bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cell pathology in bipolar disorder
Authors: Rajkowska Grazyna 
Published: March 2003

Objectives:
The objective of this paper is to review findings of morphometric postmortem studies conducted on tissues from subjects with bipolar disorder (BPD) to demonstrate that impairments of cell morphology and resilience may underlie the neurobiology of BPD.
Methods:
Reports of alterations in number, density and size of neurons and glial cells in BPD are reviewed. Owing to the low number of postmortem studies on cellular pathology in BPD, abstracts of recent symposia are also discussed.
Results and Conclusions:
In BPD, significant reductions in the volume of several brain regions, as well as region‐ and layer‐specific reductions in the number, density and/or size of neurons and glial cells have been demonstrated. Moreover, the results of recent clinical and preclinical studies investigating the molecular and cellular targets of mood stabilizing and antidepressant medications provide intriguing possibilities that impairments in neuroplasticity and cellular resilience may underlie the neurobiology of BPD. Future studies will likely examine the role of both genetic and environmental factors in the pathogenesis and cellular changes in BPD.
Laterality of pain in migraine with comorbid unipolar depressive and bipolar II disorders
Authors: Fasmer Ole Bernt , Oedegaard Ketil Joachim 
Published: March 2003

Objectives:  The purpose of the present study has been to examine differences in the laterality of pain in patients with migraine and comorbid unipolar depressive (UP) and bipolar II (BP II) disorders.Methods:  Semi‐structured interviews of 102 patients with major affective disorders were conducted, using DSM‐IV criteria for affective disorders combined with Akiskal's criteria for affective temperaments and International Headache Society criteria for migraine. The group of patients reported on in the present study encompass 47 subjects with UP (n=24) or BP II (n=23) disorders. Fifteen of the bipolar II patients fulfilled DSM‐IV criteria while eight were diagnosed according to the broader criteria of Akiskal.Results:  Sixteen of the 38 patients with migraine headaches had bilateral pain or pain equally often on the left or right side while 22 had pain predominantly located on one side. Among the UP patients the pain was most often on the right side (8/10) while among the BP II patients the pain was most often on the left (9/12, p = 0.01). Apart from the presence of hypomanic symptoms in the BP II group there were no clinical or demographic characteristics that distinguished these two sub‐groups of affective disorders.Conclusions:  These results indicate that there may be a differential affection of the cerebral hemispheres in patients with migraine and comorbid unipolar depressive disorder versus patients with migraine and comorbid bipolar II disorder.
Left prefrontal transcranial magnetic stimulation (TMS) treatment of depression in bipolar affective disorder: a pilot study of acute safety and efficacy
Authors: Nahas Ziad , Kozel F Andrew , Li Xingbao , Anderson Berry , George Mark S 
Published: March 2003

Objectives:  Repetitive transcranial magnetic stimulation (rTMS) has been shown to improve depressive symptoms. We designed and carried out the following left prefrontal rTMS study to determine the safety, feasibility, and potential efficacy of using TMS to treat the depressive symptoms of bipolar affective disorder (BPAD).Methods:  We recruited and enrolled 23 depressed BPAD patients (12 BPI depressed state, nine BPII depressed state, two BPI mixed state). Patients were randomly assigned to receive either daily left prefrontal rTMS (5 Hz, 110% motor threshold, 8 sec on, 22 sec off, over 20 min) or placebo each weekday morning for 2 weeks. Motor threshold and subjective rating scales were obtained daily, and blinded Hamilton Rating Scale for Depression (HRSD) and Young Mania Rating Scales (YMRS) were obtained weekly.Results:  Stimulation was well tolerated with no significant adverse events and with no induction of mania. We failed to find a statistically significant difference between the two groups in the number of antidepressant responders (>50% decline in HRSD or HRSD <10 – 4 active and 4 sham) or the mean HRSD change from baseline over the 2 weeks (t=−0.22, p=0.83). Active rTMS, compared with sham rTMS, produced a trend but not statistically significant greater improvement in daily subjective mood ratings post‐treatment (t=1.58, p=0.13). The motor threshold did not significantly change after 2 weeks of active treatment (t=1.11, p=0.28).Conclusions:  Daily left prefrontal rTMS appears safe in depressed BPAD subjects, and the risk of inducing mania in BPAD subjects on medications is small. We failed to find statistically significant TMS clinical antidepressant effects greater than sham. Further studies are needed to fully investigate the potential role, if any, of TMS in BPAD depression.
Longitudinal outcome in patients with bipolar disorder assessed by life‐charting is influenced by DSM‐IV personality disorder symptoms
Authors: Bieling Peter J , MacQueen Glenda M , Marriot Michael J , Robb Janine C , Begin Helen , Joffe Russell T , Young L Trevor 
Published: March 2003

