bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Fentanyl and Naloxone on a Thalamic Induced Painful Response in Intractable Epileptic Patients
Authors: Velasco, Marcos , Brito, Francisco , Jimenez, Fiacro , Gallegos, Monica , Velasco, Ana Luisa , Velasco Francisco 
Published: April 2003

Acute high-frequency (60/s) high-intensity (2,100–2,300 µA) stimulation of the mesial, caudal and inferior portion of the centromedian thalamic region within or close to the parafascicular nucleus produced a sharp, intense, cramp-like painful response localized to the face and shoulder (medial stimulation) or arm and hand (lateral stimulation) contralateral to the stimulation site in 4 intractable epileptic patients in whom depth electrodes had been implanted as a part of a neuroaugmentive procedure for seizure control. This thalamic induced painful response was always accompanied by objective clinical signs (facial gesticulation and contraction of the corresponding muscles) during thalamic stimulation and significant increments in EEG, EKG and respiratory frequencies and EMG muscular tonus from 10 s before to 10 s after thalamic stimulation. Opioid agonists (fentanyl 5.0 µg/kg) and antagonists (naloxone 3.5 µg/kg) were administered to induce and regulate a state of neuroleptanalgesia used for the subcutaneous internalization of the chronic stimulation systems. Under these conditions, we observed that fentanyl greatly attenuated and naloxone increased the intensity of the painful response, as well as the EEG, somatic and vegetative parameters evaluating such a painful response. Differences were significant when one compares the changes in response to electrical stimulation in EEG, EKG, respiration and EMG after the administration of fentanyl (decrease p = 0.001) and naloxone (increase p = 0.01) compared to those obtained after the administration of saline or no drugs during baseline recordings. These data suggest that this thalamic induced painful response is mediated by inhibition or activation of the morphine receptors of the thalamic cells primarily related to the pain process.
The Relationship of Imaging Techniques to the Accuracy of Frameless Stereotaxy
Authors: Schulder Michael , Fontana Peter , Lavenhar Marvin A. , Carmel Peter W. 
Published: April 2003

<i>Objective:</i> We analyzed the accuracy of a frameless stereotactic system using computed tomographic (CT) and magnetic resonance imaging (MRI) scans of different slice thickness and T<sub>1</sub> versus T<sub>2</sub> weighting of MRI. <i>Methods:</i> An open skull with graphite pegs fixed to its base was used for all scans. CT scans were done with slice thicknesses of 1, 2 and 3 mm. MRI-visible markers were placed on top of pegs for T<sub>1</sub>-weighted and T<sub>2</sub>-weighted MRI scans, which were acquired at thicknesses of 1.5, 3 and 5 mm. For each scan, 3 separate registrations of a probe were performed; the distance between the actual probe location and that displayed on the registered image was noted. Each measurements was repeated 3 times for each registration. <i>Results:</i> Greatest accuracy was achieved with 3-mm-slice CT scans; this was not improved by using thinner slices. T<sub>1</sub>-weighted 1.5-mm MRI scans were 23% less accurate and T<sub>2</sub>-weighted 3-mm scans 37% less accurate. <i>Conclusions:</i> Frameless stereotaxy should be done using CT scans when the greatest possible accuracy is desired. There appears to be no advantage to using slice thicknesses less than 3 mm. For most craniotomy applications, T<sub>1</sub>-weighted MRI using 3-mm slices provides sufficient accuracy. Lesions imaged only on T<sub>2</sub>-weighted MRI also can be approached with
adequate precision using 3-mm scans.
Reassessing the Role of Urodynamics after Cerebrovascular Accident
Authors: Khorsandi Moez , Ginsberg Phillip C. , Harkaway Richard C. 
Published: April 2003

