (mean 71.9) were included in our survey. The serum thyrotropin levels of these participants were measured by monoclonal antibodies TSH immunoradiometric assays. A normal range, 0.45–4.65 µU/ml, was determined from the middle 95% of the TSH distribu- tion of 140 ‘disease-free’ subjects. By reference to the normal range, 23 (2.51%) participants had high (>4.65 µU/ml), and 41 (4.47%) had low (<0.46 µU/ml) TSH levels. The overall prevalence of thyroid dysfunction in the sample was 6.98%. Of the 23 participants with high TSH levels, 8 (34.8%) had low free T4 values (<1.21 ng/dl), so-called overt hypothyroidism, and of the 41 participants with low TSH levels, only 1 (2.4%) had high T3 values, so-called T3 thyrotoxicosis. Antithyroid antibodies were found in 56.5% of those with high TSH levels but only 12.2% of those with low TSH levels (odds ratio = 8.53, 95% confidence limits = 2.55–28.50, p < 0.001). This result indicates that autoimmune disease is still the major cause of hypothyroidism in aged people. However, the prevalence of subclinical hyperthyroidism is higher than that of subclinical hypothyroidism and it might relate to nonautoimmune factors.
Measuring Human Age by Estimating Lifetime Caloric Consumption
Authors: Gruber Ronald P. , Kalamas Alicia D. 
Published: April 2003

<i>Background:</i> This study was prompted by a desire to measure human age by a means other than chronological or biological age. The purpose of the study was to use the total lifetime caloric intake in men as an index of aging. <i>Method:</i> The study was carried out by developing an algorithm to approximate the lifetime caloric intake. The total caloric intake is expressed such that one calorie-age year is defined as the total calories expended by an individual during his/her 20th year. <i>Results:</i> The results indicated that (1) the caloric intake of men progressively decreases with advancing age, that (2) the caloric-age is usually less than chronological age, and that (3) the caloric-age algorithm is a simple although crude method to assess lifetime caloric intake. <i>Conclusion:</i> The most important conclusion is that a person can get a better appreciation of the importance of avoiding excess caloric intake if human age is measured in terms of lifetime caloric intake.
Circulating Activated Protein C inSubjects with Heterozygous Gln506-Factor V
Authors: Petäjä Jari , Hakala Leena , Rasi Vesa , Griffin John H. 
Published: April 2003

Congenital resistance to activated protein C due to a point mutation in the factor V gene (Gln506-FV) is the most common genetic risk factor for familial venous thrombosis. Considering the central role of activated protein C as a physiological anticoagulant, the question of why the thrombotic risk associated with Gln506-FV was not more pronounced was asked. We hypothesized that in Gln506-FV heterozygotes, enhanced thrombin formation might preferentially activate protein C and thereby constitute a compensatory antithrombotic effect. We compared the circulatory level of activated protein C in twelve heterozygous carriers of Gln506-FV mutation with that in eighteen noncarriers in same families, and used prothrombin fragment 1+2 as a measure of thrombin generation. The circulating level of activated protein C was higher but not significantly different in heterozygotes compared with normal relatives. Activated protein C levels correlated strongly and positively with protein C antigen levels in both carriers (Spearman R 0.684, p < 0.05) and controls (Spearman R 0.642, p < 0.01). Correlation between activated protein C and prothrombin fragment 1+2 levels was of borderline significance (Spearman R 0.354, p = 0.055). In the current study, thrombin formation assessed by prothrombin fragment 1+2 levels was not significantly enhanced in subjects with heterozygous Gln506-FV compared with family members without the mutation. In conclusion, enhanced thrombin formation is not present in all healthy Gln506-FV heterozygotes in basal conditions. It seems that enhanced protein C activation by thrombin does not constitute a compensatory anticoagulant feedback loop in heterozygous carriers of Gln506-FV. However, the positive correlation between prothrombin fragment 1+2 and activated protein C suggests that, in healthy subjects and in basal conditions, thrombin upregulates the anticoagulant protein C pathway. Thus, it is questionable whether prothrombin fragment 1+2 can directly be used as an indicator of a hypercoagulable state.
Increase in Thrombin Generation after Coronary Thrombolysis with rt-PA or Streptokinase with Simultaneous Heparin versus Heparin Alone
Authors: Réganon E. , Ferrando F. , Vila V. , Villa P. , Martínez-Sales V. , Fayos L. , Ruano M. , Aznar J. 
Published: April 2003