Objectives:  Few studies have examined the question of how personality features impact outcome in bipolar disorder (BD), though results from extant work and studies in major depressive disorder suggest that personality features are important in predicting outcome. The primary purpose of this paper was to examine the impact of DSM‐IV personality disorder symptoms on long‐term clinical outcome in BD.Methods:  The study used a ‘life‐charting’ approach in which 87 BD patients were followed regularly and treated according to published guidelines. Outcome was determined by examining symptoms over the most recent year of follow‐up and personality symptoms were assessed with the Structured Clinical Interview for DSM‐IV (SCID‐II) instrument at entry into the life‐charting study.Results:  Patients with better outcomes had fewer personality disorder symptoms in seven out of 10 disorder categories and Cluster A personality disorder symptoms best distinguished euthymic and symptomatic patients.Conclusions:  These results raise important questions about the mechanisms linking personality pathology and outcome in BD, and argue that conceptual models concerning personality pathology and BD need to be further developed. Treatment implications of our results, such as need for psychosocial interventions and treatment algorithms, are also described.
Deep white matter hyperintensities in patients with bipolar depression, unipolar depression and age‐matched control subjects
Authors: Silverstone Trevor , McPherson Heather , Li Qunhuan , Doyle Terry 
Published: March 2003

Objective: Hyperintensities in the white matter of the brain (DWH) and in the periventricular area (PVH) seen on magnetic resonance imaging (MRI) have been reported to be more frequent in patients with bipolar disorder (BP) than in normal subjects. To examine this further we compared MRI of patients with BP with age‐matched patients with major depressive disorder (unipolar depression, UP) and healthy control subjects.Methods: T2 weighted axial and coronal brain MRI scans were obtained from 13 patients in the depressive phase of BP, 11 with current UP and 19 age‐matched control subjects. The degree of DWH and PVH present in each scan was determined using a standardized scoring method.Results: The PVH ratings were similar in the three groups of subjects. However, proportionately more BP patients had higher DWH scores than either UP patients or controls. Although this difference did attain statistical significant, a main effect of age was noted. Further, subjects over the age of 50 were under‐represented in the UP group.Conclusions: Notwithstanding the small total sample size and relative lack of older subjects in the UP group, the fact that almost twice as many BP patients showed more severe DWH suggests that patients with BP may be more vulnerable to develop these changes than UP patients and healthy controls.
Effect of chronic Li+ treatment on free intracellular Mg2+ in human neuroblastoma SH‐SY5Y cells
Authors: Abukhdeir Abde M , Layden Brian T , Minadeo Nicole , Bryant Fred B , Stubbs Evan B. , De Freitas Duarte Mota 
Published: March 2003

Objectives:  Previous findings have demonstrated Li+/Mg2+ competition at therapeutic intracellular Li+ levels after acute Li+ treatment in human neuroblastoma SH‐SY5Y cells. In the current study, we examined whether Li+/Mg2+ competition exists at therapeutically relevant extra‐ and intracellular [Li+] after chronic Li+ loading times.Methods:  In human neuroblastoma cells, intracellular free Mg2+ was determined by fluorescence spectroscopy with the fluorophore furaptra. Intracellular Li+ and Mg2+ were measured by atomic absorption spectrophotometry.Results:  After loading of the neuroblastoma cells with 1–2 mM extracellular Li+ for 24–72 h, the observed, increased intracellular free [Mg2+] levels were significantly higher (p < 0.03) than those in matched Li+ free cells, and intracellular [Li+] was found to be at therapeutic intracellular levels (0.7–1.5 mM).Conclusions:  The results demonstrate that Li+/Mg2+ competition exists after chronic treatment with Li+ at therapeutically relevant intracellular Li+ levels in neuroblastoma cells. We found differences between acute and chronic Li+ treatment effects on the extent of Li+/Mg2+ competition. Possible reasons for these differences are discussed.
Aggressive angiomyxoma in females: is radical resection the only option?
Authors: CHAN IK MING , HON EDMUND , NGAI SUK WAI , NG TONG YOW , WONG LING CHUI 
Published: March 2003