<b>Background and Purpose:</b> To determine whether there is a gender difference in the need for urodynamics in the evaluation of urinary incontinence after cerebrovascular accident (CVA). <b>Materials and Methods:</b> We studied 72 consecutive post-CVA patients with new onset urinary incontinence documented by the patients or the persons who looked after them. Patients were evaluated between 4 and 6 weeks after their CVA and all had negative urine cultures and a postvoid residual urine determination. Exclusion criteria included narrow angle glaucoma, postvoid residual urine greater than 100 cm<sup>3</sup> and radiographic evidence for a brainstem infarct. This left 30 male (mean age 65) and 30 female (mean age 67) patients evaluable. Patients were empirically started on anticholinergic medications and timed voids for 4 weeks after which cytoscopy and cystometry were performed. <b>Results:</b> 28/30 females (93%) reported subjective improvement in their continence with conservative measures. 1 (3%) was found to have a urethral diverticulum, and 1 (3%) had uninhibited detrusor contractions that did not improve with medications. In the male group, 20/30 (67%) reported subjective improvement, 5 (17%) developed elevated postvoid residual urine volumes, 3 (10%) were diagnosed with urethral strictures, 1 (3%) had a bladder neck contracture, and 1 (3%) had transitional cell carcinoma in situ in the bladder. <b>Conclusion:</b> In the patient with new onset urinary incontinence in the initial period after CVA, an empiric trial of anticholinergic medications and timed voiding may be warranted in a select population of female patients without urodynamic testing or cystoscopy. This conservative approach may not be appropriate in males because of their increased likelihood of having secondary urologic conditions.
Clinical Efficacy of Oxybutynin on Sensory Urgency as Compared with That on Motor Urgency
Authors: Hashimoto Kiyoshi , Ohnishi Norio , Esa Atsunobu , Sugiyama Takahide , Park Young-Chol , Kurita Takashi 
Published: April 2003

<i>Objective:</i> Anticholinergic drug is widely accepted as an effective medication for frequency, urgency and urge incontinence related to detrusor overactivity (motor urgency). In order to elucidate whether anticholinergic drug is also effective for these symptoms related to bladder hypersensitivity (sensory urgency), clinical efficacy of oxybutynin on sensory urgency was compared with that on motor urgency. <i>Method:</i> Twenty-four patients with sensory urgency, and 53 patients with motor urgency were treated with oxybutynin (6 mg/day) for 4 weeks and subjective and objective efficacies were evaluated. Subjective parameters were quantified with urge score (grade 0–3) and daily numbers of voiding and incontinence. Objective efficacies were evaluated with pre-/ postcomparison of cystometric parameters. <i>Results:</i> Excellent or good overall efficacy was obtained in 62.5% (15/24) of the sensory urgency group and 60.4% (32/53) of the motor urgency group. There was no statistical difference between these two groups. Objective cystometric parameters, bladder volume at first sensation and maximum cystometric capacity, statistically improved after the treatment in both groups. <i>Conclucion:</i> The results suggest that oxybutynin works as well on sensory urgency as it does on motor urgency.
Role of Urologic Evaluation in the Adult Spina bifida Patient
Authors: Persun Michelle L. , Ginsberg Phillip C. , Harmon Justin D. , Harkaway Richard C. 
Published: April 2003

<i>Objective:</i> To evaluate a population of adult spina bifida patients performing clean intermittent catheterization (CIC) and determine the indications for urologic consultation and intervention. <i>Methods:</i> We evaluated 52 adults (ages 18–37 years) with a history of lumbar myelomeningocele, all of whom performed CIC and were dry between catheterizations. We excluded 12 patients with conditions potentially predisposing to renal insufficiency (staghorn calculus, n = 3; multiple admissions for pyelonephritis, n = 5; history of vesicoureteral reflux, n = 2, and renal scarring on ultrasound, n = 2), leaving 40 patients evaluable. Each patient kept a catheterization diary for 2 weeks from which an average catheterized volume was recorded. <i>Results:</i> In patients with normal ultrasound and normal serum creatinine (<1.5 mg/dl), there were no individuals (0/20) whose average catheterized volume corresponded to a bladder pressure of >40 cm H<sub>2</sub>O on cystometry. However, in the patients with hydronephrosis and/or elevated creatinine, 30% (6/20) had average catheterized volumes corresponding to a bladder pressure of >40 cm H<sub>2</sub>O, and are therefore theoretically at risk for upper tract deterioration. <i>Conclusion:</i> Many spina bifida patients receive urologic care only as children, and those without urinary calculi or urinary incontinence are assumed to be urologically stable. However, certain patients have urodynamic parameters which put them at risk for renal deterioration even if they appear to be problem-free. We recommend a yearly renal ultrasound and serum creatinine determination in all adult spina bifida patients with immediate urologic consultation and urodynamics if either is abnormal.
No Change with Age in Semen Volume, Sperm Count and Sperm Motility in Individual Men Consulting an Infertility Clinic
Authors: Krause Walter , Habermann Barbara 
Published: April 2003