This study compares the extent of inhibition of thrombin generation and activity achieved in patients with acute myocardial infarction receiving fibrinolytic treatment (streptokinase SK, or rt-PA) and concomitant intravenous heparin treatment adjusted to the patients’ weight with that achieved with the same heparin regimen but without fibrinolytic therapy. The study involved 90 patients, grouped according to their treatment: SK+heparin; rt-PA+heparin, and heparin without thrombolytic agents. Prothrombin fragment 1+2 (F1+2), thrombin-antithrombin complex (TAT), fibrinopeptide A (FPA) and activated partial thromboplastin time were measured. Patients treated with SK+heparin or rt-PA+heparin and higher F1+2 plasma levels than the patients treated with heparin alone at 12, 48 and 72 h in the case of SK+heparin, and at 12, 24, 48 and 72 h in that of rt-PA+heparin. Compared to baseline, the plasma levels of FPA were decreased in the three treatment groups at 24–48 h. There were no significant changes in TAT and FPA plasma levels among the three treatment groups at the different times. After thrombolytic therapy with both SK and rt-PA, there was an increase in thrombin generation, although high-dose intravenous heparin inhibited the different increases in thrombin associated with the thrombolytic agents to the same extent.
Protein-Bound Heparin/Heparan Sulfates in Human Adult and Umbilical Cord Plasma
Authors: Xiao Hongyan , Miller Steven J. , Bang Nils U. , Faulk W. Page 
Published: April 2003

We used thrombin times and a competitive radiometric assay to identify, quantitate and characterize endogenous heparin-like molecules in umbilical cord (n = 58) and normal adult (n = 25) plasma. Thrombin times for cord plasma (29.6 ± 3.6 s) were significantly longer (p ≤ 0.0005) than those for adult plasma (18.9 ± 2.3 s), suggesting increased endogenous heparins. A radiometric assay based on the displacement of <sup>125</sup>I-heparin from protamine-Sepharose revealed that protease-digested plasma contained heparin/heparan sulfate, and plasma that was not digested with protease appeared not to contain heparin/heparan sulfate. More heparin/heparan sulfate was identified in cord than in adult plasma (p ≤ 0.05), but heparinase digestion produced significantly (p ≤ 0.001) reduced concentrations of heparin/heparan sulfate in only 39% of the samples. The lack of heparinase sensitivity in 61% of the protease-digested samples apparently was due to low molecular weight (LMW) heparins, for control heparin fragments of 5 kD that did not extend thrombin times were also less affected by heparinase, but the same LMW heparins were detected by radiometric assay. Despite normal thrombin times in all samples, the amounts of endogenous heparin/heparan sulfate identified in protease-digested samples by radiometric assay were of sufficient concentrations to produce inordinately prolonged thrombin times when compared with the same concentrations of unfractionated heparin. Collectively, these findings suggest the presence of a plasma reservoir of endogenous heparin/heparan sulfates in normal cord and adult plasma. These endogenous heparin/heparan sulfates are bound to plasma proteins, and an as yet undetermined proportion of these bound heparin/heparans are most likely LMW molecules.
Soluble P-Selectin and Proinflammatory Cytokines in Patients with Polygenic Type IIa Hypercholesterolemia
Authors: Ferroni Patrizia , Basili Stefania , Vieri Mario , Martini Francesca , Labbadia Giancarlo , Bellomo Ada , Gazzaniga Pier Paolo , Cordova Corrado , Alessandri Cesare 
Published: April 2003

Plasma soluble P-selectin (sP-selectin), β-thromboglobulin (β-TG), von Willebrand Factor (vWF), prothrombin factor 1+2 (F1+2), IL-6 and IL-1β levels were analyzed in 35 consecutive patients with polygenic type IIa hypercholesterolemia (HC) and 35 age- and sex-matched healthy subjects. sP-selectin (p < 0.005), β-TG (p < 0.05) and IL-1β (p < 0.02) levels were higher in HC patients than healthy subjects whereas no significant difference was observed for vWF. sP-selectin directly correlated with β-TG (p < 0.05) and IL-1β levels (p < 0.005), but not with the other variables analyzed. A direct correlation was observed between F1+2 and IL-6 (p < 0.05), total cholesterol (p < 0.05) or LDL cholesterol (p < 0.05). We conclude that HC is associated with an increase of plasma sP-selectin levels, and that sP-selectin may be considered as a marker of in vivo platelet activation in type IIa polygenic HC. The correlations observed among the variables analyzed in the study suggest that proinflammatory cytokines might play a role in the prothrombotic state often associated with HC.
Hereditary Desmoid Disease in a Family with a Germline <i>Alu I</i> Repeat Mutation of the APC Gene
Authors: Halling Kevin C. , Lazzaro Carlo R. , Honchel Ronald , Bufill José A. , Powell Steven M. , Arndt Carola A.S. , Lindor Noralane M. 
Published: April 2003