Background. Aggressive angiomyxoma is a rare mesenchymal tumor, characterized by frequent local recurrences. Our aim is to assess the role of radical resection.Methods. Retrospective case review. The records of five patients with aggressive angiomyxoma during the period from 1984 to 1998 were reviewed and analyzed. A MEDLINE search from 1983 to May 1999 was performed. The clinical presentation, surgical treatment, resection margin involvement and clinical outcomes were analyzed.Results. Together with our five cases, 106 cases have been reported in the world literature. The female‐to‐male ratio was 6.6:1. The age distribution was wide, with the peak incidence at 31 to 35. The local recurrence rate was high. Seventy‐one percent of recurrence occurred within the first 3 years. Patients with clear resection margins have similar chances of remaining disease‐free compared with those having tumor‐involved resection margins. There was no correlation between the size of the tumors and the chance of recurrence.Conclusions. Though we aim for complete resection, incomplete or partial resection is acceptable, especially when high operative morbidity is anticipated and preservation of fertility is an issue. Long‐term follow‐up and careful monitoring with imaging techniques are essential for timely identification of recurrence and prompt resection.
Laparoscopic colposuspension: a short term urodynamic follow‐up and a three‐year questionnaire‐study
Authors: PERSSON JAN , BOSSMAR THOMAS , WØLNER‐HANSSEN PÅL 
Published: March 2003

Background. The purpose of the study was to evaluate outcome, urodynamic correlates and adverse effects of laparoscopic colposuspension using polytetrafluoroethylene sutures.Methods. Eighty‐five consecutive women with primary stress urinary incontinence at one university hospital were included in this prospective non‐controlled study. During videolaparoscopic surgery, two polytetrafluoroethylene sutures were placed on each side of the urethra and fixed to the Cooper ligaments. Pre‐ and postoperative clinical and urodynamic evaluations, including pad‐test, were performed. A mailed questionnaire was used to evaluate cure‐rate and complication‐rate three years after surgery.Results. At follow‐up examination, we considered 62 of 76 women (82%) as being cured, ten (13%) improved, and four (5%) as being failures. The questionnaires were returned by 80 women; 41 (51%) considering themselves as cured and 31 (39%) improved, and eight women (10%) as unimproved or minimally improved. Clinical outcome was not associated with alterations in urethral functional length or in urethral closing pressure. Short preoperative urethral functional length was associated with failure (p=0.04).The incidence of new onset urge symptoms and of new onset recto/enterocele was 13% and 9% respectively.Conclusions. Laparoscopic colposuspension resulted in acceptable cure rate in short‐, and medium long term evaluation. However, a decline in cure rate was observed. Cured women had significantly longer preoperative urethral functional length than women still leaking after surgery.
Second lower genital tract squamous cell carcinoma following cervical cancer
Authors: SENKUS ELŻBIETA , KONEFKA TOMASZ , NOWACZYK MONIKA , JASSEM JACEK 
Published: March 2003

Background. Patients after treatment for cervical cancer have increased risk of developing second squamous cell malignancy of the lower genital tract.Material and methods. A retrospective study of 46 patients with second lower genital tract epidermoid cancers following previous treatment for invasive cervical carcinoma.Results. Patient age at diagnosis of cervical cancer was 27 to 68 years (median 44 years) and at diagnosis of the second malignancy – 43 to 72 years (median 63 years). There were four cases (9%) of synchronous cancers. Time span between metachronous malignancies ranged from 66 to 406 months (median 206 months). In 32 cases (70%) second lesion was located in the vagina and in 14 (30%) – in the vulva. Out of 35 previously irradiated patients, in 24 (69%) second tumor was located within the high dose volume and in 11 (31%) – outside it. Treatment of second cancer consisted of surgery in 12 patients (26%), radiotherapy – in 23 (50%), combined surgery and radiotherapy – in five (11%), chemotherapy – in four (9%) and surgery plus chemotherapy – in one case. Median survival was 52 months and five‐year survival from the diagnosis of second malignancy – 47.5%. No prognostic factors for survival were identified.Conclusion. Treatment outcome in patients with second lower genital tract carcinoma is unsatisfactory due to poor feasibility of another definite treatment after previous radical surgery and/or radiotherapy.
Transverse uterine incision non‐closure versus closure: an experimental study in sheep
Authors: GÜL ABDÜLAZIZ , ŞİMŞEK YALÇIN , UĞRAŞ SERDAR , GÜL TALIP 
Published: March 2003