In the human male, Leydig cell function of the testis declines slowly but significantly with age. A similar decline in the spermatogenic activity, however, is not well proven by consistent data. Cross-section studies quoted in the literature mostly describe only minor changes in different sperm parameters with age. In our database we identified 253 men who had attended our department since 1989 for subsequent semen analyses at intervals of more than 1 year. The semen analyses were performed according to the guidelines of the WHO with the exception that motility parameters were measured by CASA. The mean interval between the two analyses was 967 days with a range of 341–2,731 days. None of the parameters evaluated showed a significant increase or decrease with time. The mean seminal volume was identical in the two analyses. Mean sperm count increased during the observation period by 12 · 10<sup>6</sup> spermatozoa/year. In 177 patients an increase and in 73 patients a decrease occurred. Also a corresponding increase in total sperm count was observed. Sperm motility increased in 123 patients, and it decreased in 123 patients. Only slight differences in the increase or decrease of the two parameters between the groups of patients with and without a history of genital diseases and/or varicocele were found. The results of our study do not support the suggestion that the sperm parameters decrease with age.
Increased Sensitivity of Myeloid Leukemia Cell Lines: Potential of Lovastatin as Bone-Marrow-Purging Agent
Authors: Scheffold Christian , Schöttker Björn , Lefterova Petja , Csipai Markus , Glasmacher Axel , Huhn Dieter , Neubauer Andreas , Schmidt-Wolf Ingo G.H. 
Published: April 2003

Lovastatin reduces the isoprenylation of p21<sup>ras</sup> via suppression of mevalonic acid generation. Lovastatin has been shown to reduce tumor cell proliferation in a dose-dependent manner. Here, the potential of lovastatin for purging leukemia cells from bone marrow was investigated using the myeloblastic cell lines K562 and KG-1 as a model system, derived from an erythroleukemia and an acute myelogenous leukemia, respectively. Optimal purging conditions were determined using an MTT proliferation and a leukemia colony assay. Elimination of leukemia cells was time- and dose-dependent. Depletion of K562 was 2.5 logs for 100 μ<i>M</i> of lovastatin at 72 h of incubation. Compared to another purging agent, 100 μg/ml mafosfamide had an activity comparable to 100 m<i>M</i> lovastatin. Interestingly, KG-1 acute myelogenous leukemia cells were even more sensitive to lovastatin than K562 cells. In clonogenic assays, 100 μ<i>M</i> of lovastatin resulted in a 3- to 4-log reduction of K562 colonies. Lovastatin had a progressive effect on normal hematopoietic progenitor cells. At a concentration of 100 μ<i>M</i> of lovastatin, CFU-GM colonies were reduced by 1–2 logs. In conclusion, a differential effect on leukemia and normal progenitor cells could be detected in a clonogenic assay. These results suggest that lovastatin deserves further study as an agent for ex vivo marrow purging.
Factors Influencing Effectiveness of Deferiprone in a Thalassaemia major Clinical Setting
Authors: Del Vecchio Giovanni Carlo , Crollo Elisabetta , Schettini Federico , Schettini Francesco , Fischer Roland , De Mattia Domenico 
Published: April 2003

The effectiveness of deferiprone (L1) and the influence of other factors were determined in a clinical setting. Patients of Southern Italian origin, affected by β-thalassaemia major (n = 13: 7 M, 6 F), aged 10–28 years (median 18 years), were treated with L1 within a ‘Controlled Programme’ of the Italian Ministry of Health. Desferrioxamine could not be administered in these patients because of anaphylactic reactions or other serious side effects. L1 was considered to be effective when the liver iron concentration was reduced or stable as measured by biomagnetic liver susceptometry. L1 proved to be effective in 3 out the 9 evaluable patients. A high pre-L1 iron overload was the main clinical factor influencing L1 effectiveness.
Angioimmunoblastic Lymphadenopathy with Dysproteinemia: Emphasis on Pathogenesis and Treatment
Authors: Sallah Sabah , Gagnon Gregory A. 
Published: April 2003

