bluuebunny/crossref_metadata_2025_split huggingface dataset:
‘Secondary’ Hughes (Antiphospholipid) Syndrome in Unusual Clinical Settings
Authors: Mourou M. , Abdella N. , Qurttom M.A.F. , Malaviya A.N. 
Published: April 2003

<b>Objectives and Importance:</b> Hughes (antiphospholipid) syndrome is mainly seen among patients with systemic lupus erythematosus (SLE). This has been called ‘secondary’ in contrast to ‘primary’ where no obvious underlying disease is detectable. The objective of this report is to highlight the fact that Hughes syndrome can, however, also occur in association with other underlying diseases or, as a result of certain therapies. The importance of this report is in emphasizing the fact that secondary Hughes syndrome can occur in several settings other than SLE or SLE-like illness. <b>Clinical Presentation:</b> Here we describe 3 patients with clinical features of arterial or venous thromboses associated with significant levels of anticardiolipin antibodies. Their underlying diseases were, however, neither SLE nor ‘SLE-like’ illness. One of them had been on oral contraceptive pills, the 2nd patient had Behçet’s disease and the 3rd patient had liver carcinoma associated with hepatitis C infection. Thus, these patients could be classified under the category of ‘secondary’ Hughes (antiphospholipid) syndrome. <b>Conclusion:</b> The 1st patient recovered and remained well during a 12-month follow-up after the discontinuation of oral contraceptive pills combined with long-term low-dose aspirin therapy. The last patient remained normal in the 12-month follow-up period on long-term warfarin treatment at a dose adequate to keep the international normalized ratio above 3. The 2nd patient died of uncontrollable hypercoagulability associated with advanced extensive malignancy and related complications. It is, therefore, recommended that the possibility of Hughes syndrome be considered in any clinical situation characterized with hypercoagulable state. If proven, long-term anticoagulation may benefit the patient.
Temporal Trend and Factors Associated with Delayed Hospital Admission of Stroke Patients
Authors: Casetta Ilaria , Granieri Enrico , Gilli Giuseppe , Lauria Giuseppe , Tola Maria Rosaria , Paolino Ezio 
Published: April 2003

The effectiveness of stroke treatment depends on the time interval between onset of symptoms and admission to hospital. The purpose of our investigation was to assess, over a 10-year period, the mean delay in admission to hospital in stroke patients to determine factors which might be associated with this delay, to define the putative number of patients available for accrual in clinical trials, and to identify strategies aimed at decreasing the time to admission. We collected data on all stroke patients consecutively admitted to our clinic from 1986 to 1995. The following variables were investigated: age, sex, educational and occupational level, home accommodation, family and personal history of vascular disease or factors known to affect the risk of vascular disease, and type and severity of stroke. The individual and independent contribution of these variables was assessed by univariate and multivariate analysis. The accurate time of stroke onset was established for 760 patients. Of these, 24.7% were admitted within 1 h from the onset of symptoms, 41% within 2 h, 54% within 4 h and 72.5% within 12 h. The mean delay was 21 ± 2 h (SE) and the median was 3.5 h. Acute onset of neurological deficits, stroke severity and family history of cerebrovascular disease were associated with earlier presentation. According to the current guidelines for thrombolytic therapy, only 16% of the patients could have been included in a clinical trial. This study suggests that despite a relatively short time to hospital admission in most patients and an altered help-seeking behavior over time, many stroke patients did not present early enough to be recruited for clinical trials or to benefit from new treatments. The majority of patients with timely presentation were not eligible for acute treatment, or were subjects with severe stroke for whom caution is advised before initiating thrombolytic therapy. It has been suggested that the patient’s indecision to seek medical help is the most important reason for a delayed hospital admission of stroke patients. These results underscore the importance of interventions aimed at reducing the delay in stroke treatment induced by patients who are unaware of the decisive role of the time of treatment induction. The finding that earliest admissions for stroke comprised patients with a previous history of cerebrovascular disease suggests that an education campaign might highlight the importance of an early admission.
Amisulpride versus Amineptine and Placebo for the Treatment of Dysthymia
Authors: Boyer P. , Lecrubier Y. , Stalla-Bourdillon A. , Fleurot O. 
Published: April 2003