Subject. This study was designed to investigate whether the non‐closure of the layers of the uterus during low transverse cesarean section would result in healing and have advantage on closure.Material and method. Thirty pregnant ewes randomly divided into two groups. Each group included 15 ewes. Each ewe was anesthetized at para‐vertebral region with the injection of 20 ml Prilocine 2%. Following left transverse abdominal incision, a transverse incision was made on the uterus and lambs were delivered. In the first group, uterine incision line was left open. In the second group, uterine incision line was sutured with no. 1 Chromic catgut by Schimiden technique. In both groups, all layers of abdominal wall except skin were sutured as en‐bloc with Vicryl® no. 2, by continuous suture technique. Skin was sutured with no. 00 silk interrupted sutures. The ewes were slaughtered four months after cesarean section. A coworker was asked to open the abdominal cavities, and score the intra‐abdominal adhesions. Tissues taken from incision line of each uterus were fixed in 10% neutral buffered‐formalin and were embedded in paraffin‐block. Sections were cut and stained with hematoxylin‐eosin. A pathologist, who knew nothing about the study, evaluated all sections, and reported the findings. Student's t test was used for comparison of mean ewe age, gestational age, and mean operation time of the two groups. Z test was used for comparing the ratio of the two groups by means of histopathological findings.Results. No cervical dilatation and delivery of the placenta were seen during the four week follow up period. The average operating time was significantly less for the non‐closure group (48.07±3.83 minutes) than for the closure group (62.53±6.57 minutes; p=0.001). The ranges of myometrial necrosis (100% versus 13.3%; p=0.001) and endometriosis (53.3% versus 00.0%; p=0.001) were significantly higher for closure group than for non‐closure group.Conclusion. It was found that non‐closure layers of the uterus along low transverse cesarean incision proves to have no adverse effect on immediate and late postoperative period in ewes. Our data showed that non‐closure of all layers of the uterus results in significantly less muscular necrosis and endometriosis than closure group. We suggest that lower uterine incision can be left unclosed or, at least, simple closure can be preferable instead of vigorous locking technique.
High prevalence of the prothrombin gene mutation in women with intrauterine growth retardation, abruptio placentae and second trimester loss
Authors: KUPFERMINC MICHAEL J. , PERI HAVA , ZWANG ETI , YARON YUVAL , WOLMAN IGAL , ELDOR AMIRAM 
Published: March 2003

Background. It has been reported recently that obstetric complications are associated with thrombophilias. Our objective was to investigate the association between pregnancy complications and the guanine 20210 adenine (G20210A) mutation in prothrombin gene.Methods. Two hundred and twenty‐two women (study group) with obstetric complications were tested for the prothrombin mutation. Indications for testing were: severe preeclampsia, mild preeclampsia, intrauterine growth retardation, severe abruptio placentae, unexplained stillbirth, second trimester loss, and three or more consecutive spontaneous abortions. We also tested 156 healthy women who had at least one normal pregnancy and comprised the control group.Results. Demographic data of the study and control groups were similar. Twenty‐eight women of the study group (13%) were found to be heterozygous carriers of the 20210 variant of the prothrombin gene compared to five (3.2%) of the control group, p=0.001, odds ratio (OR) 2.9; 95% confidence interval (CI) 1.3–6.5. Compared to the control women, the prothrombin gene mutation was significantly more prevalent in women with IUGR, abruptio placentae, and second trimester loss but not in women with mild or severe preeclampsia, stillbirth and habitual abortion.Conclusions. Our data demonstrate that the mutation in the prothrombin gene is associated with specific pregnancy complications.
Primary treatment of cervical carcinoma
Authors: HAGEN BJØRN , SKJELDESTAD FINN EGIL , HALVORSEN TORE , STRICKERT TROND , TINGULSTAD SOLVEIG , LORENZ ELKE , ONSRUD MATHIAS 
Published: March 2003