Two families with autosomal dominantly inherited desmoid tumors have recently been shown to have germline mutations at the 3′ end of the APC gene. We subsequently identified an Amish family with autosomal dominantly inherited desmoid tumors. Genetic analysis performed on one family member, a 47-year-old man with multiple desmoid tumors and no colon polyps, revealed a protein truncating mutation in the middle of the APC gene. The truncating mutation is the result of a 337-bp insertion of an Alu I sequence into codon 1526 of the APC gene. The presence of a poly(A) tail at the 3′ end of the insertion suggests that the Alu I sequence was inserted by a retrotranspositional event. Germline insertions of Alu I sequences have occasionally been reported to cause other genetic diseases including type I neurofibromatosis, hereditary site-specific breast cancer (BRCA2), and hemophilia B. However, this is the first report of a germline mutation of the APC gene resulting from an Alu I insertion.
Neural Control of Coronary Blood Flow
Authors: Feigl Eric O. 
Published: April 2003

Parasympathetic control of coronary blood flow has been extensively studied in dogs, and a clear vasodilator effect not dependent on changes in myocardial metabolism was observed. Parasympathetic vasodilatation is mediated via nitric oxide (EDRF) and is activated during carotid baroreceptor and chemoreceptor reflexes. Intracoronary infusions of acetylcholine in humans results in increased coronary blood flow and epicardial coronary artery dilatation except in atherosclerotic epicardial coronary vessels, which show a paradoxical vasoconstriction. Sympathetic α-adrenoceptor-mediated coronary vasoconstriction has been repeatedly demonstrated whenever there is adrenergic activation of the heart, as during exercise or a carotid sinus baroreceptor reflex in dogs or during a cold pressor reflex in humans. Recent evidence indicates that there is a beneficial effect of this paradoxical vasoconstrictor influence in that it helps preserve flow to the vulnerable inner layer of the left ventricle, but only when both heart rate and coronary flow are high. β-Adrenoceptor-mediated coronary vasodilatation also occurs during adrenergic activation of the heart. The dominant site for β-vasodilatation is in small arterioles, while the dominant site for α-vasoconstriction is in microvessels larger than ∼100 µm diameter. The β-adrenoceptor coronary vasodilatation is an example of feedforward open-loop control that complements the closed-loop negative feedback control by local metabolic factors. The combined feedback and feedforward control mechanism has the advantage of an excellent match between coronary blood flow and myocardial oxygen consumption with a rapid response time but without the instability inherent in high gain feedback systems.
The Etiology of Acute Scrotal Swelling on Surgical Exploration among Children and Adolescents in Jahra
Authors: Grover Vinod K. , Adib Salim M. , Joseph Leons , Nur Ali M. Ali 
Published: April 2003

<b>Objective:</b> To describe the clinical presentation as well as the outcome of surgically explored acute scrotal swellings among children and adolescents recorded at the Al-Jahra Hospital, Kuwait during the period 1985–1995. <b>Methods:</b> Hospital records of 120 cases were reviewed. <b>Results:</b> Seventeen percent of the cases were found to be testicular torsions (TT) and 40% torsions of testicular appendages (TAT). Other etiologies included traumatic swelling (15%), idiopathic edema (13%), epididymo-orchitis (10%), hydroele (4%) and others (2%). Ages of patients ranged from 6 months to 18 years, averaging 9.3 years (SD = 2.9) for TAT cases and 10.1 years (SD = 6.4) for TT cases. Swelling and pain were located on the left side for 65% of the torsion cases. Direct trauma was reported in 22% of the torsion cases. In 90% of TT cases, orchidopexy was performed with success. Subsequent testicular atrophy occurred in only 1 patient who had symptoms for more than 48 h prior to surgery. Orchidectomy was directly performed on necrosed testes in a patient with signs lasting more than 48 h, and another patient with signs lasting 4 days. <b>Conclusions:</b> Primary health care physicians in Jahra district should continue to educate parents and adolescents to recognize the gravity of scrotal pain, and the importance of early response as a way of avoiding testicular necrosis.