Angioimmunoblastic lymphadenopathy with dysproteinemia (AILD) is a rare lymphoproliferative disorder characterized by diffuse lymphadenopathy, fever, hepatosplenomegaly, hemolytic anemia, and polyclonal hypergammaglobulinemia. Morphologically, the involved lymph nodes demonstrate complete effacement of the normal architecture, prominent neovascularization and infiltration by immunoblasts and plasma cells. Other terms that have been used to describe this entity include diffuse plasmacytic sarcomatosis, immunoblastic lymphadenopathy, lymphogranulomatosis X, and immunologic aberrations in idiopathic reticulosis. Initially, AILD was thought to be a disease of B-cell origin that represented reactive immune response to unknown stimulus and high potential for malignant transformation. It is now evident that AILD in 80% of cases follows an aggressive course with short median survival, especially, if complete response with chemotherapy is not achieved. Immunologic and molecular studies have demonstrated that the majority of AILD cases are T-cell clonal disorders. Despite the numerous reports on the role of Epstein-Barr virus in this disorder, it is unknown whether the presence of this virus is associated with the immune defect that accompanies AILD, or whether it is a pathogenetic factor. In contrast to non-Hodgkin’s lymphomas, a stage is not usually assigned to the patient since the disease is systemic in nature, subsequently, parameters such as extent of disease and tumor bulk used to identify high-risk patients with non-Hodgkin’s lymphomas, do not appear to correlate with disease activity or prognosis in AILD. Treatment of AILD has been unsatisfactory, with approximately 25% of patients achieving complete and sustained remission when combined chemotherapy agents are used. This article is devoted to a discussion of the different manifestations, suggested pathogenesis, and treatment of AILD.
Comparison of Progenitor Cell Content in Sequential Peripheral Blood Progenitor Collections after Mobilization with Chemotherapy and Granulocyte Macrophage Colony- Stimulating Factor
Authors: Chang Eric , Parker John , Groshen Susan , Watkins Kristy , Douer Dan 
Published: April 2003

Optimal timing of peripheral blood progenitor cell (PBPC) harvest to collect maximal stem cell numbers is unknown. We assessed the progenitor cell content in 128 PBPC harvests from 21 patients primed with chemotherapy and granulocyte macrophage-colony stimulating factor (GM-CSF) in relation to absolute neutrophil count (ANC) at collection time. Samples were obtained by leukapheresis during rebound from chemotherapy-induced neutropenia while receiving GM-CSF, and assayed by flow cytometry for CD34+ and by colony assays for CFU-GM and BFU-E. The CD34+ cell concentrations per sample tended to be greater at an ANC <1,000 mm<sup>3</sup> and decreased with rising ANC (p = 0.001). The CFU-GM and BFU-E concentrations per sample remained relatively constant with rising ANC (p = 0.72, p = 0.90, respectively). Total CD34+ cell number per harvest per kg slightly increased with ANC levels (p = 0.044) whereas the total CFU-GM and the total BFU-E per kilogram increased more modestly with rising ANC (p < 0.001, p < 0.001, respectively). We conclude that after priming with chemotherapy and GM-CSF, PBPC could be collected at different absolute neutrophil counts without greatly affecting total CD34+ cell numbers. The greater concentration of CD34+ progenitor cells at a lower ANC together with the CFU-GM and BFU-E peaking with higher ANC suggest a less mature progenitor cell population at lower ANC levels.
Effects of Renal Perfusion Pressure on Renal Interstitial Hydrostatic Pressure and Na<sup>+</sup> Excretion: Role of Endothelium-Derived Nitric Oxide
Authors: Nakamura Tetsuya , Alberola Antonio M. , Salazar F. Javier , Saito Yuichiro , Kurashina Toshiaki , Granger Joey P. , Nagai Ryozo 
Published: April 2003

The purpose of this study was to examine the role of endothelium-derived nitric oxide in modulating the effect of renal perfusion pressure (RPP) on renal interstitial hydrostatic pressure (RIHP) and urinary Na<sup>+</sup> excretion (UNaV). The effects of RPP on renal hemodynamics, RIHP, and Na<sup>+</sup> and Li<sup>+</sup> excretions were determined in control Sprague-Dawley rats, in Sprague-Dawley rats pretreated with intravenous infusion of N<sup>G</sup>-nitro-<i>L</i>-arginine methyl ester (<i>L</i>-NAME) at doses of 1, 5, and 50 µg/kg/min, and in rats pretreated with <i>L</i>-NAME (5 µg/kg/min) plus <i>L</i>-arginine (10 mg/kg/min). The RPP was changed from 95 to 135 mm Hg by an electronically servo-controlled aortic occluder above the renal arteries in all groups. Increasing RPP in control rats from 95 to 135 mm Hg increased RIHP (from 4.4 ± 0.5 to 8.7 ± 1.2 mm Hg), UNaV (from 2.37 ± 0.61 to 8.29 ± 1.59 µEq/min), and fractional excretion of Li<sup>+</sup> (from 38.0 ± 2.5 to 51.4 ± 6.0%). In rats pretreated with <i>L</i>-NAME (5 µg/kg/min), increases in RPP from 95 to 135 mm Hg had no effect on RIHP (from 1.6 ± 0.4 to 2.2 ± 0.6 mm Hg) or fractional excretion of Li<sup>+</sup> and markedly attenuated pressure-natriuresis relationship (from 1.84 ± 0.50 to 2.88 ± 0.65 µEq/min). Although <i>L</i>-NAME did reduce renal plasma flow and glomerular filtration rate, the autoregulatory responses to RPP were maintained. In rats pretreated with <i>L</i>-NAME plus <i>L</i>-arginine, RIHP, UNaV, and fractional excretion of Li<sup>+</sup> responses to RPP were similar to the control rats. The results of this study indicate that endothelium-derived nitric oxide plays an important role in modulating the effect of RPP on Na<sup>+</sup> excretion by enhancing the transmission of RPP into the renal interstitium.
The Fibronectin Production Is Increased by Thrombospondin via Activation of TGF-β in Cultured Human Mesangial Cells
Authors: Tada Hisaya , Isogai Sho 
Published: April 2003