Amisulpride, a selective antagonist for D<sub>2</sub> and D<sub>3</sub> dopamine receptors, acts preferentially on presynaptic receptors increasing dopaminergic transmission at low doses. In a multicentre, 3-month, placebo-controlled study, amisulpride (50 mg/day) was compared to amineptine (200 mg/day) in the treatment of primary dysthymia. A total of 323 patients were enrolled. Amisulpride and amineptine were found to be statistically superior to placebo (p < 0.0001) on the Clinical Global Impression (item 2): 63, 64 and 33% responders, respectively; improvement of Montgomery-Asberg Depression Rating Scale and Scale for the Assessment of Negative Symptoms scores following amisulpride or amineptine treatment was twice as high as with placebo (p < 0.0001). The adverse event profile of amisulpride was similar to that of placebo except for endocrine symptoms in female patients; amineptine showed mainly events linked to psychic activation (insomnia, nervousness). Results show that amisulpride can improve symptoms of chronic depression in dysthymia.
Blood Flow Velocity in the Peripheral Circulation of Glaucoma Patients
Authors: O’Brien Colm , Butt Zahida 
Published: April 2003

Using the laser Doppler technique we measured finger blood flow velocity in 25 untreated primary open-angle glaucoma (POAG), 22 untreated low-tension glaucoma (LTG) and 19 age-matched normal subjects. Four blood flow measurements were recorded: baseline flow, after immersion in warm water for 2 min (40°C maximum flow), after 10 s exposure to cold water (4°C minimum flow) and time to recover to baseline flow after cold immersion. Significant differences between the LTG group and both the normal and POAG groups were found in a greater maximum flow (p = 0.03 and p = 0.01, respectively), a lower minimum flow (p = 0.04 and p = 0.03, respectively) and a longer recovery time to baseline flow (p = 0.0001 for both the normal and POAG groups). A longer recovery time to baseline flow (p = 0.008) in POAG was the only difference between the normal and POAG groups. Both glaucoma groups had more systemic vascular disease than normal, and there were more smokers in the POAG group than normals. Subgroup assessment performed with migraine, vascular disease and smoking subjects excluded from the analysis did not alter the overall results. We conclude that systemic vasospasm is a strong feature of low-tension glaucoma.
Significant Immediate and Long-Term Reduction of Astigmatism after Lateral Rectus Recession in Divergent Duane’s Syndrome
Authors: Killer H.E. , Bähler A. 
Published: April 2003

Duane’s syndrome is associated with anisometropia and amblyopia. We encountered 1 patient with right divergent Duane’s syndrome (type 2 according to Huber’s classification) with high astigmatism of the right eye and a head turn. In order to improve the head turn and thereby avoid eccentric gaze through the glasses, the right lateral rectus muscle was recessed by 7.75 mm. Postoperatively, the amount of astigmatism was reduced by 1.5 dpt with no change of the axis. This change of refraction remained stable over a follow-up time of 18 months.
The Short-Term Effect of Adding Brimonidine 0.2% to Timolol Treatment in Patients with Open-Angle Glaucoma
Authors: Yüksel Nurşen , Altıntaş Özgül , Karabaş Levent , Alp Banu , Çağlar Yusuf 
Published: April 2003

Brimonidine, a highly selective α<sub>2</sub>-adrenoceptor agonist, was studied to determine its ocular hypotensive effect and side effects in patients with elevated intraocular pressure (IOP) while on continuing therapy with timolol. This was a prospective, randomized, placebo-controlled study in 15 patients with primary open-angle or pseudoexfoliation glaucoma on therapy receiving timolol 0.5% twice daily, with IOP greater than or equal to 22 mm Hg in one eye. IOP measurements, blood pressure and pulse rate were assessed on 2 days at a baseline and 1, 2, 4, 6 and 8 h later. A single drop of brimonidine 0.2% or placebo was added to treatment with timolol. The reductions in IOP at all time intervals observed with brimonidine + timolol were significantly greater than those with timolol + placebo. The maximum mean net decrease in IOP was 19.23 ± 10.60% at 4 h. Statistically significant decreases in systemic blood pressure and pulse rate without clinical symptoms were observed in the group receiving brimonidine + timolol. This study suggests that a combination of brimonidine and timolol may have potential in the treatment of glaucoma. Further clinical trials with brimonidine are indicated to assess its further role as adjunctive agent.
Corneal Wound Healing after Superficial Foreign Body Injury: Vitamin A and Dexpanthenol versus a Calf Blood Extract
Authors: Egger S.F. , Huber-Spitzy V. , Alzner E. , Scholda C. , Vecsei V.P. 
Published: April 2003