Objective. To study the primary care of cervical carcinoma with regard to clinical and pathological factors, treatment decisions, complications and survival.Design. A historical cohort comprising all women hospitalized with invasive cervical carcinoma (n=293) during the period 1987–1996.Results. Median age was 52 years (range 23–90). FIGO stage distribution was 62%, 15%, 18% and 5% in stages I, II, III and IV, respectively. Early stage disease correlated with young age. Histologic types were: squamous cell carcinoma 84%, adenocarcinoma 11%, adenosquamous carcinoma 4% and small cell/anaplastic carcinoma 1%. Primary therapies were: surgery 188 women (64%), radiotherapy 99 women (34%), chemotherapy two women (0.7%); four women not treated (1.3%). Complications after surgery in 25 women (13%), none were fatal. Acute or late complications after primary or postoperative radiotherapy in 39 women (25%), seven (4.6%) were late serious complications. Three women died from complications related to radiotherapy. Mean follow‐up of surviving patients was 58 months. Overall disease specific five‐year survival was 70%. Five‐year survival in stages IA, IB, II and III was 100%, 88%, 58% and 20%, respectively. One‐year survival in stage IV was 31%. Median survival in stages III and IV according to curative or palliative aim of treatment was 20 and 6 months, respectively (p<0.005).Conclusion. Satisfactory quality of diagnosis and therapy have been maintained through regional care for cervical cancer patients.
Concentration of Interleukin‐12 in the peritoneal fluid is not influenced by the presence of endometriosis, its stage or the phase of the menstrual cycle
Authors: Gazvani Rafet , Bates Michelle , Vince Gillian , Christmas Stephen , Lewis‐Jones Iwan , Kingsland Charles 
Published: March 2003

Background. IL‐12 is a key immunomodulatory cytokine. Its presence or concentration in peritoneal fluid is not related to the presence of endometriosis or the stage of the disease. A study was carried out to gain insight into the role of IL‐12 in the development and maintenance of endometriosis in relation to menstrual cycle.Methods. A prospective study recruiting 64 consecutive women undergoing laparoscopic surgery for benign gynecological indications. Peritoneal fluid was obtained during laparoscopy. Concentration of IL‐12 was measured and correlated to the presence of endometriosis, its stage and the phase of the menstrual cycle.Result(s). Peritoneal fluid concentrations of IL‐12 showed no correlation with the presence of endometriosis, the AFS stage of the disease or the phase of the menstrual cycle.Conclusion(s). IL‐12 is a normal constituent of peritoneal fluid in around one third of the population tested and is not involved in the pathogenesis of endometriosis at any stage of the disease or the phase of the menstrual cycle.
Laparoscopically assisted vaginal management of deep endometriosis infiltrating the rectovaginal septum
Authors: Chapron Charles , Jacob Sandrine , Dubuisson Jean‐Bernard , Vieira Marco , Liaras Etienne , Fauconnier Arnaud 
Published: March 2003

Background. Two aims: 1) To assess the results of laparoscopically assisted vaginal management of deep endometriosis infiltrating the rectovaginal septum (RVS); 2) to pinpoint the differences between this procedure and that used for deep endometriotic lesions located on the uterosacral ligaments (USL).Methods. Descriptive retrospective study. Twenty‐nine consecutive patients operated for deep endometriosis infiltrating the RVS were included in this series.Results. One patient only (3.5%) presented a major complication of the recto‐vaginal fistula type. After a one step reoperation under anesthesia, the post operative history was uncomplicated and no sequelae are to be deplored. With respect to dysmenorrhea (DM), deep dyspareunia (DP) and chronic pelvic pain (CPP), there was an improvement in respectively 91.7% (22 patients), 100% (24 patients) and 92.9% (13 patients) of cases. For each of these 3 symptoms the median score according to the visual analog scale was significantly lower after the operation (for DM: 7.6±2.0 versus 1.7±2.6; for DP 7.5±1.9 versus 0.5±1.1; for CPP 5.9±2.8 versus 1.4±3.2) (p<0.0001).Conclusions. These results demonstrate that provided the surgeon is highly skilled in laparoscopy, operative laparoscopy is efficient for the treatment of patients presenting painful symptoms related to deep endometriotic infiltrating the RVS. From the technical point of view the rectum must be freed, leaving the deep endometriotic nodule attached to the posterior wall of the vagina. Resection of the whole lesion requires the posterior wall of the vagina to be resected, whereas ureterolysis is often unnecessary. So for lesions located on the RVS the vagina is opened systematically, unlike the situation when resecting deep endometriotic lesions infiltrating the USL. Deep pelvic endometriosis is not synonymous with endometriosis of the RVS. Lesions truly infiltrating the RVS represent only a small proportion of all deep endometriosis lesions.