Thrombospondin (TSP) is a multifunctional glycoprotein that is synthesized by a variety of cells including mesangial cells (MCs). To clarify the effect of TSP on the pathogenesis of diabetic nephropathy, we studied the effect of glucose concentrations on TSP synthesis in cultured human MCs. Thereafter, the effects of TSP on the activation of transforming growth factor beta (TGF-β) and fibronectin production were investigated in MCs. Incubating MCs with elevated glucose levels for 6 days resulted in an increase in TSP synthesis, measured by an enzyme-linked immunosorbent assay, both in culture media and cell layers. Treatment of MCs with TSP (final concentrations 1 and 5 µg/ml) for 24 h resulted in an increase (1.3- and 2.1-fold, respectively) in active TGF-β, which was determined with an enzyme-linked immunosorbent assay using TGF-β-soluble receptor type II, in the culture media without having any effect on the production of total TGF-β. Exposure of MCs to TSP caused enhancement of fibronectin production in both media and cell layers in a TSP dose-dependent manner with the maximum at a TSP concentration of 1 µg/ml. The TSP-induced increase in fibronectin production from MCs was completely prevented by concomitant treatment with 10 µg/ml anti-TGF-β neutralizing antibody. These results indicate that the TSP production is promoted by a high ambient glucose concentration in human MCs and that TSP, in turn, causes an increase in fibronectin production via activation of TGF-β.
i-STAT Hand-Held Point-of-Care Analyzer for Dialysis Units
Authors: Gault M.H. , Harding C.E. , Duffett S. , Longerich L. 
Published: April 2003

The i-STAT hand-held analyzer assays ten tests including electrolytes, gases, urea, glucose, ionized calcium, and hematocrit. Eight different cartridges assay one to eight tests. We have previously confirmed or demonstrated that accuracy and precision for blood assays are comparable to accepted laboratory methods. We now report similar results for hemodialysis dialysate and peritoneal dialysis effluent. The i-STAT analyzer is simple to use, and dialysis nurses produced accurate results with 20 min training. The results are viewed digitally on the analyzer and automatically on a small attachable printer. i-STAT blood analysis is most valuable when results are desired immediately, anywhere, including before, during and after dialysis in hemodialysis units. Hemodialysate analysis using i-STAT can be most valuable for rapidly checking dialysis machine function such as dialysate mixing and conductivity and ramping results and dialysate concentrations prepared in the unit. Peritoneal effluent analysis is useful for rapid evaluation of membrane function.
Sulfonylureas Stimulate Renin Secretion from the Perfused Kidney of the Rat
Authors: Ochi Hiroshi , Ikeda Tadasu 
Published: April 2003

To elucidate whether sulfonylureas directly influence renin secretion, the effect of tolbutamide, glibenclamide, or chlorpropamide on renin secretion was investigated by using the perfused kidney of the rat. The isolated kidneys of male Wistar rats (200–250 g) were perfused with a medium containing 2 µM tolbutamide, 2 µM glibenclamide, and 2 µM chlorpropamide, respectively. Renin activity significantly increased from a basal value of 11.7 ± 3.6 to a peak value of 20.6 ± 5.5 ng/Ang I/ml/h with tolbutamide, from 14.4 ± 4.6 to 32.7 ± 6.5 ng/Ang I/ml/h with glibenclamide, and from 15.0 ± 4.9 to 30.4 ± 6.1 ng/Ang I/ml/h with chlorpropamide. The cAMP concentration in the effluent was not changed by the addition of the sulfonylureas. In kidneys perfused with a calcium-free medium, glibenclamide produced a significant increase in renin activity from a basal value of 13.4 ± 2.1 to a peak value of 30.6 ± 3.4 ng Ang I/ml/h. These results suggest that sulfonylureas stimulate renin secretion from perfused rat kidneys.