A prospective randomized double-blind clinical study was performed to investigate corneal wound healing after treatment either with an eye gel containing calf blood extract or an eye ointment containing vitamin A and dexpanthenol. A total of 54 outpatients were included in this study, all treated for corneal foreign body injury. The size of the corneal lesions was measured by planimetry on days 0, 1, and on the following days until complete epithelial healing occurred. Results showed the calf blood extract eye gel to be statistically more effective in promoting corneal wound healing, especially in patients with wound areas larger than 6 mm<sup>2</sup>.
The Comparison of Intraocular Pressure Reductions after Isometric and Isokinetic Exercises in Normal Individuals
Authors: Avunduk Avni Murat , Yilmaz Berna , Şahin Nermin , Kapicioglu Zerrin , Dayanır Volkan 
Published: April 2003

The lowering effect of physical exercise on intraocular pressure (IOP) has been reported both in healthy people and those with glaucoma, but a comparison of the lowering effect of isometric and isokinetic exercises on IOP has not been conducted in any study. Our aims were to investigate the relationship between intensity of exercise and IOP, and whether a significant difference in IOP lowering effect existed between isometric and isokinetic exercises. Sixty-seven patients with an age range of 23–40 who had no ocular disease were randomly divided into two groups. While 31 patients in the first group, group A, performed isokinetic exercise with the Cybex 6000 dynamometer, 32 patients in the second group, group B, had isometric exercises with the same machine. IOP was measured in the right eye of patients with Shiøtz tonometer just before and 10 min following exercise. Exercise intensity and total energy consumption were determined by the machine for each patient. While IOP values measured before exercise, the degree of exercise applied, and total energy consumption did not differ significantly between groups, both isometric and isotonic exercises lowered IOP significantly. As a result, isometric and isokinetic exercises lowered IOP in ophthalmologically normal subjects with direct relationship to exercise intensity and total energy consumption. Since the pressure lowering effect of isokinetic exercise was more significant, it might prove useful to glaucomatous patients.
Postmortem Findings Two Weeks after Oral Treatment for Metastatic <i>Candida</i> Endophthalmitis with Fluconazole
Authors: Ohnishi Yoshitaka , Tawara Akihiko , Murata Toshinori , Sakamoto Taiji , Arakawa Tetsuo , Ishibashi Tatsuro 
Published: April 2003

The purpose of this histological study was to present postmortem findings in both eyes of a 53-year-old male with liver dysfunction 2 weeks after short-time oral treatment with 200 mg/day fluconazole for metastatic <i>Candida</i> endophthalmitis due to intravenous hyperalimentation for 18 days. <i>Candida</i> had been demonstrated in the venous blood and on the tip of the intravenous catheter. The bilateral fungal endophthalmitis with hypopyon responded well to fungistatic therapy, but the patient suddenly died from heart failure. Both eyes were obtained at autopsy. <i>Candida</i> was demonstrated only in vitreous puff balls but not in the retina or uvea. Fluconazole administered for a short period had little effect in eliminating fungus from vitreous puff balls, which have no blood supply. Prolonged administration of the antifungal drug or vitrectomy should be considered when treating an eye with vitreous puff balls in the presence of fungal endophthalmitis.
Calcium Mobilization in Isolated Epithelial Cells of the Endolymphatic Sac
Authors: Arishige Shuso , Takumida Masaya , Yajin Koji 
Published: April 2003

Endolymphatic sac epithelial cells were isolated from the endolymphatic sac of the guinea pig by enzymatic and mechanical dissociation. The intracellular free calcium ion concentrations ([Ca<sup>2+</sup>]i) of the isolated cells were determined using the Ca<sup>2+</sup>-sensitive dye fura-2. The isolated cells were classified into two types, i.e. light and dark cells. In the resting state, [Ca<sup>2+</sup>]i in the cells was variable in both types of cells. In the presence of 200 µ<i>M</i> ATP, there was a rapid rise in [Ca<sup>2+</sup>]i. These findings suggest that endolymphatic sac epithelial cells may have receptor-mediated Ca channels which may play an important role for a nerve-mediated local feedback system of the endolymphatic sac to regulate homeostasis of endolymph volume, pressure and electrolyte balance.
Time Course of Eye Nystagmus and Body Movement after Peripheral Vestibular Lesions in Guinea Pigs
Authors: Thompson G.C. , Ross C.D. , Britton B.H. 
Published: April 2003

Body movement of guinea pigs was measured using a force platform at various times before and after unilateral end organ ablation and before and after sham surgery. Both spontaneous and drop-evoked movement patterns differed in the same animal after vestibular ablation and from control animals that received sham lesions. Whereas measures of eye nystagmus disappeared by 48 h postablation, measures of body movement indicated persistent differences even at 72 h. We conclude that the force platform can differentiate between movement patterns of normal and vestibular-lesioned animals and, in fact, measures a vestibular deficiency that is independent of eye nystagmus. The force platform appears to be a useful addition to evaluate vestibular deficits as well as to detect any benefits of pharmacological or surgical therapies.
Titanium and Glass-Ionomer Cement as Ossicular Replacement Materials: Biocompatibility Results after Implantation in the Rabbit
Authors: Schwager Konrad , Geyer G. 
Published: April 2003

The middle ear poses unique challenges when finding suitable materials for ossicular reconstruction, primarily because of its link to the external environment via the eustachian tube, which leads to a greater potential for exposure to infectious agents. In this animal study, the biocompatibilities of titanium and glass-ionomer cement were assessed in the middle ear of the rabbit after being implanted as total ossicular replacement prostheses (TORPs) or as free pins. Animals were sacrified after 28, 84, 168, 336, or 504 days or 2 years, and a cutting saw technique was used to prepare slides for light microscopy. Slides were examined for mucosal coverage and any sign of foreign body reaction. Both materials showed good acceptance in the middle ear. After 28 days, the TORPs were covered by middle ear mucosa. As expected, it took a longer time (up to 504 days) to cover the free implants. An interesting finding was the growth of new bone on both the surface of the titanium implants and the glass-ionomer prostheses. The results of this animal study indicate that both titanium and glass-ionomer cement are favorable materials for ossicular replacement prostheses.
Can Short-Latency Vestibulospinal Reflexes in Lower Leg Muscles Be Elicited by Tapping the Head?
Authors: Iida Masahiro , Bötzel Kai , Dieterich Marianne , Krafczyk Siegbert , Brandt Thomas , Hitouji Kayoko , Igarashi Makoto , Sakai Makoto 
Published: April 2003

A gentle tap on the forehead evoked short-latency motor responses in the sternocleidomastoid muscle, which may be vestibulocollic reflexes with characteristics similar to those elicited by clicks. We tested this paradigm in subjects standing upright, in order to determine the differential effects of taps on the forehead on the patterns and latencies of spinal stretch and vestibulospinal reflexes, which are important for postural control. Taps on the forehead elicited short-latency inhibitory electromyographic responses in both gastrocnemius muscles with a mean latency of 48.3 ± 3.1 ms (onset) to 98.3 ± 6.3 ms (end). Taps on the sternum elicited similar responses from the gastrocnemius muscles, indicating that vestibular stimulation is not essential for eliciting these responses. Both responses may play a role in predetermining the strategy for correcting body perturbations. The actual reflex is probably elicited by somatosensory input from the neck, which converges with vestibular input for the multisensory control of posture.
Surgical Anatomy of the Facial Nerve in Chinese Mastoids
Authors: Low W.K. 
Published: April 2003

Since racial differences in mastoid morphology exist, there may be racial differences in the surgical anatomy of the facial nerve in the mastoid. Thirty Chinese adult temporal bones were dissected. The facial nerve in the mastoid coursed vertically (60.0%), anteriorly (33.3%) and posteriorly (6.7%) in the sagittal plane. In the coronal plane, it coursed vertically (46.7%) and laterally (53.3%). The chorda tympani was found to have extratemporal origin in 53.3% and for the rest, the distance of its origin from the stylomastoid foramen averaged 3.17 mm (range 0.5–6.0 mm). The mean dimension of the extended facial recess was 4.40 mm (range 3.0–6.0 mm). The facial nerve was at a mean of 3.15 mm (range 2.0–5.0 mm) posterior to the most posterior point of the tympanic annulus and partially crossed the tympanic annulus from medial to lateral at this point. In conclusion, the typical surgical anatomy of the mastoid facial nerve as described in the Western literature may not apply to the Chinese.
Prognostic Factors of Chronic Rhinosinusitis under Long-Term Low-Dose Macrolide Therapy
Authors: Suzuki Hideaki , Ikeda Katsuhisa , Honma Rikako , Gotoh Satoru , Oshima Takeshi , Furukawa Masayuki , Takasaka Tomonori 
Published: April 2003

We studied the immunological and histopathological factors that affect the prognosis of chronic rhinosinusitis under long-term low-dose macrolide therapy. Sixteen patients with chronic rhinosinusitis were given 200 mg clarithromycin or 150 mg roxithromycin orally once a day without other concurrent treatments for 2–3 months. Measurement of the serum IgE level, blood cell count and differential leukocyte count of the peripheral blood, cytological assessment of the nasal smear and computed tomographic (CT) scans of the paranasal sinuses were performed before treatment. The opacity of the sinuses was estimated and scored by the CT images. After treatment, anterior ethmoidal mucosa samples were collected, an infiltrated inflammatory cells, interferon (IFN)-γ-positive cells and interleukin (IL)-4-positive cells were examined histologically and immunohistochemically. The severity of nasal symptoms was scored before and after treatment, and the improvement rate of the score (symptomatic improvement rate) was calculated. Patients with normal levels of serum IgE (≤250 U/ml) showed a significantly higher symptomatic improvement rate than those with high levels of serum IgE (42.1 ± 11.2 vs. 4.9 ± 3.1%, p = 0.046). The symptomatic improvement rate was inversely correlated with the eosinophil counts in the peripheral blood (r = –0.51, p = 0.04), in the nasal smear (r = –0.54, p = 0.045) and in the sinus mucosa (r = –0.54, p = 0.02). Meanwhile, the CT score, the number of IFN-γ-positive cells and IL-4-positive cells in the sinus mucosa and neutrophil counts in the nasal smear and in the sinus mucosa failed to correlate with the symptomatic improvement rate. These results suggest that macrolide therapy is indicated for patients without atopy or smear/tissue/peripheral blood eosinophilia. On the contrary, the severity of the disease, Th1/Th2 dominance in the sinus mucosa and neutrophilia are unlikely to be prognostic factors of chronic rhinosinusitis under long-term low-dose marolide therapy.
Development of Monovalent Ions in the Endolymph in Mouse Cochlea
Authors: Yamasaki Masayuki , Komune Shizuo , Shimozono Masami , Matsuda Keiji , Haruta Atsushi 
Published: April 2003

The present study was designed to clarify the chronological developmental process of monovalent ions (Na<sup>+</sup>, K<sup>+</sup>, Cl<sup>–</sup>) in the endolymph of the mouse in relation to the development of the endocochlear potential (EP). The EP and ionic concentrations were measured simultaneously with the ion-sensitive double-barreled microelectrodes from the scala media of the basal turn. The EP increased abruptly 7 days after birth (DAB) and reached approximately 80 mV 14 DAB. In the earliest postnatal days, the endolymphatic Na<sup>+</sup> concentration was significantly higher than that in adult mice, however, the K<sup>+</sup> and the Cl<sup>–</sup> concentrations were lower. The concentrations of all the monovalent ions in endolymph reached adult levels at 7 DAB when the EP was still under 20 mV. These data strongly suggest the presence of a different mechanism between the production of monovalent ions, especially of high K<sup>+</sup> in the endolymph and that of EP.
Regulation of Vascular Endothelial Growth Factor Receptor KDR in vitro by a Soluble Factor in Confluent Endothelial Cells
Authors: Liu Wenbiao , Ellis Lee M. 
Published: April 2003

Hypoxia regulates the expression of both vascular endothelial growth factor (VEGF) and its receptor <i>(KDR)</i>. We have shown that cell density regulates VEGF expression in colon cancer and hypothesized that a similar mechanism regulates <i>KDR</i> in endothelial cells. Human umbilical vein endothelial cells were grown as sparse and confluent monolayers. Northern blot analysis revealed that <i>KDR</i> and VEGF mRNA expression in confluent cells was more than two-fold greater than in sparse cells. In contrast, <i>flt</i>-1 expression increased only slightly in cells grown to confluence. Cells were then plated at various concentrations and subjected to semi-quantitative PCR; <i>KDR</i> mRNA expression increased as cell density increased. Serum-free conditioned medium from cells grown to confluency for 48 h was added to sparsely plated cells, and <i>KDR</i> expression in the sparse cells increased twofold. We conclude that cell density regulates <i>KDR</i> endothelial cell expression via an unidentified soluble factor.